Copyright © 2002 by the European Society of Cardiology.
Prediction of outcome by neurohumoral activation, the six-minute walk test and the Minnesota Living with Heart Failure Questionnaire in an outpatient cohort with congestive heart failure
a Department of Cardiology, University of Vienna, Vienna, Austria
c Ludwig Boltzmann Institute of Experimental Endocrinology, University of Vienna, Vienna, Austria
b Ludwig Boltzmann Institute of Cardiovascular Research, University of Vienna, Vienna, Austria
revised November 14, 2001; accepted November 21, 2001
Abstract
Aims To compare the precursor of atrial and brain natriuretic peptide (N-ANP, N-BNP), brain natriuretic peptide (BNP), big endothelin-1, the 6-min walk test and the Minnesota Living with Heart Failure Questionnaire (LHFQ) with regard to short-term outcome in an ambulatory heart failure population.
Methods and Results Ninety-six individuals (left ventricular ejection fraction of 26±10%) were included in the study. Within 1 day blood samples of N-ANP, N-BNP, BNP and big endothelin-1 were obtained, and the 6-min walk test and LHFQ were measured. The predictive power of these variables—including renin–angiotensin system antagonist therapy—in respect of 1-year event-free survival were calculated with a Cox regression analysis. All investigated variables had the power to predict outcome in a univariate analysis. Multivariate analysis revealed that N-ANP (chi-square=58 P<0·0001), BNP (chi-square=8 P<0·01), the LHFQ (chi-square=6 P<0·02) and the renin–angiotensin system antagonist (chi-square=4P <0·05), are independent predictors.
Conclusion We conclude that, in an open clinical cohort of patients with large differences in the progression of the disease, N-ANP, BNP and LHFQ are the most reliable predictors of worsening heart failure in the short term. However, the dosage of the ACE inhibitor influenced short-term survival in this population. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.
Key Words: Heart failure, N-atrial natriuretic peptide, N-brain natriuretic peptide, brain natriuretic peptide, big endothelin-1, six-minute walk test, Minnesota Living with Heart Failure Questionnaire
f1 Correspondence: Martin Hülsmann, MD, Department of Cardiology, University of Vienna, Währinger Gürtel 18–20, A-1090 Vienna, Austria.
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