| Complementary roles of simple variables, NYHA and N-BNP, in indicating aerobic capacity and severity of heart failure. | |
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MedLine Citation:
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PMID: 15982497 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: The extent of exercise intolerance in patients with chronic heart failure (CHF) is dependent on and representative of the severity of heart failure. However, few primary care physicians have direct access to facilities for formal exercise testing. We have therefore explored whether information readily obtainable in the community can reliably predict the functional capacity of patients. METHODS AND RESULTS: Ninety-six subjects with a wide range of cardiac function (10 healthy controls and 86 CHF patients with NYHA classes I-IV, LVEF 36.9+/-15.2%) were recruited into the study and had resting plasma N-BNP and cardiopulmonary exercise testing to measure peak oxygen consumption (VO2). Significantly higher N-BNP levels were found in the CHF group (299.3 [704.8] fmol/ml, median [IQR]) compared with the healthy control group (7.2 [51.2] fmol/ml), p<0.0001. There were significant correlations between peak VO2 and N-BNP levels (R=0.64, P<0.001), peak VO2 and NYHA class (R=0.76, P=0.001), but no significant correlation was seen between peak VO2 and LVEF (R=0.0788, P=0.33). Multivariate analysis identified plasma N-BNP (P<0.0001) and NYHA class (P<0.0001) as significant independent predictors of peak VO2. Logistic modelling with NYHA class and log N-BNP to predict peak VO2<20 ml/kg/min showed that the area under the curve of receiver-operating-characteristic (ROC) curve was 0.906 (95% CI 0.844-0.968). A nomogram based on the data has been constructed to allow clinicians to estimate the likelihood of peak VO2 to be <20 ml/kg/min for given values of plasma N-BNP and NYHA class. CONCLUSIONS: By combining information from a simple objective blood test (N-BNP) and a simple scoring of functional status (NYHA), a clinician can deduce the aerobic exercise capacity and indirectly the extent of cardiac dysfunction of patients with CHF. |
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Authors:
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S G Williams; L L Ng; R J O'Brien; S Taylor; D J Wright; Y F Li; L B Tan |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: International journal of cardiology Volume: 102 ISSN: 0167-5273 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2005 Jul |
Date Detail:
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Created Date: 2005-06-28 Completed Date: 2005-10-24 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Ireland |
Other Details:
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Languages: eng Pagination: 279-86 Citation Subset: IM |
Affiliation:
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Academic Unit of Molecular Vascular Medicine, University of Leeds, Martin Wing, Leeds General Infirmary, Leeds, LS1 3EX, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Biological Markers / blood Echocardiography Electrocardiography Exercise Test* Exercise Tolerance / physiology* Female Heart Failure* / blood, classification, physiopathology Heart Ventricles / physiopathology, ultrasonography Humans Male Middle Aged Natriuretic Peptide, Brain / blood* Oxygen Consumption / physiology* Peptide Fragments / blood* Predictive Value of Tests Severity of Illness Index Ventricular Function, Left / physiology* |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain |
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