title: B-type natriuretic peptide: powerful predictor of end-stage chronic heart failure in individuals with systolic dysfunction of the systemic right ventricle.
abstract: OBJECTIVE
  To assess whether B-type natriuretic peptide (BNP) can serve as a predictor of end-stage chronic heart failure (CHF) in patients with severe systolic dysfunction of the systemic right ventricle (SRV).
  
  
  METHODS
  We performed a retrospective analysis in 28 patients with severe systolic dysfunction of the SRV (ejection fraction 23 ± 6%) who were evaluated as heart transplant (HTx) candidates between May 2007 and October 2014. The primary endpoints of the study (end-stage CHF) were progressive CHF, urgent HTx, and ventricular assist device (VAD) implantation. Plasma BNP levels were measured using a chemiluminescent immunoassay.
  
  
  RESULTS
  During median follow-up of 29 months (interquartile range, 9-50), 3 patients died of progressive CHF, 5 patients required an urgent HTx, and 6 patients underwent VAD implantation. BNP was a strong predictor of end-stage CHF (hazard ratio per 100 ng/L: 1.079, 95% confidence interval, 1.042-1.117, P<0.001). The following variables with corresponding areas under the curve (AUC) were identified as the most significant predictors of end-stage CHF: BNP (AUC 1.00), New York Heart Association functional class class III or IV (AUC 0.98), decompensated CHF in the last year (AUC 0.96), and systolic dysfunction of the subpulmonal ventricle (AUC 0.96).
  
  
  CONCLUSIONS
  BNP is a powerful predictor of end-stage CHF in individuals with systolic dysfunction of the SRV.
authors: Marketa
authors: M
authors: Hegarova
authors: Jaroslav
authors: J
authors: Brotanek
authors: Milos Kubanek, Department of Cardiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague, Czech Republic, milos.kubanek@ikem.cz.
authors: Milos
authors: M
authors: Kubanek
authors: Radka
authors: R
authors: Kockova
authors: Janka
authors: J
authors: Franekova
authors: Vera
authors: V
authors: Lanska
authors: Ivan
authors: I
authors: Netuka
authors: Vojtech
authors: V
authors: Melenovsky
authors: Ivan
authors: I
authors: Malek
authors: Josef
authors: J
authors: Kautzner
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology*
chemical_list: D020097:Natriuretic Peptide, Brain