Key result
NT-proBNP levels at peak exercise demonstrated similar prognostic ability to resting levels, significantly correlating with LVEF (r=-0.630, P<0.001) and peak oxygen uptake (r=-0.740, P<0.001).
Why the study?
Does measuring NT-proBNP at peak exercise improve prognostic and predictive ability compared to resting levels in patients with systolic heart failure?
Cohort (n=90)
Does measuring NT-proBNP at peak exercise improve prognostic and predictive ability compared to resting levels in patients with systolic heart failure?
Measuring NT-proBNP at peak exercise does not provide incremental prognostic or predictive value over resting levels in patients with systolic heart failure.
Peak-exercise NT-proBNP adds no incremental prognostic value over resting levels in systolic HF; should not change practice and remains hypothesis-generating.
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.
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Kallistratos et al. (2011) conducted a cohort in Systolic heart failure (n=90). NT-proBNP at peak exercise vs. NT-proBNP at rest was evaluated on Correlation with left ventricular ejection fraction (LVEF) and peak oxygen uptake (Vo2) (r = -0.630 for LVEF; r = -0.740 for peak Vo2, p=<.001). NT-proBNP levels at peak exercise demonstrated similar prognostic ability to resting levels, significantly correlating with LVEF (r=-0.630, P<0.001) and peak oxygen uptake (r=-0.740, P<0.001).
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