B-Type Natriuretic Peptides for the Evaluation of Exercise Intolerance

Abstract Background Cardiopulmonary exercise testing is the method of choice for the differentiation of exercise intolerance. This study sought to assess the utility of B-type natriuretic peptide (BNP) and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) for the identification of a cardiocirculatory exercise limitation. Methods In 162 patients undergoing cardiopulmonary exercise testing, rest and peak exercise BNP and NT-proBNP levels were measured. In 94 patients fulfilling criteria for appropriate effort and sufficient diagnostic certainty, the accuracy of BNP and NT-proBNP for the prediction of a cardiocirculatory limitation, as assessed based on clinical and exercise testing data, was determined. Results A cardiocirculatory limitation was identified in 27 (29%) patients. Median (interquartile range) resting BNP [162 (45-415) vs 39 (19-94) vs 24 (15-46) pg/mL; P