Title : Relationships between N-terminal Pro-B type Natriuretic Peptide and echocardiographic parameters in patients with mid range heart failure
Abstract:
Background: N-terminal pro-B type natriuretic peptide (NT-proBNP) has been introduced as a useful parameter for assessing left ventricular (LV) function. We aimed to evaluate correlation between NT proBNP on the LV systolic and diastolic echocardiographic parameters in mid-range heart failure so called “grey area”
Methods: NT-proBNP and echocardiography were measured within 24 hours were enrolled and cases with less than 125 pg/ml of serum NT-proBNP or LVEF≥50% or LVEF<40% in echocardiography, increased serum creatinine level (Cr≥2.0 pg/ml) were excluded.
Results: Among total 530 patients (54% female, mean age 69.0±13.1 years NT-proBNP levels ranged from 125 to 35,000 pg/ml with a mean of 4369 pg/ml. NT-proBNP levels were not significantly correlated with EF by volumetry (r=0.06, p=0.143), mitral annular S’(r=0.04, p=0.43), mitral annular E’(r=0.04, p=0.34), left atrial volume index (r=0.05, p=0.22). Transmitral E /mitral annular E’ (E/E’) (r=0.11, p=0.01), right ventricular systolic pressure (r=0.22, p<0.001), and LV mass index (r=0.09, p=0.032) showed significant correlation wigh NT-proBNP level. NT-proBNP showed low sensitivities and specificity to determine high E/E’ ratio above 13 on cut-off values of the ROC curve with specificity of 75% (58.0% at 1640 pg/ml).
Conclusions: NT-proBNP was proved as a useful marker for assessing LV diastolic function in patients with mid range heart failure, but It showed relatively low sensitivity to determining LV diastolic function in this population.
