The aim of this study was to evaluate the
prognostic value of renal function in relation
to amino-terminal portion of the pro-hormone
B-type natriuretic peptide (NTproBNP)
and parameters of cardiopulmonary
exercise testing in predicting mortality and
morbidity in patients with moderate chronic
heart failure (CHF). Sixty-one CHF patients
were included in the study. Patients’ characteristics
were: age 64.3±11.6 years; New York
Heart Association class I/II/III: 14/37/10; left
ventricular ejection fraction: 0.30±0.13 (%);
NT-proBNP: 252.2±348.0 (ng/L); estimated
creatinine clearance (e-CC): 73.6±31.4
(mL/min); estimated glomerular filtration
rate (e-GFR): 66.1±24.6 (mL/min/1.73 m2);
the highest O2 uptake during exercise (VO2–
peak): 1.24±0.12 mL/kg/min; VO2/workload:
8.52±1.81 (mL/min/W)]. During follow up
(59.5±4.0 months) there were 15 cardiac
deaths and 16 patients were hospitalized due
to progression of heart failure. NT-proBNP
and VO2/workload were independently associated
with cardiac death (P=0.007 and
P=0.006, respectively). Hospitalization for
progressive CHF was only associated with
NT-proBNP (P=0.002). The combined cardiac
events (cardiac death and hospitalization)
were associated with NT-proBNP and VO2/
workload (P=0.007 and P=0.005, respectively).
The addition of estimates of renal function
(neither serum creatinine nor e-GFR)
did not improve the prognostic value for any
of the models.In conclusion, in patients with
moderate CHF, increased NT-proBNP and
reduced VO2/ workload identify those with
increased mortality and morbidity, irrespective
of estimates of renal function.
VO2, workload, NT-proBNP, prognosis, chronic heart failure, renal function
Hein J. Verberne, Department of Nuclear Medicine, Room F2-238, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands. Tel. +31.20.5669111 – Fax: +31.20.5669092. E-mail: h.j.verberne@amc.uva.nl
2011-10-25T00:00:00
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