title: Biological variation of brain natriuretic peptide and cardiac events in stable outpatients with nonischemic chronic heart failure.
abstract: BACKGROUND
  To evaluate the biological variation and prognostic value of brain natriuretic peptide (BNP) for stable outpatients with nonischemic chronic heart failure (NICHF).
  
  
  RESULTS
  Biological variation in BNP was evaluated using an automated assay system in 140 outpatients with NICHF. The stable clinical condition during the 2-month study period was defined as unchanged NYHA and unchanged left ventricular ejection fraction; therefore, 7 patients were excluded during the 2 months. Thereafter, 133 patients were prospectively followed and the relationship between cardiac events and the plasma BNP concentrations (at baseline and after 2 months) were evaluated as well as the changes in BNP. The biological variation in BNP (2-month interval) was calculated as 22.3%. During a mean follow-up period of 42 months, 26 patients had cardiac events. According to stepwise multivariate analyses, plasma BNP after 2 months (P=0.0002) and % change in BNP (P=0.0067) were significant independent predictors of cardiac events.
  
  
  CONCLUSIONS
  These findings indicated that a combination of the absolute value of BNP after 2 months and % increase in BNP (2-month interval) is useful for predicting cardiac events in stable outpatients with NICHF.
authors.affiliation: Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Seta, Otsu, Japan.
authors.forename: Keizo
authors.initials: K
authors.lastname: Nishiyama
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tsutamoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamaji
authors.forename: Chiho
authors.initials: C
authors.lastname: Kawahara
authors.forename: Masanori
authors.initials: M
authors.lastname: Fujii
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Minoru
authors.initials: M
authors.lastname: Horie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood / Q000150:complications; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000150:complications; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000209:etiology; D006349:Heart Valve Diseases / Q000097:blood / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010045:Outpatients; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D013318:Stroke Volume
chemical_list: D020097:Natriuretic Peptide, Brain; D003404:Creatinine