BACKGROUND: Preserved ventricular function is increasingly recognised in CHF. Although, NTpro-BNP is a well-established diagnostic marker in heart failure with impaired EF, its significance in heart failure with preserved EF is unclear. NT pro-BNP is secreted from the ventricular wall and plasma levels correlate to ventricular function. This study sought to determine the diagnostic and prognostic significance of plasma NTpro-BNP in patients with preserved EF heart failure. METHODS: We recruited 133 consecutive patients with decompensated HF. The primary end point was death or hospital readmission. RESULTS: Median (IQR) NTpro-BNP level at admission was elevated at 5043 ng/L (2693-10,784) and was significantly lower in preserved EF, 3569 ng/L (1707-6340) than in impaired EF, 6363 ng/L (3648-13,250) (P=0.001). Eight (6%) and 19 (14%) patients died after 1 and 6 months, respectively. In a regression analysis, worsening of NTpro-BNP levels after treatment was not predictive of mortality in heart failure with preserved EF (P=0.83). Levels at discharge correlated with readmission rates at 6 months in both groups, i.e. impaired (P=0.03) and preserved EF (P=0.02). CONCLUSION: NTpro-BNP is a reliable diagnostic marker of decompensation. However, in preserved EF heart failure, the plasma levels are significantly lower and a worsening in levels after treatment is not predictive of mortality.
BACKGROUND: Preserved ventricular function is increasingly recognised in CHF. Although, NTpro-BNP is a well-established diagnostic marker in heart failure with impaired EF, its significance in heart failure with preserved EF is unclear. NT pro-BNP is secreted from the ventricular wall and plasma levels correlate to ventricular function. This study sought to determine the diagnostic and prognostic significance of plasma NTpro-BNP in patients with preserved EF heart failure. METHODS: We recruited 133 consecutive patients with decompensated HF. The primary end point was death or hospital readmission. RESULTS: Median (IQR) NTpro-BNP level at admission was elevated at 5043 ng/L (2693-10,784) and was significantly lower in preserved EF, 3569 ng/L (1707-6340) than in impaired EF, 6363 ng/L (3648-13,250) (P=0.001). Eight (6%) and 19 (14%) patients died after 1 and 6 months, respectively. In a regression analysis, worsening of NTpro-BNP levels after treatment was not predictive of mortality in heart failure with preserved EF (P=0.83). Levels at discharge correlated with readmission rates at 6 months in both groups, i.e. impaired (P=0.03) and preserved EF (P=0.02). CONCLUSION: NTpro-BNP is a reliable diagnostic marker of decompensation. However, in preserved EF heart failure, the plasma levels are significantly lower and a worsening in levels after treatment is not predictive of mortality.
Authors: Pasqualina L Santaguida; Andrew C Don-Wauchope; Mark Oremus; Robert McKelvie; Usman Ali; Stephen A Hill; Cynthia Balion; Ronald A Booth; Judy A Brown; Amy Bustamam; Nazmul Sohel; Parminder Raina Journal: Heart Fail Rev Date: 2014-08 Impact factor: 4.214
Authors: Khibar Salah; Susan Stienen; Yigal M Pinto; Luc W Eurlings; Marco Metra; Antoni Bayes-Genis; Valerio Verdiani; Jan G P Tijssen; Wouter E Kok Journal: Heart Date: 2019-04-08 Impact factor: 5.994