© 2006 European Society of Cardiology
Unexplained week-to-week variation in BNP and NT-proBNP is low in chronic heart failure patients during steady state
a Department of Cardiology and Endocrinology, Clinic E, Frederiksberg University Hospital Ndr. Fasanvej 57'59, DK-2000-Frederiksberg, Denmark
b Department of Cardiology, The Heart Centre, Rigshospitalet University Hospital DK-2100-Copenhagen, Denmark
c Department of Clinical Physiology and Nuclear Medicine, The PET Centre Rigshospitalet University Hospital, DK-2100-Copenhagen, Denmark
d Cluster for Molecular Imaging, University of Copenhagen DK-2200 Copenhagen, Denmark
* Corresponding author. Tel.: +45 38 16 43 24; fax: +45 38 16 43 59. morten.schou{at}fh.hosp.dk
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Abstract |
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Background: The usefulness of brain-natriuretic-peptide (BNP) and N-terminal-pro-brain-natriuretic-peptide (NT-proBNP) for monitoring of chronic heart failure (CHF) patients has been questioned because of high levels of unexplained variation.
Aims: Week-to-week total variance (CVT), unexplained variation (CVI), reference change values (RCV), index of individualities (IOI) and number of samples (N) with week-to-week intervals needed to estimate the underlying homeostatic set point (15%) for BNP and NT-proBNP were calculated in pre-specified stable CHF patients.
Methods and results: We measured plasma concentrations of BNP and NT-proBNP, clinical and laboratory variables in 20 CHF patients with a 7-days interval. Only patients considered to be in steady state were included. The CVI was 15% (BNP) and 8% (NT-proBNP). CVT was 16% (BNP) and 8% (NT-proBNP) and RCV was 43% (BNP) and 23% (NT-proBNP). IOI was 0.14 for BNP and 0.03 for NT-proBNP and N was 1 for BNP and 1 for NT-proBNP.
Conclusions: Our data demonstrate that unexplained variation of BNP and NT-proBNP is low in CHF patients during steady state, which is a prerequisite for the use of these peptides for monitoring of the disease.
Key Words: BNP • NT-proBNP • Unexplained variation • Reference change value • Chronic heart failure
Received December 27, 2005; Revised March 7, 2006; Accepted May 2, 2006
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