TY - JOUR
T1 - The potential of brain natriuretic peptide as a biomarker for New York Heart Association class during the outpatient treatment of heart failure
AU - Lee, Shang Chiun
AU - Stevens, Tracy L.
AU - Sandberg, Sharon M.
AU - Heublein, Denise M.
AU - Nelson, Susan M.
AU - Jougasaki, Michihisa
AU - Redfield, Margaret M.
AU - Burnett, John C.
N1 - Funding Information:
This study was supported by grants HL 36634 and HL 07111 from the National Institutes of Health, the Miami Heart Research Institute, the Mayo Foundation, the Bruce and Ruth Rappaport Program in Vascular Biology, and the Marriott Foundation.
PY - 2002
Y1 - 2002
N2 - Background: Plasma C-terminal atrial natriuretic peptide (C-ANP), N-terminal ANP (N-ANP), and brain natriuretic peptide (BNP) have diagnostic utility in detecting left ventricular dysfunction. Their relative value in monitoring symptom status during the chronic treatment of congestive heart failure (CHF) remains undefined. Methods and Results: Ninety-eight subjects with CHF were evaluated. Baseline natriuretic peptides were measured by radioimmunoassay, left ventricular ejection fraction (LVEF) was estimated with echocardiography, and New York Heart Association (NYHA) class was determined independently by attending heart failure specialists. Forty-one subjects were restudied during a 6- to 12-month follow-up period after optimizing therapy. At baseline, all natriuretic peptides and LVEF correlated positively with NYHA class (P < .005). Plasma BNP, however, correlated best with NYHA class. At follow-up, only changes of BNP correlated to changes of NYHA class (P = .04). BNP decreased (-45% ± 12%, N = 14, P = .002) in subjects whose NYHA class improved whereas BNP remained unchanged (-1% ± 10%, N = 25, P = .95) in those whose NYHA class was stable. Conclusions: This investigation demonstrates the superiority of plasma BNP as compared to ANP and LVEF in objectively assessing NYHA class during the chronic treatment of CHF. Given that clinical assessment of CHF is subjective, plasma BNP is a useful objective biomarker in monitoring human CHF in the outpatient setting.
AB - Background: Plasma C-terminal atrial natriuretic peptide (C-ANP), N-terminal ANP (N-ANP), and brain natriuretic peptide (BNP) have diagnostic utility in detecting left ventricular dysfunction. Their relative value in monitoring symptom status during the chronic treatment of congestive heart failure (CHF) remains undefined. Methods and Results: Ninety-eight subjects with CHF were evaluated. Baseline natriuretic peptides were measured by radioimmunoassay, left ventricular ejection fraction (LVEF) was estimated with echocardiography, and New York Heart Association (NYHA) class was determined independently by attending heart failure specialists. Forty-one subjects were restudied during a 6- to 12-month follow-up period after optimizing therapy. At baseline, all natriuretic peptides and LVEF correlated positively with NYHA class (P < .005). Plasma BNP, however, correlated best with NYHA class. At follow-up, only changes of BNP correlated to changes of NYHA class (P = .04). BNP decreased (-45% ± 12%, N = 14, P = .002) in subjects whose NYHA class improved whereas BNP remained unchanged (-1% ± 10%, N = 25, P = .95) in those whose NYHA class was stable. Conclusions: This investigation demonstrates the superiority of plasma BNP as compared to ANP and LVEF in objectively assessing NYHA class during the chronic treatment of CHF. Given that clinical assessment of CHF is subjective, plasma BNP is a useful objective biomarker in monitoring human CHF in the outpatient setting.
KW - Heart failure
KW - NYHA class
KW - Natriuretic peptides
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U2 - 10.1054/jcaf.2002.125368
DO - 10.1054/jcaf.2002.125368
M3 - Article
C2 - 12140807
AN - SCOPUS:0036023205
SN - 1071-9164
VL - 8
SP - 149
EP - 154
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 3
ER -