Unexplained week-to-week variation in BNP and NT-proBNP is low in chronic heart failure patients during steady state

Background: The usefulness of brain-natriuretic-peptide (BNP) and N-terminal-pro-brain-natriuretic-peptide (NT-proBNP) for monitoring of chronic heart failure (CHF) patients has been questioned because of high levels of unexplained variation. Aims: Week-to-week total variance (CV T ), unexplained va...

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Bibliographic Details
Published in:European journal of heart failure 2007-01, Vol.9 (1), p.68-74
Main Authors: Schou, Morten, Gustafsson, Finn, Nielsen, Per H., Madsen, Lene H., Kjaer, Andreas, Hildebrandt, Per R.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Algorithms
Biomarkers - blood
BNP
chronic heart failure
Female
Heart Failure - blood
Heart Failure - physiopathology
Humans
Male
Middle Aged
Monitoring, Physiologic - methods
Natriuretic Peptide, Brain - blood
NT-proBNP
Patient Selection
Peptide Fragments - blood
reference change value
Reference Values
Reproducibility of Results
unexplained variation
Ventricular Dysfunction, Left - physiopathology
Ventricular Function, Left - physiology
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Summary:Background: The usefulness of brain-natriuretic-peptide (BNP) and N-terminal-pro-brain-natriuretic-peptide (NT-proBNP) for monitoring of chronic heart failure (CHF) patients has been questioned because of high levels of unexplained variation. Aims: Week-to-week total variance (CV T ), unexplained variation (CV I ), reference change values (RCV), index of individualities (IOI) and number of samples (N) with week-to-week intervals needed to estimate the underlying homeostatic set point (15%) for BNP and NT-proBNP were calculated in pre-specified stable CHF patients. Methods and results: We measured plasma concentrations of BNP and NT-proBNP, clinical and laboratory variables in 20 CHF patients with a 7-days interval. Only patients considered to be in steady state were included. The CV I was 15% (BNP) and 8% (NT-proBNP). CV T was 16% (BNP) and 8% (NT-proBNP) and RCV was 43% (BNP) and 23% (NT-proBNP). IOI was 0.14 for BNP and 0.03 for NT-proBNP and N was 1 for BNP and 1 for NT-proBNP. Conclusions: Our data demonstrate that unexplained variation of BNP and NT-proBNP is low in CHF patients during steady state, which is a prerequisite for the use of these peptides for monitoring of the disease.
ISSN:1388-9842
1879-0844
DOI:10.1016/j.ejheart.2006.05.001