Issledovanie urovnya mozgovogo natriyureticheskogo peptida na vysote fizicheskoy nagruzki u bol'nykh s khronicheskoy serdechnoy nedostatochnost'yu i sokhrannoy sistolicheskoy funktsiey levogo zheludochka

The measurement of the concentration of brain natriuretic peptide (BNP) and its N-terminal fragment (NT-proBNP) has currently enjoyed wide application in the diagnosis of chronic heart failure (CHF); however, the use of these markers for the diagnosis of CHF with preserved left ventricular (LV) systolic function has been inadequately studied. The purpose of the investigation was to study the level of NT-proBNP at peak exercise in patients with CHF and preserved LV systolic function as compared with changes in NT-proBNP concentrations during exercise in healthy individuals. The serum concentration of NT-proBNP was determined in 22 patients with CHF and preserved LV systolic function and in 15 subjects without CHF at rest and peak treadmill exercise testing by the standard Bruce protocol. In the CHF group, the increment in NT-proBNP at peak exercise (d NT-proBNP) was 3.2 times greater than that in the control group (p = 0.02) and the percentage increase in NT-proBNP (d NT-proBNP/NT-proBNP at rest 100%) was 3.4 times higher than that in the controls (p = 0.02). In the patients with CHF, the ratio of d NT-proBNP to exercise duration was 5.4 times greater than that in the subjects without CHF (p = 0.003) and that of percentage increase in NT-proBNP to exercise duration was 7 times higher than that in the controls (p = 0.004). The absolute and percentage increments in NT = proBNP correlated with exercise duration (p = 0.009 and p = 0.035, respectively); the percentage increase in NT-proBNP also correlated with ejection fraction (p = 0.016).