Brain natriuretic peptide is a reliable indicator of ventilatory abnormalities during cardiopulmonary exercise test in heart failure patients

Whether brain natriuretic peptide (BNP), a neurohormone marker of ventricular dysfunction, correlates with an enhanced ventilatory response (EVR) during cardiopulmonary exercise test, a wellknown predictor of prognosis, in systolic heart failure (HF) is currently unknown.Resting BNP was measured in 134 consecutive stable outpatients aged 69±11 years with mild to moderate HF and LV ejection fraction (LVEF) 40% who performed a maximal exercise test. EVR was assessed as the slope of the relation between minute ventilation and carbon dioxide production (VE/VCO2 slope) ?35. LVEF averaged 33±7%, BNP 350±396 pg/ml, and the VE/VCO2 slope 36±8. Fifty-six of 123 patients(45%) had EVR. BNP correlated with VE/VCO2 slope (r