title: Diastolic function and BNP changes during exercise predict oxygen consumption in chronic heart failure patients.
abstract: B-type natriuretic peptide (BNP) is a diagnostic and prognostic marker in heart failure (CHF) patients.
  
  
  OBJECTIVE
  To assess the relation between BNP, diastolic function and exercise capacity in CHF patients.
  
  
  METHODS
  Fifty CHF patients underwent cardiopulmonary exercise testing. BNP levels were determined at baseline and at peak exercise. Patients were divided in two groups: with lower (<14 ml/kg/min) or higher (>or=14 ml/kg/min) peak oxygen consumption (VO(2)).
  
  
  RESULTS
  Seventeen patients with lower peak VO(2) showed larger incidence of restrictive pattern of the transmitral flow (7/17 vs 4/33, p =0.036). E/Ea ratio was inversely related with peak VO(2) (r =-0.419, p =0.004) and directly related with BNP levels at baseline (r =0.449, p =0.001) and at peak exercise (r =0.475, p =0.001). LV ejection fraction was similar in the two groups. Independent predictors of exercise tolerance were E/Ea ratio (p =0.003), lg BNP at baseline (p =0.034) and increase in lg BNP during exercise (p =0.038).
  
  
  CONCLUSIONS
  In CHF patients, E/Ea ratio is a predictor of exercise tolerance and is related with BNP level at rest and at peak exercise.
authors.affiliation: Division of Cardiology, Fatebenefratelli Hospital, Benevento, Italy. qciampi@iol.it
authors.forename: Quirino
authors.initials: Q
authors.lastname: Ciampi
authors.forename: Gabriele
authors.initials: G
authors.lastname: Borzillo
authors.forename: Emanuele
authors.initials: E
authors.lastname: Barbato
authors.forename: Bruno
authors.initials: B
authors.lastname: Petruzziello
authors.forename: Sandro
authors.initials: S
authors.lastname: Betocchi
authors.forename: Bruno
authors.initials: B
authors.lastname: Villari
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010101:Oxygen Consumption; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain