Alveolar Membrane Conductance Decreases as BNP Increases During Exercise in Heart Failure. Rationale for BNP in the Evaluation of Dyspnea

Gaia Cattadori, Karlman Wasserman, Chiara Meloni, Saima Mustaq, Mauro Contini, Anna Apostolo, Daniele Andreini, Damiano Magrì, Susanna Sciomer, Fabrizio Veglia, Giovanni Berna, Giovanni Introcaso, Pietro Palermo, Cesare Fiorentini, Piergiuseppe Agostoni

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Abstract

Background: In left ventricular failure (LVF) patients, brain natriuretic peptide (BNP), lung diffusion for carbon monoxide (DLCO), and alveolar-membrane conductance (DM) correlate with LVF severity and prognosis. The reduction of DLCO and DM during exercise reflects pulmonary edema formation. Methods and Results: To evaluate, in LVF patients, the correlation between BNP and lung diffusion parameters at rest and during exercise, we studied 17 severe LVF patients, 13 moderate, and 10 normals measuring BNP and lung diffusion parameters before, at the end, and 1 hour after a 10-minute high-intensity constant-workload exercise. At rest, a significant correlation exists between BNP and lung diffusion parameters. Resting BNP, DLCO, and DM correlate with peak oxygen consumption (P <.0001 for all analyses). With exercise, BNP increase is significant (severe LVF 180 ± 49 pg/mL, moderate 68 ± 58, normals 18 ± 12); differently, only in severe LVF, with exercise, DLCO (-1.1 ± 0.7 mL/mm Hg/min, P <.0001) and DM (-6.4 ± 2.8, P <.0006) decrease. One hour after exercise, only in severe LVF, BNP is still higher than at rest, while DLCO, DM, and DM/Vc are lower. Significant correlations are observed between BNP and DM changes during exercise and recovery (P <.0001) in severe LVF. Conclusions: In severe LVF, BNP changes during exercise correlate with simultaneous reductions in DM, suggesting that BNP increase and pulmonary edema formation could be related.

Original languageEnglish
Pages (from-to)136-144
Number of pages9
JournalJournal of Cardiac Failure
Volume15
Issue number2
DOIs
Publication statusPublished - Mar 2009

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Brain Natriuretic Peptide
Dyspnea
Heart Failure
Exercise
Membranes
Lung
Pulmonary Edema
Carbon Monoxide
Workload
Oxygen Consumption

Keywords

  • brain natriuretic peptide
  • Exercise
  • heart failure
  • lung diffusion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{9db09d813f5845ed994b7ebd25804b04,
title = "Alveolar Membrane Conductance Decreases as BNP Increases During Exercise in Heart Failure. Rationale for BNP in the Evaluation of Dyspnea",
abstract = "Background: In left ventricular failure (LVF) patients, brain natriuretic peptide (BNP), lung diffusion for carbon monoxide (DLCO), and alveolar-membrane conductance (DM) correlate with LVF severity and prognosis. The reduction of DLCO and DM during exercise reflects pulmonary edema formation. Methods and Results: To evaluate, in LVF patients, the correlation between BNP and lung diffusion parameters at rest and during exercise, we studied 17 severe LVF patients, 13 moderate, and 10 normals measuring BNP and lung diffusion parameters before, at the end, and 1 hour after a 10-minute high-intensity constant-workload exercise. At rest, a significant correlation exists between BNP and lung diffusion parameters. Resting BNP, DLCO, and DM correlate with peak oxygen consumption (P <.0001 for all analyses). With exercise, BNP increase is significant (severe LVF 180 ± 49 pg/mL, moderate 68 ± 58, normals 18 ± 12); differently, only in severe LVF, with exercise, DLCO (-1.1 ± 0.7 mL/mm Hg/min, P <.0001) and DM (-6.4 ± 2.8, P <.0006) decrease. One hour after exercise, only in severe LVF, BNP is still higher than at rest, while DLCO, DM, and DM/Vc are lower. Significant correlations are observed between BNP and DM changes during exercise and recovery (P <.0001) in severe LVF. Conclusions: In severe LVF, BNP changes during exercise correlate with simultaneous reductions in DM, suggesting that BNP increase and pulmonary edema formation could be related.",
keywords = "brain natriuretic peptide, Exercise, heart failure, lung diffusion",
author = "Gaia Cattadori and Karlman Wasserman and Chiara Meloni and Saima Mustaq and Mauro Contini and Anna Apostolo and Daniele Andreini and Damiano Magr{\`i} and Susanna Sciomer and Fabrizio Veglia and Giovanni Berna and Giovanni Introcaso and Pietro Palermo and Cesare Fiorentini and Piergiuseppe Agostoni",
year = "2009",
month = "3",
doi = "10.1016/j.cardfail.2008.10.002",
language = "English",
volume = "15",
pages = "136--144",
journal = "Journal of Cardiac Failure",
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TY - JOUR

T1 - Alveolar Membrane Conductance Decreases as BNP Increases During Exercise in Heart Failure. Rationale for BNP in the Evaluation of Dyspnea

AU - Cattadori, Gaia

AU - Wasserman, Karlman

AU - Meloni, Chiara

AU - Mustaq, Saima

AU - Contini, Mauro

AU - Apostolo, Anna

AU - Andreini, Daniele

AU - Magrì, Damiano

AU - Sciomer, Susanna

AU - Veglia, Fabrizio

AU - Berna, Giovanni

AU - Introcaso, Giovanni

AU - Palermo, Pietro

AU - Fiorentini, Cesare

AU - Agostoni, Piergiuseppe

PY - 2009/3

Y1 - 2009/3

N2 - Background: In left ventricular failure (LVF) patients, brain natriuretic peptide (BNP), lung diffusion for carbon monoxide (DLCO), and alveolar-membrane conductance (DM) correlate with LVF severity and prognosis. The reduction of DLCO and DM during exercise reflects pulmonary edema formation. Methods and Results: To evaluate, in LVF patients, the correlation between BNP and lung diffusion parameters at rest and during exercise, we studied 17 severe LVF patients, 13 moderate, and 10 normals measuring BNP and lung diffusion parameters before, at the end, and 1 hour after a 10-minute high-intensity constant-workload exercise. At rest, a significant correlation exists between BNP and lung diffusion parameters. Resting BNP, DLCO, and DM correlate with peak oxygen consumption (P <.0001 for all analyses). With exercise, BNP increase is significant (severe LVF 180 ± 49 pg/mL, moderate 68 ± 58, normals 18 ± 12); differently, only in severe LVF, with exercise, DLCO (-1.1 ± 0.7 mL/mm Hg/min, P <.0001) and DM (-6.4 ± 2.8, P <.0006) decrease. One hour after exercise, only in severe LVF, BNP is still higher than at rest, while DLCO, DM, and DM/Vc are lower. Significant correlations are observed between BNP and DM changes during exercise and recovery (P <.0001) in severe LVF. Conclusions: In severe LVF, BNP changes during exercise correlate with simultaneous reductions in DM, suggesting that BNP increase and pulmonary edema formation could be related.

AB - Background: In left ventricular failure (LVF) patients, brain natriuretic peptide (BNP), lung diffusion for carbon monoxide (DLCO), and alveolar-membrane conductance (DM) correlate with LVF severity and prognosis. The reduction of DLCO and DM during exercise reflects pulmonary edema formation. Methods and Results: To evaluate, in LVF patients, the correlation between BNP and lung diffusion parameters at rest and during exercise, we studied 17 severe LVF patients, 13 moderate, and 10 normals measuring BNP and lung diffusion parameters before, at the end, and 1 hour after a 10-minute high-intensity constant-workload exercise. At rest, a significant correlation exists between BNP and lung diffusion parameters. Resting BNP, DLCO, and DM correlate with peak oxygen consumption (P <.0001 for all analyses). With exercise, BNP increase is significant (severe LVF 180 ± 49 pg/mL, moderate 68 ± 58, normals 18 ± 12); differently, only in severe LVF, with exercise, DLCO (-1.1 ± 0.7 mL/mm Hg/min, P <.0001) and DM (-6.4 ± 2.8, P <.0006) decrease. One hour after exercise, only in severe LVF, BNP is still higher than at rest, while DLCO, DM, and DM/Vc are lower. Significant correlations are observed between BNP and DM changes during exercise and recovery (P <.0001) in severe LVF. Conclusions: In severe LVF, BNP changes during exercise correlate with simultaneous reductions in DM, suggesting that BNP increase and pulmonary edema formation could be related.

KW - brain natriuretic peptide

KW - Exercise

KW - heart failure

KW - lung diffusion

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U2 - 10.1016/j.cardfail.2008.10.002

DO - 10.1016/j.cardfail.2008.10.002

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JO - Journal of Cardiac Failure

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