Document Detail

Is hormonal activation during exercise useful for risk stratification in patients with moderate congestive heart failure?
MedLine Citation:
PMID:  15309008     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We previously demonstrated that A-type natriuretic peptide (ANP) at peak exercise was an independent predictor of cardiac survival. No data are available concerning the predictive value of B-type natriuretic peptide (BNP) at peak exercise. METHODS: One hundred and fifty consecutive stable patients with moderate congestive heart failure (CHF) underwent echocardiography and a cardiopulmonary exercise test. Blood samples were drawn at rest and at peak exercise for the determination of plasma levels of ANP, BNP, and norepinephrine. RESULTS: Exercise significantly increased plasma values of ANP, BNP, and norepinephrine. After a median follow-up period of 1171 days, there were 35 cardiac related deaths. Mortality rates at 1 and 2 years were 4% and 8%, respectively. Independent predictors of cardiac survival were percent of maximal predicted oxygen consumption (RR = 4.8 [2.1-11], P =.002), BNP at rest (RR = 2.5 [1.2-5.6], P =.01), and left atrial diameter (RR = 2.8 [1.2-6.5], P =.02). CONCLUSIONS: In patients with stable, moderate CHF, plasma levels of ANP, BNP, and norepinephrine measured at peak exercise did not improve risk stratification. However, in addition to percent of maximal predicted oxygen consumption and left atrial diameter, plasma level of BNP at rest was an independent predictor of survival in CHF patients with low risk of cardiac events.
Pascal de Groote; Benoît Soudan; Nicolas Lamblin; Nathalie Rouaix-Emery; Eugène Mc Fadden; Thibaut Meurice; Frédéric Mouquet; Christophe Bauters
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  148     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-08-13     Completed Date:  2005-01-13     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:  349-55     Citation Subset:  AIM; IM    
TOP Service de Cardiologie C, Hôpital Cardiologique, Lille Cedex, France.
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MeSH Terms
Atrial Natriuretic Factor / blood
Exercise / physiology*
Exercise Test
Follow-Up Studies
Heart Atria / pathology
Heart Failure / blood*,  diagnosis,  mortality,  physiopathology
Middle Aged
Natriuretic Peptide, Brain / blood*
Nordefrin / blood
Oxygen / metabolism
Risk Assessment / methods
Stroke Volume
Survival Analysis
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain; 6539-57-7/Nordefrin; 7782-44-7/Oxygen; 85637-73-6/Atrial Natriuretic Factor

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