Correlation between levels of N-terminal pro-B-type natriuretic peptide and degrees of heart failure.
BACKGROUND
The N-terminal fragment of pro Brain Natriuretic Peptide (NT-pro BNP) is a neuro-hormone synthesized in the cardiac ventricles in response to increased wall tension. The purpose of this study was to assess the correlation between the NT-pro BNP levels and the New York Heart Association function class (NYHA Fc) of dyspnea and echocardiographic findings for the patients who visited our cardiology departments.


METHODS
From October, 2002 to April, 2003, serum NT-pro BNP levels were measured in 348 patients who visited the Samsung Medical Center and the Jong Koo Lee Heart Clinic.


RESULTS
The NT-pro BNP levels were increased with the progression of NYHA Fc of dyspnea (p < 0.001 by ANOVA), the increase in the systolic left ventricular internal dimension (p < 0.05), and the decrease in the ejection fraction (p < 0.01). For the NYHA Fc I patients, the NT-pro BNP levels were positively correlated with age (0 < 0.001) and left atrial size (p < 0.001). For the patients with ischemic heart disease, the NT-pro BNP levels were also positively correlated with the NYHA Fc (p < 0.001 by ANOVA). The NT-pro BNP levels were increased with the increase in the systolic (p < 0.001) and diastolic pressure (p = 0.017), the left ventricular internal dimension as well as the decrease in the ejection fraction (p < 0.001). The area under the receiver operating characteristic (ROC) curve for the NT-pro BNP levels was 0.994 (95% confidence interval, 0.979-0.999), and the most reliable cut-off level for the NT-pro BNP was 293.6 pg/mL.


CONCLUSIONS
The NT-pro BNP levels were positively correlated with the NYHA Fc of dyspnea and the systolic dysfunction for the patients who visited our cardiology departments. A 300 pg/mL value for the NT-pro BNP cut-off point appears to be a sensitive level to differentiate dyspnea originating from an ailing heart or not for the patients who visited our cardiology departments.
Song
Bong Geun
BG
Department of Internal Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Cardiac and Vascular Center and Laboratory Medicine, Seoul, Korea.
Jeon
Eun Seok
ES
Kim
Yong Hoon
YH
Kang
Min Kyung
MK
Doh
Joon Hyung
JH
Kim
Phil Ho
PH
Ahn
Seok Jin
SJ
Oh
Hye Lim
HL
Kim
Hyun-Joong
HJ
Sung
Ji Dong
JD
Lee
Sang Chol
SC
Gwon
Hyeon Cheol
HC
Kim
June Soo
JS
Kim
Duk-Kyung
DK
Lee
Sang Hoon
SH
Hong
Kyung Pyo
KP
Park
Jeong Euy
JE
Lee
Soo Youn
SY
Lee
Jong Koo
JK
D004417:Dyspnea / Q000503:physiopathology; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain; D009419:Nerve Tissue Proteins / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
D009419:Nerve Tissue Proteins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain