Document Detail


B-type natriuretic peptide kinetics and cardiopulmonary exercise testing in heart failure.
MedLine Citation:
PMID:  17182129     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In patients with chronic heart failure (CHF), B-type natriuretic peptide (BNP) is related to peak oxygen consumption (peak VO2) and the relationship between minute ventilation and carbon dioxide production (VE/VCO2 slope). However, the exercise response depends on the mode of exercise. This study sought to compare peak treadmill and bicycle exercise responses with respect to their relationship with BNP and to assess whether BNP measured at rest or during exercise could identify patients with greater functional impairment and ventilatory inefficiency. METHODS: Twenty-three patients with mild-to-moderate stable systolic CHF (age 72+/-8 years, left ventricular ejection fraction 32+/-7%) underwent treadmill and bicycle cardiopulmonary exercise testing within 5 (interquartile range 3-7) days. BNP was measured at rest and at peak exercise. RESULTS: BNP at rest was an independent multivariate predictor of both peak VO2 and the VE/VCO2 slope for both exercise modes. However, the proportion of variance explained univariately and multivariately was < or = 0.55, indicating that BNP did not strongly explain the variation of peak VO2 and the VE/VCO2 slope. The exercise-induced rise in circulating BNP did not differ between the test modes [treadmill: 50 (24-89) pg/ml vs. bicycle: 46 (15-100) pg/ml; p=0.73]. BNP levels at peak exercise were strongly related to resting values, but did not provide additional information on peak VO2 or the VE/VCO2 slope. CONCLUSIONS: In typical CHF patients, BNP measured at rest or at peak exercise does not strongly predict peak VO2 or the VE/VCO2 slope regardless of the exercise mode, and is therefore not a sufficiently accurate surrogate for cardiopulmonary exercise testing.
Authors:
Micha Maeder; Thomas Wolber; Hans Rickli; Jonathan Myers; Dietrich Hack; Walter Riesen; Daniel Weilenmann; Peter Ammann
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2006-12-19
Journal Detail:
Title:  International journal of cardiology     Volume:  120     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-07-23     Completed Date:  2007-10-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  391-8     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Internal Medicine, Kantonsspital St. Gallen, Switzerland. micha.maeder@bluewin.ch
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Carbon Dioxide / metabolism
Cross-Sectional Studies
Exercise Test / methods*
Female
Heart Failure / blood*,  classification,  physiopathology
Humans
Male
Natriuretic Peptide, Brain / blood*
Oxygen Consumption / physiology*
Prospective Studies
Pulmonary Ventilation / physiology*
Rest / physiology
Chemical
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain; 124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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