on February 24, 2003
Circulation. 2003
Published online before print February 24, 2003, doi: 10.1161/01.CIR.0000054164.99881.00
Published online before print February 24, 2003, doi: 10.1161/01.CIR.0000054164.99881.00
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Submitted on September 10, 2002
From the VA Medical Center and University of Minnesota (I.S.A.), Minneapolis, Minn; Department of Biostatistics (L.D.F.), University of Washington, Seattle, Wash; Novartis Pharmaceuticals Corporation (Y.-T.C., R.D.G.), East Hanover, NJ; Istituto "Mario Negri" (R.L., S.M., G.T.), Milan, Italy; ANMCO Research Center (A.P.M.), Florence, Italy; and University of Minnesota (J.N.C.), Minneapolis, Minn. * To whom correspondence should be addressed. E-mail: anand001{at}tc.umn.edu.
Background--Neurohormones are considered markers of heart failure progression. We examined whether changes in brain natriuretic peptide (BNP) and norepinephrine (NE) over time are associated with corresponding changes in mortality and morbidity in the Valsartan Heart Failure Trial. Methods and Results--Plasma BNP and NE were measured before randomization and during follow-up in Conclusions--Not only are plasma BNP and NE important predictors of heart failure M&M, but changes in these neurohormones over time are associated with corresponding changes in M&M. These data further reinforce their role as significant surrogate markers in HF and underscore the importance of including their measurement in HF trials.
Revised on December 5, 2002
Accepted on December 5, 2002
Changes in Brain Natriuretic Peptide and Norepinephrine Over Time and Mortality and Morbidity in the Valsartan Heart Failure Trial (Val-HeFT)
Inder S. Anand MD, DPhil*,
4300 patients in the Valsartan Heart Failure Trial. The relation between baseline BNP and NE and all-cause mortality and first morbid event (M&M) was analyzed in subgroups, with values above and below the median, and by quartiles. The change and percent change from baseline to 4 and 12 months in BNP and NE were also analyzed by quartiles for subsequent M&M. Risk ratios for M&M were calculated using a Cox proportional hazard model. Risk ratio of M&M for patients with baseline BNP or NE above the median was significantly higher than that for patients with values below the median. Baseline BNP and NE in quartiles also showed a quartile-dependent increase in M&M. BNP had a stronger association with M&M than NE. Patients with the greatest percent decrease in BNP and NE from baseline to 4 and 12 months had the lowest whereas patients with greatest percent increase in BNP and NE had the highest M&M.
Key words: heart failure • trials, clinical • natriuretic peptides • norepinephrine
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Circulation 2003 107: 1231-1233.
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C. Otte, T. C. Neylan, S. S. Pipkin, W. S. Browner, and M. A. Whooley Depressive Symptoms and 24-Hour Urinary Norepinephrine Excretion Levels in Patients With Coronary Disease: Findings From the Heart and Soul Study Am J Psychiatry, November 1, 2005; 162(11): 2139 - 2145. [Abstract] [Full Text] [PDF]
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C. Kistorp, J. Faber, S. Galatius, F. Gustafsson, J. Frystyk, A. Flyvbjerg, and P. Hildebrandt Plasma Adiponectin, Body Mass Index, and Mortality in Patients With Chronic Heart Failure Circulation, September 20, 2005; 112(12): 1756 - 1762. [Abstract] [Full Text] [PDF]
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M. Petersson, P. Friberg, G. Eisenhofer, G. Lambert, and B. Rundqvist Long-term outcome in relation to renal sympathetic activity in patients with chronic heart failure Eur. Heart J., May 1, 2005; 26(9): 906 - 913. [Abstract] [Full Text] [PDF]
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W. L. Miller, K. A. Hartman, M. F. Burritt, D. D. Borgeson, J. C. Burnett Jr, and A. S. Jaffe Biomarker Responses during and after Treatment with Nesiritide Infusion in Patients with Decompensated Chronic Heart Failure Clin. Chem., March 1, 2005; 51(3): 569 - 577. [Abstract] [Full Text] [PDF]
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R. Bassan, A. Potsch, A. Maisel, B. Tura, H. Villacorta, M. V. Nogueira, A. Campos, R. Gamarski, A. C. Masetto, and M. A. Moutinho B-type natriuretic peptide: a novel early blood marker of acute myocardial infarction in patients with chest pain and no ST-segment elevation Eur. Heart J., February 1, 2005; 26(3): 234 - 240. [Abstract] [Full Text] [PDF]
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