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European Heart Journal 2002 23(11):886-891; doi:10.1053/euhj.2001.3115
Copyright © 2002 by the European Society of Cardiology.
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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

M. Hülsmanna,f1, R. Bergera, B. Sturma, A. Bojicb, W. Woloszczukc, J. Bergler-Kleina and R. Pachera

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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