© 2006 European Society of Cardiology
Correlation between serial measurements of N-terminal pro brain natriuretic peptide and ambulatory cardiac filling pressures in outpatients with chronic heart failure
a Department of Cardiology, Karolinska University Hospital 171 76, Stockholm, Sweden
b Department of Endocrinology, Medical University Graz, Austria
c Unitá Operativa di Cardiologia Clinica, Istituto Clinico Humanitas Milan, Italy
d Divisione di Cardiologia, IRCCS Policlinico S Matteo Pavia, Italy
e Department of Cardiology, Charité Hospital Berlin, Germany
f Department of Internal Medicine III, University of Cologne Germany
* Corresponding author. Tel.: +46 8 5177 1629; fax: +46 8 31 10 44. E-mail address: frieder.braunschweig{at}karolinska.se
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Abstract |
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Background: Serial measurements of N-terminal pro brain natriuretic peptide (NT-proBNP) have been suggested for the management of outpatients with chronic heart failure (CHF). The relationship between NT-proBNP plasma levels and central haemodynamic parameters in this setting is not known.
Methods: In 19 outpatients with CHF, NT-proBNP was related to central haemodynamic information, continuously measured with an implanted haemodynamic monitor (IHM) during 24 h of daily living activities ("24 h") and during supine rest ("rest"). In 13 patients, three to seven serial measurements were obtained with a mean time interval of 39 days (range 19–113).
Results: At the first visit (n=19), NT-proBNP plasma levels were dispersed over a wide range of filling pressures and not correlated with the 24 h median of the right ventricular systolic pressure (RVSP) and the estimated pulmonary artery pressure (ePAD). However, in the individual patient, serial measurements yielded significant positive correlations between NT-proBNP and RVSP (p=0.006) and ePAD (p=0.001). During "24 h" compared with "rest", the median RVSP and ePAD were elevated by 20±16% and 32±18%, respectively, and corresponded better with NT-proBNP (p<0.05).
Conclusion: In outpatients with CHF, single measurements of NT-proBNP are not correlated with cardiac filling pressures. However, serial measurements of NT-proBNP in each individual patient show a significant positive correlation with central haemodynamic parameters and reflect changes in the haemodynamic state over time.
Key Words: Natriuretic peptides • Chronic heart failure • Haemodynamics • Implantable devices
Received October 24, 2005; Revised February 3, 2006; Accepted March 8, 2006
Supported by Medtronic, Bakken Research Center, Maastricht, The Netherlands and the Swedish Heart and Lung Foundation, Stockholm, Sweden.
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