The Correlation between the Plasma Level of NT-Pro BNP and Left Ventricular Diastolic Dysfunction (original) (raw)
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Medicina Moderna - Modern Medicine, 2021
Objective: The importance of the NT-proBNP value in detecting patients at risk of developing heart failure (HF) and its importance in guiding medical management to prevent the development of HF. Material and methods: The study is a prospective study and includes 314 patients who was presented at the Bagdasar-Arseni Emergency Hospital for cardiology consultation, by appointment, for a period of 3 years. The inclusion criteria were as follows: essential hypertension (diagnosed more than 5 years before), diabetes mellitus (insulin-deficient or under treatment with oral ant diabetics diagnosed more than 5 years before), ischemic heart disease, mild or moderate valvulopathy (mild or moderate mitral regurgitation and large or moderate aortic stenosis) and permanent or paroxysmal atrial fibrillation. Exclusion criteria were as follows: a previous diagnosis of heart failure or left ventricular systolic dysfunction, and the presence of signs or symptoms of heart failure at the time of enroll...
Arquivos Brasileiros De Cardiologia, 2006
OBJECTIVE: To determine whether NT pro-BNP levels are high in patients reporting pericardial diseases, as well as to investigate how they relate to diastolic dysfunction echocardiographic measures.METHODS: Twenty-five patients were split into two groups: 1) pericardial effusion (PE): 15 patients; 2) constrictive pericarditis (CP): 10 patients. A control group was made up with 30 individuals reporting no heart disease. Pericardial effusion was evaluated by bidimensional echocardiogram, with restriction evaluated by pulsed Doppler of mitral flow. CP diagnosis was confirmed by MRI. NT pro-BNP levels were measured by immunoassay and detected by electrochemiluminescence.RESULTS: From the 15 PD patients, 14 reported relevant PD, and only 1, moderate PD. Log NT pro-BNP was shown to be higher in PD (p < 0.05), with log mean of 2.31 pg/ml and CP (p < 0.05), with log mean of 2.67 pg/ml, when compared to control group, log mean of 1.32 pg/ml. No difference was reported between PD and CP (p = 0.149). The NT pro-BNP log showed to be correlated to peak velocity of the E wave (r = 0.845; p = 0.001) and with E/A (r = 0.717; p = 0.003).CONCLUSION: NT pro-BNP is shown to have increased in pericardial diseases, and is associated to diastolic dysfunction. It may serve as an additional method in quantifying restriction.
Biomedical papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia, 2006
We investigated the performance of brain natriuretic peptides (BNP and NT-proBNP) in detecting various degrees of left ventricular systolic dysfunction. The NT-proBNP assay (Roche) and the BNP assay (Bayer Shionoria) were performed in 46 patients (mean age 50 years; range 20-79 years) with various types of heart disease (chronic heart failure due to coronary artery disease, cardiomyopathy, acquired valve disease, congenital heart diseases) and different impairment of left ventricular systolic dysfunction was assessed by echocardiography. Patients were divided into four groups according to the left ventricular ejection fraction (LVEF) correlated with clinical severity. Significant differences in medians of NT-proBNP and BNP values between all groups were determined (P= 0.0161 for NT-proBNP and P=0.0180 for BNP). For identifying patients with severe systolic dysfunction (LVEF<40%), receiver operating characteristic (ROC) analysis for both BNP and NT-proBNP was performed. The diagno...
International Journal of Advances in Medicine
Background: The primary aim of the current investigation was to evaluate the role of NT-proBNP in the diagnosis of diastolic heart failure and its correlation with echocardiography.Methods: Hospital based observational and analytical study undertaken on a total of 65 patients of diastolic heart failure fulfilling clinical inclusion criteria. The enrolled patients had a mean age of 54.5 years with a female preponderance (33 females vs. 32 males). Patients underwent clinical evaluation and echocardiography examination. NT-proBNP estimation was done using autoanalyzer working on principle of electrochemiluminisense. Patients were divided into various grades of diastolic dysfunction on the basis of echocardiography. Statistical analysis was done to find the significance of levels of NT-proBNP and its correlation with the grading of diastolic heart failure.Results: There was a statistically significant higher level of serum NT-proBNP in patients with diastolic heart failure and the incre...
