© 2003 European Society of Cardiology
Major increase in brain natriuretic peptide indicates right ventricular systolic dysfunction in patients with heart failure
a Department of Nuclear Medicine, Montpellier University Hospital 371, Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
b Department of Cardiology B, Montpellier University Hospital 371, Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
c Department of Statistics and Epidemiology, Montpellier University Hospital 371, Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
* Corresponding author. Service Central de Médecine Nucléaire, Centre Hospitalier Universitaire Lapeyronie, 371, Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France. Tel.: +33-4-67-33-85-98; fax: +33-4-67-33-84-65 E-mail address: d-mariano_goulart{at}chu-montpellier.fr
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Abstract |
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This study sought to investigate whether the presence of right ventricular systolic dysfunction with pre-existing left ventricular systolic dysfunction is associated with higher plasma brain natriuretic peptide (BNP) levels, compared with patients with isolated left ventricular dysfunction. Eighty-five patients referred for evaluation of isotopic ventricular function were prospectively included in the study. Left (LVEF) and right (RVEF) ventricular ejection fractions were evaluated by gated blood pool scintigraphy and compared with plasma BNP levels. BNP correlated negatively with LVEF, except in patients with ischaemic heart disease (P=0.09) and in patients with LVEF<40% (P=0.11). In contrast, BNP levels correlated negatively with RVEF for all subgroups. Among patients with RVEF<40%, no significant BNP difference was found between patients with or without additional left ventricular systolic dysfunction (P=0.51). Among patients with LVEF<40%, plasma BNP levels were significantly higher in patients with RVEF<40% than in patients with RVEF
40% (P=0.004) whereas age, renal function, clinical findings, ventricular volumes, LVEF or medication were not significantly different. In conclusion, an important increase in BNP levels in patients with left ventricular systolic dysfunction should be considered by cardiologists as an indication of high risk of right ventricular dysfunction and should justify further investigation.
Key Words: Right ventricle • Ejection fraction • Brain natriuretic peptide
Received August 2, 2002; Revised November 18, 2002; Accepted February 17, 2003
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