title: N-terminal pro B-type natriuretic peptide levels: correlation with echocardiographically determined left ventricular diastolic function in an ambulatory cohort.
abstract: OBJECTIVE
  To investigate the correlations of plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) levels with echocardiographic measurements of left ventricular (LV) systolic and/or diastolic function.
  
  
  BACKGROUND
  Plasma levels of NT-proBNP are increased in heart failure. The extent to which NT-proBNP levels increase in LV diastolic dysfunction has not been well characterized.
  
  
  METHODS
  Plasma NT-proBNP levels were measured in 191 consecutive, clinically stable, ambulatory patients. Echocardiography was used to determine LV systolic (LV ejection fraction [LVEF]) and diastolic function by mitral E wave to Doppler tissue early diastolic lateral annulus velocity ratio (E/Em). Patients with a history, physical findings, and/or echocardiographic evidence of cardiovascular disease (n = 148) were grouped as: (1) normal LV systolic function (LVEF > or = 55%, n = 81); and (2) LV systolic dysfunction (LVEF < 55%, n = 67). They were compared to a group of healthy control subjects (n = 43). Multivariate regression analyses were used to determine significant correlations with plasma NT-proBNP levels.
  
  
  RESULTS
  NT-proBNP levels correlated negatively with LVEF (P < .001) and positively with E/Em (P = .001). Multivariate regression analysis demonstrated a significant correlation of NT-proBNP levels with LVEF (P < .001) and E/Em (P = .03).
  
  
  CONCLUSIONS
  In this clinically stable, ambulatory cohort of patients with cardiovascular disease and healthy control subjects, plasma NT-proBNP levels were significantly higher in those with LV systolic dysfunction and/or elevated filling pressures, independent of the effects of LV mass, renal function, and age. These results suggest that NT-proBNP levels may be a useful adjunct in the characterization of patients presenting with history and/or symptoms compatible with LV systolic and/or diastolic dysfunction.
authors.affiliation: Cardiovascular Imaging and Clinical Research Core Laboratory, Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri 63110, USA.
authors.forename: Sheng-Jing
authors.initials: SJ
authors.lastname: Dong
authors.forename: Lisa
authors.initials: L
authors.lastname: de las Fuentes
authors.forename: Angela L
authors.initials: AL
authors.lastname: Brown
authors.forename: Alan D
authors.initials: AD
authors.lastname: Waggoner
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Ewald
authors.forename: Víctor G
authors.initials: VG
authors.lastname: Dávila-Román
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014861:Washington / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain