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
M3 - Article
C2 - 19254673
AN - SCOPUS:60849083539
VL - 15
SP - 136
EP - 144
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
SN - 1071-9164
IS - 2
ER -