BNP and NT‐proBNP predict echocardiographic severity of diastolic dysfunction

AbstractAims: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.

BNP and NT‐proBNP predict echocardiographic severity of diastolic dysfunction Journal Articles