title: Peak VO(2) is more potent than B-type natriuretic peptide as a prognostic parameter in cardiac patients.
abstract: BACKGROUND
  It is well-known that both B-type natriuretic peptide (BNP) and peak oxygen uptake (VO(2)) are independent predictors of mortality in patients with heart failure. This study investigates the predictive power of BNP and peak VO(2) for survival in cardiac patients.
  
  
  RESULTS
  A total of 609 patients with cardiac disease participated in the study. They underwent cardiopulmonary exercise testing to determine peak VO(2), with BNP being measured before exercise testing During 502.5 median follow-up days, 29 patients died of cardiovascular disease. In the univariate Cox proportional hazards analysis, peak VO(2) and BNP were both found to be significant prognostic indices for survival. The time-dependent ROC curve analysis (Heagerty 2006) was applied to 3 predictors: peak VO(2), BNP, and then both, with gender and age as adjusted variables. The area under the curve (AUC) compared with the follow-up period curves of peak VO(2) and the 2 combined variables (ie, BNP and peak VO(2)) were consistently over that of BNP. The integrated AUC indices were 0.80 (peak VO(2)), 0.81 (peak VO(2) and BNP) and 0.70 (BNP), respectively.
  
  
  CONCLUSIONS
  These results indicate that peak VO(2) is more potent than BNP for predicting the mortality in patients with mixed cardiac disease.
authors: Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. kubozono@cepp.ne.jp
authors: Takuro
authors: T
authors: Kubozono
authors: Haruki
authors: H
authors: Itoh
authors: Keiko
authors: K
authors: Oikawa
authors: Akihiko
authors: A
authors: Tajima
authors: Tomoko
authors: T
authors: Maeda
authors: Tadanori
authors: T
authors: Aizawa
authors: Hiroyuki
authors: H
authors: Iinuma
authors: Yosuke
authors: Y
authors: Tokuda
authors: Yasuo
authors: Y
authors: Ohashi
authors: Long Tai
authors: LT
authors: Fu
mesh_terms: D000368:Aged; D015308:Anaerobic Threshold; D015415:Biomarkers / Q000097:blood; D005080:Exercise Test; D005260:Female; D006331:Heart Diseases / Q000097:blood* / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010100:Oxygen; D010101:Oxygen Consumption; D011379:Prognosis; D016016:Proportional Hazards Models
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D010100:Oxygen