Keywords

BNP, heart failure, NYHA functional class, quality of life

 

Authors

  1. Athanasopoulos, Leonidas V. PhD, MD
  2. Dritsas, Athanasios MD
  3. Doll, Helen A. DPhil
  4. Cokkinos, Dennis V. PhD, MD

Abstract

PURPOSE: To assess the relationships between New York Heart Association (NYHA) functional class, quality of life, aerobic capacity (peak oxygen uptake, [latin capital V with dot above]O2), ventilatory efficiency (minute ventilation/carbon dioxide production slope, VE/[latin capital V with dot above]CO2 slope), and brain natriuretic peptide (BNP) in creating a model for predicting peak [latin capital V with dot above]O2.

 

METHODS: Cardiopulmonary exercise testing was performed in 62 patients. A baseline blood sample was taken to measure the N-terminal prohormone BNP (NT-proBNP). Patients also completed the Minnesota Living with Heart Failure Questionnaire (MLHF) and the Specific Activity Questionnaire (SAQ), and NYHA functional class was determined.

 

RESULTS: NYHA functional class correlated more strongly with SAQ score than with MLHF score. Peak [latin capital V with dot above]O2 and VE/[latin capital V with dot above]CO2 slope had stronger associations with NYHA functional class and SAQ score than with MLHF score. NT-proBNP plasma levels correlated more significantly with NYHA functional class and SAQ score (both P < .001) than with MLHF score. Using multiple linear regression analysis adjusted for age and sex, SAQ score, NT-proBNP, and etiology of heart failure had significant independent relationships with peak [latin capital V with dot above]O2, explaining 63% of its variability (adjusted R2 = 0.596).

 

CONCLUSIONS: Cardiopulmonary exercise variables and plasma NT-proBNP are associated more with NYHA functional class and SAQ score than with MLHF score. When combined, SAQ score, NT-proBNP, and etiology of heart failure can satisfactorily predict peak oxygen uptake.