BACKGROUND: Data on the value of baseline brain natriuretic peptide (BNP) and autonomic markers in predicting heart failure (HF) hospitalization after an acute myocardial infarction (AMI) are limited. METHODS: A consecutive series of patients with AMI without a previous history of HF (n = 569) were followed up for 8 years. At baseline, the patients had a blood sample for determination of BNP, a 24-hour Holter recording for evaluating heart rate variability (HRV) and heart rate turbulence (HRT), and an assessment of baroreflex sensitivity (BRS) using phenylephrine test. RESULTS: During the follow-up, 79 (14%) patients were hospitalized due to HF. Increased baseline BNP, decreased HRV, HRT, and BRS had a significant association with HF hospitalization in univariate comparisons (P < 0.001 for all). After adjusting with all the relevant clinical parameters, BNP, HRV, and HRT still significantly predicted HF hospitalization (P < 0.001 for BNP and for the short-term scaling exponent alpha(1), P < 0.01 for turbulence slope). In the receiver operator characteristics curve analysis, the area under the curve for BNP was 0.77, for the short-term scaling exponent alpha(1) 0.69, for turbulence slope 0.71, and for BNP/standard deviation of all N-N intervals ratio 0.80. CONCLUSION: Baseline increased BNP and impaired autonomic function after AMI yield significant information on the long-term risk for HF hospitalization.
BACKGROUND: Data on the value of baseline brain natriuretic peptide (BNP) and autonomic markers in predicting heart failure (HF) hospitalization after an acute myocardial infarction (AMI) are limited. METHODS: A consecutive series of patients with AMI without a previous history of HF (n = 569) were followed up for 8 years. At baseline, the patients had a blood sample for determination of BNP, a 24-hour Holter recording for evaluating heart rate variability (HRV) and heart rate turbulence (HRT), and an assessment of baroreflex sensitivity (BRS) using phenylephrine test. RESULTS: During the follow-up, 79 (14%) patients were hospitalized due to HF. Increased baseline BNP, decreased HRV, HRT, and BRS had a significant association with HF hospitalization in univariate comparisons (P < 0.001 for all). After adjusting with all the relevant clinical parameters, BNP, HRV, and HRT still significantly predicted HF hospitalization (P < 0.001 for BNP and for the short-term scaling exponent alpha(1), P < 0.01 for turbulence slope). In the receiver operator characteristics curve analysis, the area under the curve for BNP was 0.77, for the short-term scaling exponent alpha(1) 0.69, for turbulence slope 0.71, and for BNP/standard deviation of all N-N intervals ratio 0.80. CONCLUSION: Baseline increased BNP and impaired autonomic function after AMI yield significant information on the long-term risk for HF hospitalization.
Authors: John G F Cleland; Jean-Claude Daubert; Erland Erdmann; Nick Freemantle; Daniel Gras; Lukas Kappenberger; Luigi Tavazzi Journal: N Engl J Med Date: 2005-03-07 Impact factor: 91.245
Authors: K E Airaksinen; K U Tahvanainen; D L Eckberg; M J Niemelä; A Ylitalo; H V Huikuri Journal: J Am Coll Cardiol Date: 1998-11-15 Impact factor: 24.094
Authors: Heikki V Huikuri; Jari M Tapanainen; Kai Lindgren; Pekka Raatikainen; Timo H Mäkikallio; K E Juhani Airaksinen; Robert J Myerburg Journal: J Am Coll Cardiol Date: 2003-08-20 Impact factor: 24.094
Authors: Eldrin F Lewis; Lemuel A Moye; Jean L Rouleau; Frank M Sacks; J Malcolm O Arnold; J Wayne Warnica; Greg C Flaker; Eugene Braunwald; Marc A Pfeffer Journal: J Am Coll Cardiol Date: 2003-10-15 Impact factor: 24.094
Authors: J Nolan; P D Batin; R Andrews; S J Lindsay; P Brooksby; M Mullen; W Baig; A D Flapan; A Cowley; R J Prescott; J M Neilson; K A Fox Journal: Circulation Date: 1998-10-13 Impact factor: 29.690
Authors: Vaiibhav N Patel; Brian R Pierce; Rohan K Bodapati; David L Brown; Diane G Ives; Phyllis K Stein Journal: JACC Heart Fail Date: 2017-04-05 Impact factor: 12.035