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NT-proBNP is a weak indicator of cardiac function and haemodynamic response to exercise in chronic heart failure

Lookup NU author(s): Miloš Parović, Dr Nduka Okwose, Dr Guy MacGowanORCiD, Professor Djordje JakovljevicORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Aims: N-terminal prohormone of brain natriuretic peptide (NT-proBNP) plays an important role in diagnosis and management of heart failure. The aim of the present study was to assess haemodynamic response to exercise, and to evaluate the relationship between NT-proBNP, cardiac function and exercise tolerance in chronic heart failure.Methods: A single-centre, cross sectional, pilot study recruited 17 patients with chronic heart failure with reduced left ventricular ejection fraction (age 67±7 years), and 20 healthy volunteers (age 65±12 years). The NT-proBNP was measured in the heart failure group. All participants completed maximal graded cardiopulmonary exercise stress testing coupled with gas exchange (using metabolic analyzer for determination of exercise tolerance i.e. peak O2 consumption), and continuous haemodynamic measurements (i.e. cardiac output and cardiac power output) using non-invasive bioreactance technology. Results: Heart failure patients demonstrated significantly lower peak exercise cardiac function and exercise tolerance than healthy controls, i.e. cardiac power output (5.0±2.0 vs. 3.2±1.2 watts, p<0.01), cardiac output (18.2±6.3 vs. 13.5±4.0 l/min, p<0.01), heart rate (148±23.7 vs. 111±20.9 beats/min, p<0.01), oxygen consumption (24.3±9.5 vs. 16.8±3.8 ml/kg/min, p<0.01). There was no significant relationship between NT-proBNP and cardiac function at rest, i.e. cardiac power output (r=-0.28, p=0.28), cardiac output (r=-0.18, p=0.50), and oxygen consumption (r=-0.18, p=0.50) or peak exercise, i.e. cardiac power output (r=0.18, p=0.49), cardiac output (r=0.13, p=0.63), and oxygen consumption (r=-0.05, p=0.84).Conclusions: Lack of a significant and strong relationship between the NT-proBNP and measures of cardiac function and exercise tolerance may suggest that natriuretic peptides should be considered with caution in interpretation of the severity of cardiac dysfunction and functional capacity in chronic heart failure.

Publication metadata

Author(s): Parovic M, Okwose NC, Bailey K, Velicki L, Seferovic PM, MacGowan GA, Jakovljevic DG

Publication type: Article

Publication status: Published

Journal: ESC Heart Failure

Year: 2019

Volume: 6

Issue: 2

Pages: 449-454

Print publication date: 01/04/2019

Online publication date: 20/02/2019

Acceptance date: 03/02/2019

Date deposited: 04/02/2019

ISSN (electronic): 2055-5822

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1002/ehf2.12424


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Funder referenceFunder name
777204Commission of the European Communities