The potential of brain natriuretic peptide as a biomarker for New York Heart Association class during the outpatient treatment of heart failure

Shang Chiun Lee, Tracy L. Stevens, Sharon M. Sandberg, Denise M. Heublein, Susan M. Nelson, Michihisa Jougasaki, Margaret May Redfield, John C Jr. Burnett

Research output: Contribution to journalArticle

121 Citations (Scopus)

Abstract

Background: Plasma C-terminal atrial natriuretic peptide (C-ANP), N-terminal ANP (N-ANP), and brain natriuretic peptide (BNP) have diagnostic utility in detecting left ventricular dysfunction. Their relative value in monitoring symptom status during the chronic treatment of congestive heart failure (CHF) remains undefined. Methods and Results: Ninety-eight subjects with CHF were evaluated. Baseline natriuretic peptides were measured by radioimmunoassay, left ventricular ejection fraction (LVEF) was estimated with echocardiography, and New York Heart Association (NYHA) class was determined independently by attending heart failure specialists. Forty-one subjects were restudied during a 6- to 12-month follow-up period after optimizing therapy. At baseline, all natriuretic peptides and LVEF correlated positively with NYHA class (P < .005). Plasma BNP, however, correlated best with NYHA class. At follow-up, only changes of BNP correlated to changes of NYHA class (P = .04). BNP decreased (-45% ± 12%, N = 14, P = .002) in subjects whose NYHA class improved whereas BNP remained unchanged (-1% ± 10%, N = 25, P = .95) in those whose NYHA class was stable. Conclusions: This investigation demonstrates the superiority of plasma BNP as compared to ANP and LVEF in objectively assessing NYHA class during the chronic treatment of CHF. Given that clinical assessment of CHF is subjective, plasma BNP is a useful objective biomarker in monitoring human CHF in the outpatient setting.

Original languageEnglish (US)
Pages (from-to)149-154
Number of pages6
JournalJournal of Cardiac Failure
Volume8
Issue number3
DOIs
StatePublished - 2002

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Brain Natriuretic Peptide
Treatment Failure
Outpatients
Heart Failure
Biomarkers
Atrial Natriuretic Factor
Stroke Volume
Natriuretic Peptides
Left Ventricular Dysfunction
Radioimmunoassay
Echocardiography
Therapeutics

Keywords

  • Heart failure
  • Natriuretic peptides
  • NYHA class

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

The potential of brain natriuretic peptide as a biomarker for New York Heart Association class during the outpatient treatment of heart failure. / Lee, Shang Chiun; Stevens, Tracy L.; Sandberg, Sharon M.; Heublein, Denise M.; Nelson, Susan M.; Jougasaki, Michihisa; Redfield, Margaret May; Burnett, John C Jr.

In: Journal of Cardiac Failure, Vol. 8, No. 3, 2002, p. 149-154.

Research output: Contribution to journalArticle

Lee, Shang Chiun ; Stevens, Tracy L. ; Sandberg, Sharon M. ; Heublein, Denise M. ; Nelson, Susan M. ; Jougasaki, Michihisa ; Redfield, Margaret May ; Burnett, John C Jr. / The potential of brain natriuretic peptide as a biomarker for New York Heart Association class during the outpatient treatment of heart failure. In: Journal of Cardiac Failure. 2002 ; Vol. 8, No. 3. pp. 149-154.
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abstract = "Background: Plasma C-terminal atrial natriuretic peptide (C-ANP), N-terminal ANP (N-ANP), and brain natriuretic peptide (BNP) have diagnostic utility in detecting left ventricular dysfunction. Their relative value in monitoring symptom status during the chronic treatment of congestive heart failure (CHF) remains undefined. Methods and Results: Ninety-eight subjects with CHF were evaluated. Baseline natriuretic peptides were measured by radioimmunoassay, left ventricular ejection fraction (LVEF) was estimated with echocardiography, and New York Heart Association (NYHA) class was determined independently by attending heart failure specialists. Forty-one subjects were restudied during a 6- to 12-month follow-up period after optimizing therapy. At baseline, all natriuretic peptides and LVEF correlated positively with NYHA class (P < .005). Plasma BNP, however, correlated best with NYHA class. At follow-up, only changes of BNP correlated to changes of NYHA class (P = .04). BNP decreased (-45{\%} ± 12{\%}, N = 14, P = .002) in subjects whose NYHA class improved whereas BNP remained unchanged (-1{\%} ± 10{\%}, N = 25, P = .95) in those whose NYHA class was stable. Conclusions: This investigation demonstrates the superiority of plasma BNP as compared to ANP and LVEF in objectively assessing NYHA class during the chronic treatment of CHF. Given that clinical assessment of CHF is subjective, plasma BNP is a useful objective biomarker in monitoring human CHF in the outpatient setting.",
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AU - Heublein, Denise M.

AU - Nelson, Susan M.

AU - Jougasaki, Michihisa

AU - Redfield, Margaret May

AU - Burnett, John C Jr.

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AB - Background: Plasma C-terminal atrial natriuretic peptide (C-ANP), N-terminal ANP (N-ANP), and brain natriuretic peptide (BNP) have diagnostic utility in detecting left ventricular dysfunction. Their relative value in monitoring symptom status during the chronic treatment of congestive heart failure (CHF) remains undefined. Methods and Results: Ninety-eight subjects with CHF were evaluated. Baseline natriuretic peptides were measured by radioimmunoassay, left ventricular ejection fraction (LVEF) was estimated with echocardiography, and New York Heart Association (NYHA) class was determined independently by attending heart failure specialists. Forty-one subjects were restudied during a 6- to 12-month follow-up period after optimizing therapy. At baseline, all natriuretic peptides and LVEF correlated positively with NYHA class (P < .005). Plasma BNP, however, correlated best with NYHA class. At follow-up, only changes of BNP correlated to changes of NYHA class (P = .04). BNP decreased (-45% ± 12%, N = 14, P = .002) in subjects whose NYHA class improved whereas BNP remained unchanged (-1% ± 10%, N = 25, P = .95) in those whose NYHA class was stable. Conclusions: This investigation demonstrates the superiority of plasma BNP as compared to ANP and LVEF in objectively assessing NYHA class during the chronic treatment of CHF. Given that clinical assessment of CHF is subjective, plasma BNP is a useful objective biomarker in monitoring human CHF in the outpatient setting.

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