title: Major increase in brain natriuretic peptide indicates right ventricular systolic dysfunction in patients with heart failure.
abstract: This study sought to investigate whether the presence of right ventricular systolic dysfunction with pre-existing left ventricular systolic dysfunction is associated with higher plasma brain natriuretic peptide (BNP) levels, compared with patients with isolated left ventricular dysfunction. Eighty-five patients referred for evaluation of isotopic ventricular function were prospectively included in the study. Left (LVEF) and right (RVEF) ventricular ejection fractions were evaluated by gated blood pool scintigraphy and compared with plasma BNP levels. BNP correlated negatively with LVEF, except in patients with ischaemic heart disease (P=0.09) and in patients with LVEF<40% (P=0.11). In contrast, BNP levels correlated negatively with RVEF for all subgroups. Among patients with RVEF<40%, no significant BNP difference was found between patients with or without additional left ventricular systolic dysfunction (P=0.51). Among patients with LVEF<40%, plasma BNP levels were significantly higher in patients with RVEF<40% than in patients with RVEF>/=40% (P=0.004) whereas age, renal function, clinical findings, ventricular volumes, LVEF or medication were not significantly different. In conclusion, an important increase in BNP levels in patients with left ventricular systolic dysfunction should be considered by cardiologists as an indication of high risk of right ventricular dysfunction and should justify further investigation.
authors.affiliation: Department of Nuclear Medicine, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34295 Cedex 5, Montpellier, France. d-mariano_goulart@chu-montpellier.fr
authors.forename: Denis
authors.initials: D
authors.lastname: Mariano-Goulart
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Eberlé
authors.forename: Vincent
authors.initials: V
authors.lastname: Boudousq
authors.forename: Azadeh
authors.initials: A
authors.lastname: Hejazi-Moughari
authors.forename: Christophe
authors.initials: C
authors.lastname: Piot
authors.forename: Charles
authors.initials: C
authors.lastname: Caderas de Kerleau
authors.forename: Régis
authors.initials: R
authors.lastname: Verdier
authors.forename: Marie-Luce
authors.initials: ML
authors.lastname: Barge
authors.forename: Frédéric
authors.initials: F
authors.lastname: Comte
authors.forename: Nicole
authors.initials: N
authors.lastname: Bressot
authors.forename: Michel
authors.initials: M
authors.lastname: Rossi
authors.forename: Pierre-Olivier
authors.initials: PO
authors.lastname: Kotzki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015637:Gated Blood-Pool Imaging; D006333:Heart Failure / Q000097:blood / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000097:blood / Q000503:physiopathology*
chemical_list: D020097:Natriuretic Peptide, Brain