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Prognostic value of B-type natriuretic peptide in patients with chronic and advanced heart failure

T Sun1, L Wang, Y Zhang

  • 1Emergency Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou City, Henan Province, China. suntongwen@163.com

Internal Medicine Journal
|February 24, 2007
PubMed

Insights

In advanced heart failure, lower B-type natriuretic peptide (BNP) levels indicate a worse prognosis. Paradoxically low BNP is an adverse marker for cardiovascular mortality in these patients.

Area of Science:

  • Cardiology
  • Biomarkers
  • Heart Failure Research

Background:

  • Elevated B-type natriuretic peptide (BNP) is linked to poor outcomes in acute heart failure.
  • This study examines the prognostic significance of BNP in chronic, advanced heart failure.

Purpose of the Study:

  • To determine the prognostic value of BNP levels in patients with advanced heart failure (NYHA class III-IV).
  • To investigate the association between BNP levels and cardiovascular mortality in this population.

Main Methods:

  • Fifty patients with NYHA class III-IV heart failure were enrolled.
  • Blood BNP levels were measured at admission, with a follow-up period of 12 months.
  • Logistic regression analysis was used to identify predictors of mortality.

Main Results:

  • No significant correlation was found between BNP levels and left ventricular ejection fraction.
  • Twelve patients (24%) died during follow-up; those who died had lower BNP levels (501 ng/L vs 877 ng/L).
  • Lower BNP levels (<520 ng/L) independently predicted cardiovascular mortality (OR 1.21, P < 0.01).

Conclusions:

  • Patients with chronic, advanced heart failure who survive tend to have higher circulating BNP levels.
  • A paradoxically low BNP level serves as an adverse prognostic marker in advanced heart failure.
Abstract

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