Testing for BNP and NT-proBNP in the diagnosis and prognosis of heart failure
PubMed, 2006
Objectives: The purpose of this systematic review was to evaluate BNP and NT-proBNP to: (a) identify determinants, (b) establish their diagnostic performance in heart failure (HF) patients, (c) determine their predictive ability with respect to mortality and other cardiac endpoints, and (d) determine their value in monitoring HF treatment. Data sources: MEDLINE, EMBASE, CINAHL, Cochrane Central, and AMED from 1989 to February 2005 were searched for primary studies. Review methods: Standard systematic review methodology, including meta-analysis, was employed. All study designs were included. Eligibility criteria included English-only studies and restricted the number of test methods to maximize generalizability. Outcomes for prognosis were limited to mortality and specific cardiac events. Further specific criteria were developed for each research question. Results: Determinants: There were 103 determinants identified including age, gender, disease, treatment, as well as biochemical and physiological measures. Few studies reported independent associations and of those that did age, female gender and creatinine levels were positively associated with BNP and NT-proBNP. Diagnosis: Pooled sensitivity and specificity values were 94 and 66 percent for BNP and 92 and 65 percent for NT-proBNP; there was minimal difference among settings (emergency, specialized clinics, and primary care). B-type natriuretic peptides also added independent diagnostic information above traditional measures for HF. Prognosis: Both BNP and NT-proBNP were found to be independent predictors of mortality and other cardiac composite endpoints in patients with risk of coronary artery disease (CAD) (risk estimate range = 1.10 to 5.40), diagnosed CAD (risk estimate range = 1.50 to 3.00), and diagnosed HF patients (risk estimate range = 2.11 to 9.35). With respect to screening, the AUC values (range = 0.57 to 0.88) suggested poor performance. Monitoring Treatment: Studies showed therapy reduced BNP and NT-proBNP, however, relationship to outcome was limited and not consistent. Conclusions: Determinants: The importance of the identified determinants for clinical use is not clear. Diagnosis: In all settings both BNP and NT-proBNP show good diagnostic properties as a rule out test for HF. Prognosis: BNP and NT-proBNP are consistent independent predictors of mortality and other cardiac composite endpoints for populations with risk of CAD, diagnosed CAD, and diagnosed HF. There is insufficient evidence to determine the value of B-type natriuretic peptides for screening of HF. Monitoring Treatment: There is insufficient evidence to demonstrate that BNP and NT-proBNP levels show change in response to therapies to manage stable chronic HF patients.
European Heart Journal, 2005
Aims Diastolic heart failure is a frequent entity but difficult to diagnose. N-terminal pro-B type natriuretic peptide (NT-proBNP) was therefore investigated as a possible non-invasive parameter to diagnose isolated diastolic dysfunction. Methods and results Sixty-eight symptomatic patients with isolated diastolic dysfunction and preserved left ventricular ejection fraction (LVEF) (!50%) and 50 patients with regular left ventricular (LV) function were examined by conventional echocardiography, tissue Doppler imaging (TDI), and left and right heart catheterization. Plasma NT-proBNP levels were determined simultaneously. Median NT-proBNP plasma levels were elevated [189.54 pg/mL (86.16-308.27) vs. 51.89 pg/mL (29.94-69.71); P , 0.001] and increased with greater severity of the diastolic dysfunction (R ¼ 0.67, P , 0.001). According to the recevier operating characteristic analysis, LV end-diastolic pressure [area under the curve (AUC) 0.84] was the most specific parameter, which had a low sensitivity (61%), however. The reliability of NT-proBNP was similar to TDI indices (AUC 0.83 vs. 0.81) and improved when compared with conventional echocardiography (AUC 0.59-0.70). NT-proBNP levels had the best negative predictive value of all methods (94%) and correlated strongly with indices of LV filling pressure, as determined by invasive measurements. Multivariable linear regression analysis confirmed NT-proBNP as an independent predictor of diastolic dysfunction with an Odds ratio of 1.2 (1.1-1.4, CI 95%) for every unit increase of NT-proBNP. Conclusion NT-proBNP can reliably detect the presence of isolated diastolic dysfunction in symptomatic patients and is an useful tool to rule out patients with reduced exercise tolerance of non-cardiac origin.