© 2004 European Society of Cardiology
Bedside tests of B-type natriuretic peptide in the diagnosis of left ventricular diastolic dysfunction in hypertensive patients
a Department of Cardiology, Lishui City Central Hospital Zhejiang Province, PR China
b School of Biomedical Sciences, Charles Sturt University Wagga Wagga NSW 2678, Australia
* Corresponding authors. Tiemin Wei is to be contacted at Department of Cardiology, Lishui City Central Hospital, Lishu City, Zhejiang Province, PR China. Tel.: +86-578-2681010; fax: +86-578-2133457. Lexin Wang, School of Biomedical Sciences, Charles Sturt University, Wagga Wagga NSW 2678, Australia, Tel.: +61-2-69332905; fax: +61-2-69-332587. E-mail address: lswtm{at}sina.com, lwang{at}csu.edu.au
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Abstract |
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Aims: To investigate the value of B-type natriuretic peptide (BNP) in diagnosing left ventricular diastolic dysfunction in patients with hypertension.
Methods: The left ventricular diastolic function and plasma BNP levels were assessed prospectively in 135 hypertensive patients.
Results: The plasma BNP in patients with (n=61) and without (n=74) diastolic dysfunction was 122±105 and 18±16 pg/ml, respectively (p<0.001). Increased BNP levels were associated with systolic blood pressure (p<0.05), left ventricular mass index (p<0.001), the E/A ratio of transmitral flow (p<0.01) and the isovolumic relaxation time (p<0.01). A receiver-operator characteristic curve showing the sensitivity and specificity of BNP against the echocardiography diagnosis of diastolic dysfunction revealed an area under the curve (accuracy) of 0.904 (p<0.01). Using a cut-off value of >40 pg/ml, the sensitivity and specificity of plasma BNP in diagnosing left ventricular diastolic dysfunction were 79% and 92%, respectively.
Conclusions: The plasma BNP levels in patients with hypertension are closely related to left ventricular hypertrophy and filling impairment. Plasma BNP may be used to facilitate the diagnosis of left ventricular diastolic dysfunction.
Key Words: Brain natriuretic peptide • Hypertension • Left ventricular mass • Diastolic function • Echocardiography
Received December 4, 2003; Revised March 1, 2004; Accepted March 26, 2004
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