Document Detail

Blood volume and brain natriuretic peptide in congestive heart failure: a pilot study.
MedLine Citation:
PMID:  16290978     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Brain natriuretic peptide (BNP) levels rise in response to stretch of ventricular myocytes or increases in wall tension, as in congestive heart failure (CHF). Brain natriuretic peptide can be released in bursts, but nonetheless, BNP levels may lag behind clinical changes. We postulated that concomitant measurement of blood volume (BV), BNP, and hemodynamics during treatment of CHF may elucidate interrelationships among changes in these parameters. METHODS: We studied 10 male patients, aged 60 +/- 8 years, who were admitted for pulmonary catheter-guided treatment of CHF. Hemodynamics, venous BNP, and blood and plasma volumes were measured at baseline before treatment and again on the following morning after 12 to 24 hours of acute treatment for CHF. RESULTS: At baseline, all 10 patients exhibited marked expansion of BV at 29% +/- 19%. At baseline, increased systolic pulmonary artery pressure correlated with BV (r = 0.615) and diastolic pulmonary artery pressure (PAD) with BV (r = 0.609). After treatment, there was an inverse correlation between change (decline) in expanded BV and change (improvement) in mixed venous oxygenation (r = -0.775) and a positive correlation with central venous pressure (CVP) (r = 0.710). Poor correlation was found between BNP and any hemodynamic parameter. Little correlation was found between absolute BNP and BV before or after treatment (r = -0.127 and -0.126, respectively). CONCLUSION: In this pilot study, changes in BV with treatment correlate better with hemodynamics than do changes in BNP, likely reflecting the lag in BNP response to treatment and its tendency to reflect long-term rather than instantaneous volume status. These preliminary data suggest that BV may be a more accurate guide in optimizing CHF treatment than BNP.
Karen B James; Richard W Troughton; Joseph Feldschuh; Daniel Soltis; Delsa Thomas; Fetnat Fouad-Tarazi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  150     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-18     Completed Date:  2005-12-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  984     Citation Subset:  AIM; IM    
Department of Cardiovascular Medicine, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
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MeSH Terms
Blood Volume*
Heart Failure / blood*,  physiopathology*
Middle Aged
Natriuretic Peptide, Brain / blood*
Pilot Projects
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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