Diastolic function and BNP changes during exercise predict oxygen consumption in chronic heart failure patients.
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.
Ciampi
Quirino
Q
Division of Cardiology, Fatebenefratelli Hospital, Benevento, Italy. qciampi@iol.it
Borzillo
Gabriele
G
Barbato
Emanuele
E
Petruzziello
Bruno
B
Betocchi
Sandro
S
Villari
Bruno
B
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
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain