Hemodynamic improvement of acutely decompensated heart failure patients is associated with decreasing levels of NT-proBNP

Background: Successful therapy in chronic clinically stable heart failure is reflected by decreasing serum NT-proBNP levels. This study evaluates therapymonitoring by NT-proBNP in comparison to invasively measured hemodynamic parameters in acutely decompensated heart failure patients. Methods and results: In 25 acutely decompensated chronic heart failure patients (NYHA III-IV, Cardiac Index (CI)<= 2.5 l/min/m(2) and a PCWP >= 15 mm Hg) changes in NT-proBNP and invasive hemodynamics were compared. Hemodynamic improvement in the first 24 h (CI >= 30% and PCWP <= 30%, compared to baseline) was associated with decreasing NT-proBNP levels; which was not seen in patients without hemodynamic improvement. To discriminate between responders and non-responders, a decline to < 80% of the baseline NT-proBNP in the first 24 h was the best cut-off. Conclusion: Hemodynamic improvement in acutely decompensated heart failure patients is associated with decreasing NT-proBNP levels. (c) 2008 Elsevier Ireland Ltd. All rights reserved.