N-terminal-probrain natriuretic peptide and echocardiography in patients with systolic heart failure.
OBJECTIVE
To compare plasma N-terminal-probrain natriuretic peptide (NT-proBNP) levels with echocardiographic data in patients with systolic heart failure.


METHODS
The study included 101 patients with systolic heart failure admitted to Al-Assad and Al-Moussa Hospitals, Damascus, Syria over a 10-month period from February 2004 to January 2005. The findings of the physical examination, electrocardiogram and blood pressure measurement were recorded along with the patient's history, risk factors, and drug treatment. We divided the patients into 4 groups according to the New York Heart Association classifications; class I=19, class II=22, class III=28, class IV=32 patients. We compared the values with 21 age-matched controls with no heart diseases (age range 49-80 years). During the study period, we carried out the plasma NT-proBNP levels and echocardiography of all patients and controls group. We used electroche-miluminescence immunoassay in measuring plasma NT-proBNP. Authorized physicians evaluated the ejection fraction (EF), systolic pulmonary pressure, and left ventricular end systolic diameter. Statistical analysis used was T-Distribution, and the difference considered to be significant at p<0.05.


RESULTS
The plasma NT-proBNP levels in patients of asymptomatic heart failure class I (mean 1,038 pg/ml) were significantly higher (p<0.001) as compared with the controls (40.9 pg/ml), and it increased directly with the severity of heart failure. Plasma NT-proBNP levels were conversely correlated with the ejection fraction EF (r= -0.56, p<0.001) and it increased as the EF declined. There was a significant direct linear correlation between plasma NT-proBNP levels and the left ventricular end systolic diameter (r=0.57) and systolic pulmonary pressure r=0.54.


CONCLUSIONS
The left ventricle releases the B-type natriuretic peptide in response to volume or pressure overload, its high level reflects the poor cardiac systolic function, which corresponds with the echocardiographic data.
Al-Meslmani
Bssam M
BM
Department of Biochemistry, Pharmacy Faculty, Department of Cardiology, Al-Assad Hospital, Damascus University, Damascus, Syria. bssam_almeslmani@yahoo.com
Fahoum
Sahar K
SK
Shamia
Marwan G
MG
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011336:Probability; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D013593:Syria / Q000453:epidemiology; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain