Peak V^^・O_2 is More Potent Than B-Type Natriuretic Peptide as a Prognostic Parameter in Cardiac Patients

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Background It is well-known that both B-type natriuretic peptide (BNP) and peak oxygen uptake (V^^・O_2) are independent predictors of mortality in patients with heart failure. This study investigates the predictive power of BNP and peak V^^・O_2 for survival in cardiac patients. Methods and Results A total of 609 patients with cardiac disease participated in the study. They underwent cardiopulmonary exercise testing to determine peak V^^・O_2, with BNP being measured before exercise testing During 502.5 median follow-up days, 29 patients died of cardiovascular disease. In the univariate Cox proportional hazards analysis, peak V^^・O_2 and BNP were both found to be significant prognostic indices for survival. The time-dependent ROC curve analysis (Heagerty 2006) was applied to 3 predictors: peak V^^・O_2, BNP, and then both, with gender and age as adjusted variables. The area under the curve (AUC) compared with the follow-up period curves of peak V^^・O_2 and the 2 combined variables (ie, BNP and peak V^^・O_2) were consistently over that of BNP. The integrated AUC indices were 0.80 (peak V^^・O_2), 0.81 (peak V^^・O_2 and BNP) and 0.70 (BNP), respectively. Conclusions These results indicate that peak V^^・O_2 is more potent than BNP for predicting the mortality in patients with mixed cardiac disease.
社団法人日本循環器学会の論文
2008-03-20