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The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements.
Eur Heart J. 2005 Nov; 26(21):2277-84.EH

Abstract

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) (> or =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=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.

Authors+Show Affiliations

Department of Cardiology and Pneumology, Charité--University Medicine Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany. ctschoepe@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16014646

Citation

Tschöpe, Carsten, et al. "The Role of NT-proBNP in the Diagnostics of Isolated Diastolic Dysfunction: Correlation With Echocardiographic and Invasive Measurements." European Heart Journal, vol. 26, no. 21, 2005, pp. 2277-84.
Tschöpe C, Kasner M, Westermann D, et al. The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements. Eur Heart J. 2005;26(21):2277-84.
Tschöpe, C., Kasner, M., Westermann, D., Gaub, R., Poller, W. C., & Schultheiss, H. P. (2005). The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements. European Heart Journal, 26(21), 2277-84.
Tschöpe C, et al. The Role of NT-proBNP in the Diagnostics of Isolated Diastolic Dysfunction: Correlation With Echocardiographic and Invasive Measurements. Eur Heart J. 2005;26(21):2277-84. PubMed PMID: 16014646.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements. AU - Tschöpe,Carsten, AU - Kasner,Mario, AU - Westermann,Dirk, AU - Gaub,Regina, AU - Poller,Wolfgang C, AU - Schultheiss,Heinz-Peter, Y1 - 2005/07/13/ PY - 2005/7/15/pubmed PY - 2006/5/13/medline PY - 2005/7/15/entrez SP - 2277 EP - 84 JF - European heart journal JO - Eur Heart J VL - 26 IS - 21 N2 - 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) (> or =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=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. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/16014646/The_role_of_NT_proBNP_in_the_diagnostics_of_isolated_diastolic_dysfunction:_correlation_with_echocardiographic_and_invasive_measurements_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehi406 DB - PRIME DP - Unbound Medicine ER -