Related Experiment Video
Updated: Jul 6, 2026
04:20
Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure
Published on: October 1, 2019
Correlation between NT-proBNP values and changes in functional capacity in patients with chronic heart failure
Rita Fernandes1, Joana Feliciano, Rui M Soares
1Serviço de Cardiologia, Hospital de Santa Marta, Lisboa, Portugal. ritamarinf@gmail.com
Summary
Changes in N-terminal pro-brain natriuretic peptide (proBNP) correlate with functional capacity in heart failure patients. A proBNP percentage variation over 28% predicts significant changes in exercise capacity, aiding clinical assessment.
Area of Science:
- Cardiology
- Exercise Physiology
Background:
- Chronic heart failure (CHF) due to dilated cardiomyopathy (DCM) significantly impacts functional capacity.
- N-terminal pro-brain natriuretic peptide (proBNP) is a biomarker used in heart failure management.
- Cardiopulmonary exercise testing (CPET) is a key method for assessing functional capacity.
Purpose of the Study:
- To evaluate the predictive value of changes in proBNP for changes in functional capacity in DCM-CHF patients.
- To determine the threshold of proBNP variation that indicates significant functional capacity changes.
Main Methods:
- 37 DCM-CHF patients underwent two CPET evaluations with proBNP measurements.
- The modified Bruce protocol was used for symptom-limited treadmill CPET.
- Absolute and percentage variations (AV and PV) in peak oxygen uptake (pVO2) and proBNP were analyzed.
Main Results:
- ProBNP variations showed correlation with pVO2 variations.
- A proBNP percentage variation (PV) of 28% demonstrated 80% sensitivity and 79% specificity for predicting a >10% change in pVO2 PV.
- ROC curve analysis confirmed the predictive value of proBNP PV (AUC=0.876, p=0.01).
Conclusions:
- Changes in proBNP levels correlate with functional capacity variations in DCM-CHF patients.
- A proBNP PV exceeding 28% is a significant predictor of functional capacity changes as assessed by CPET.
Related Concept Videos
01:30Heart Failure VII: Nursing Interventions
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
01:17Pathophysiology of Heart Failure
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:29Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
01:30Heart Failure IV: Classification and Diagnostic Evaluation
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
01:26Heart Failure III: Clinical Manifestations
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...