Istituto di Fisiologia Clinica     
Scardovi A. B., De Maria R., Coletta C., Aspromonte N., Perna S., Infusino T., D'Errigo P., Rosato S., Greggi M., Di Giacomo T., Ricci R., Ceci V. Brain natriuretic peptide is a reliable indicator of ventilatory abnormalities during cardiopulmonary exercise test in heart failure patients. In: Medical Science Monitor, vol. 12 (5) pp. CR191 - 195. International Scientific Literature Inc, 2006.
Whether brain natriuretic peptide (BNP), a neurohormone marker of ventricular dysfunction, correlates with an enhanced ventilatory response (EVR) during cardiopulmonary exercise test, a wellknown predictor of prognosis, in systolic heart failure (HF) is currently unknown.Resting BNP was measured in 134 consecutive stable outpatients aged 6911 years with mild to moderate HF and LV ejection fraction (LVEF) <40% who performed a maximal exercise test. EVR was assessed as the slope of the relation between minute ventilation and carbon dioxide production (VE/VCO2 slope) ?35. LVEF averaged 337%, BNP 350396 pg/ml, and the VE/VCO2 slope 368. Fifty-six of 123 patients(45%) had EVR. BNP correlated with VE/VCO2 slope (r=0.453; p<0.01). By multivariate logistic regression, plasma BNP was the only independent predictor of EVR (RR: 1.004 per unit increment, 95%CI: 1.002-1.006, p<0.0001). A BNP ?160 pg/ml had 86% sensitivity, 67% specifi city,and 76% overall accuracy for the prediction of EVR (chi square: 37.4, RR: 12.2, 95%CI: 4.96-30.3,p<0.0001, AUC 0.815 (95%CI: 0.738-0.892)).In systolic HF, plasma BNP is related to an enhanced ventilatory response to exercise and offers a simple and reliable alternative to the cardiopulmonary exercise test in patients with inability or contraindications to exercise.
Subject heart failure
cardiopulmonary exercise test
brain natriuretic peptide
VE/VCO2 slope

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