title: Elevated NT-ProBNP levels in patients with increased left ventricular filling pressure during exercise despite preserved systolic function.
abstract: BACKGROUND
  The role of brain natriuretic peptides in the detection of mild forms of isolated diastolic dysfunction is still uncertain. We therefore investigated the plasma levels of the N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with heart failure symptoms during exercise, despite preserved systolic cardiac function.
  
  
  RESULTS
  Fifteen control subjects and 15 symptomatic patients with preserved left ventricular ejection fraction of > or =50%, near normal Doppler echocardiographic indices, and left and right heart catheter indices at rest but increased filling pressures during exercise were studied. Plasma NT-proBNP levels and surrogate parameters of diastolic function were determined simultaneously. The median NT-proBNP plasma level was elevated (median, 145.2 pg/mL [range, 69.7-273.4 pg/mL] vs 38.3 pg/mL [range, 22.1-64.7 pg/ml]; P < .0001) in patients with increased filling pressure during exercise and correlated strongly with the pulmonary capillary wedge pressure (r = 0.78; P < .001).
  
  
  CONCLUSIONS
  NT-proBNP levels are increased in patients with increased filling pressures during exercise and useful for the detection of diastolic dysfunction in patients with exertional dyspnea.
authors.affiliation: Department of Cardiology and Pneumology, Charité-University Medicine Berlin, Campus Benjamin Franklin, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Tschöpe
authors.forename: Mario
authors.initials: M
authors.lastname: Kasner
authors.forename: Dirk
authors.initials: D
authors.lastname: Westermann
authors.forename: Thomas
authors.initials: T
authors.lastname: Walther
authors.forename: Regina
authors.initials: R
authors.lastname: Gaub
authors.forename: Wolfgang C
authors.initials: WC
authors.lastname: Poller
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Schultheiss
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D015444:Exercise / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012372:ROC Curve; D012044:Regression Analysis; D013599:Systole; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain