title: Prognostic value of NT-proBNP at rest and peak exercise in patients with impaired left ventricular function.
abstract: We aimed to identify whether N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) at peak exercise can provide incremental clinical information over resting levels. A total of 90 patients with systolic heart failure were prospectively studied. Levels of plasma NT-proBNP were assessed at rest and at peak exercise during a cardiopulmonary exercise test. Patients were followed-up for 30 ± 10 months. Levels of NT-proBNP at baseline and peak exercise were significantly correlated with left ventricular ejection fraction ([LVEF] r = -.629, P < .001 and r = -.630, P < .001, respectively) and peak oxygen uptake ([Vo                 (2)] r = -.752, P < .001 and r = -.740, P < .001, respectively). Levels of plasma NT-proBNP at peak exercise demonstrated similar predictive ability for the detection of patients with low peak Vo                 (2) and LVEF <28%. Levels of plasma NT-proBNP can detect low-functional class patients and patients who may be the candidates for heart transplantation with high sensitivity and specificity. At baseline and peak exercise, NT-proBNP demonstrates similar prognostic and predictive ability.
authors.affiliation: First Cardiology Department, Onassis Cardiac Surgery Centre, Athens, Greece.
authors.forename: Manolis S
authors.initials: MS
authors.lastname: Kallistratos
authors.forename: Antonios N
authors.initials: AN
authors.lastname: Pavlidis
authors.forename: Eytixia S
authors.initials: ES
authors.lastname: Chamodraka
authors.forename: Christos
authors.initials: C
authors.lastname: Varounis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Dritsas
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Laoutaris
authors.forename: Athanasios J
authors.initials: AJ
authors.lastname: Manolis
authors.forename: Dennis V
authors.initials: DV
authors.lastname: Cokkinos
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D054143:Heart Failure, Systolic / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010100:Oxygen / Q000097:blood; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D012146:Rest; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D010100:Oxygen