© 2008 European Society of Cardiology
BNP and NT-proBNP predict echocardiographic severity of diastolic dysfunction
a Population Health Research Institute and McMaster University Hamilton, Ontario, Canada
b Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital Stockholm, Sweden
c Department of Cardiology, Karolinska University Hospital Solna, Sweden
d Astra Zeneca R&D, Mölndal, Sweden
e Department of Medicine, University of Insubria Varese, Italy
* Corresponding author. Department of Cardiology, Danderyd Hospital, SE-182 88 Stockholm, Sweden. Tel.: +46 8 6556849; fax: +46 8 6226810. E-mail address: hans.persson{at}ds.se (H. Persson).
 |
Abstract |
|---|
Aims: To evaluate the best combination of clinical parameters and brain natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP), to predict diastolic dysfunction (DD) in heart failure with preserved left ventricular ejection fraction (HF-PLEF) as determined by Doppler-echocardiography.
Methods and Results: HF patients with EF > 40% in the CHARM Echocardiographic Substudy were included and classified to have normal diastolic function, or mild, moderate or severe diastolic dysfunction. Plasma BNP and NT-proBNP levels were measured and relevant clinical characteristics recorded. 181 participants were included in this analysis, 72 (40%) had moderate to severe DD. A model including age, sex, BNP, body mass index, history of atrial fibrillation, coronary artery disease, diabetes mellitus, hypertension and left atrial volume was highly predictive of moderate to severe DD; AUC 0.81 (0.73–0.88; p < 0.0001). Similarly, substitution of BNP with NT-proBNP resulted in an AUC 0.79 (0.72–0.87; p < 0.0001). In these models; BNP> 100 pg/ml (OR 6.24 CI 2.42–16.09, p=0.0002), history of diabetes (OR 3.52 CI 1.43–8.70, p=0.006) and NT-proBNP > 600 pg/ml (OR 5.93 CI 2.21–15.92, p=0.0004), history of diabetes mellitus (OR 2.75 CI 1.12–6.76, p=0.03) respectively remained independent predictors of DD in HF-PLEF.
Conclusions: Natriuretic peptides were the strongest independent predictors of DD, as determined by Doppler-echocardiography, in HF-PLEF.
Key Words: Natriuretic peptides • Diastolic dysfunction • Heart failure • Diagnosis
Received May 1, 2007; Revised November 6, 2007; Accepted January 28, 2008
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R. Tagore, L. H. Ling, H. Yang, H.-Y. Daw, Y.-H. Chan, and S. K. Sethi Natriuretic Peptides in Chronic Kidney Disease Clin. J. Am. Soc. Nephrol., November 1, 2008; 3(6): 1644 - 1651. [Abstract] [Full Text] [PDF]
|
|