Is hormonal activation during exercise useful for risk stratification in patients with moderate congestive heart failure? - 26/08/11
, Benoît Soudan, MD b, Nicolas Lamblin, MD a, Nathalie Rouaix-Emery, MD c, Eugène Mc Fadden, FRCPI d, Thibaut Meurice, MD a, Frédéric Mouquet, MD a, Christophe Bauters, MD aAbstract |
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.
Le texte complet de cet article est disponible en PDF.Plan
 | Supported by grants from Cis-Bio International, Gif-sur-Yvette, France. |
Vol 148 - N° 2
P. 349-355 - août 2004 Retour au numéro
Article précédent
- Extent of myocardial scarring on nonstress delayed-contrast–enhancement cardiac magnetic resonance imaging correlates directly with degrees of resting regional dysfunction in chronic ischemic heart disease
- Monvadi B. Srichai, Paulo R. Schvartzman, Bernhard Sturm, Jane M. Kasper, Michael L. Lieber, Richard D. White
- Antecedent hypertension and the effect of captopril on the risk of adverse cardiovascular outcomes after acute myocardial infarction with left ventricular systolic dysfunction: Insights from the Survival and Ventricular Enlargement trial
- Satish Kenchaiah, Barry R. Davis, Eugene Braunwald, Jean-Lucien Rouleau, Gilles R. Dagenais, Bruce Sussex, Richard M. Steingart, Edward J. Brown, Gervasio A. Lamas, David Gordon, Victoria Bernstein, Marc A. Pfeffer
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?