NT-ProBNP in acute heart failure: correlation with invasively measured hemodynamic parameters during recompensation

J Card Fail. 2005 Jun;11(5 Suppl):S38-41. doi: 10.1016/j.cardfail.2005.04.012.

Abstract

Background: N-terminal brain natriuretic peptide (NT-proBNP) level is elevated in patients with acute and chronic heart failure. This study addresses whether NT-proBNP correlates with invasively measured hemodynamic parameters and whether a decrease of NT-proBNP over time correlates with invasively monitored hemodynamic improvement.

Methods and results: Twenty consecutive patients with acute exacerbation of chronic heart failure (New York Heart Association class III-IV) were included in this prospective study. NT-proBNP and hemodynamic measurements by balloon-tipped pulmonary artery catheter were performed simultaneously. Recompensation strategies included vasodilators, diuretics, and inotropes. The patients were divided in 2 subgroups. Group A, by definition, had a hemodynamic improvement over 24 hours with an increase of cardiac index of >30% and a decrease of pulmonary capillary wedge pressure of >30%. Group B did not show a hemodynamic improvement. Group A had a decline of NT-proBNP levels to 42% of the baseline value over 32 hours. In group B, the NT-pro BNP levels did not change significantly over 32 hours.

Conclusion: The decrease of NT-proBNP correlates with hemodynamic improvement in patients with decompensated heart failure. The relative changes of NT-proBNP seem to be a reliable diagnostic tool in monitoring these patients. There results have been confirmed in a larger patient group.

MeSH terms

  • Biomarkers / blood
  • Catheterization, Swan-Ganz
  • Female
  • Heart Failure / blood
  • Heart Failure / diagnosis*
  • Heart Failure / physiopathology
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Prospective Studies
  • Pulmonary Wedge Pressure
  • Retrospective Studies
  • Stroke Volume
  • Time Factors
  • Vascular Resistance

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain