NT-proBNP levels and diastolic dysfunction in beta-thalassaemia major patients.
BACKGROUND
The early diagnosis and treatment of heart failure in beta-thalassaemic patients is related to survival. Iron alone or in combination with other factors causes diastolic dysfunction, which usually precedes systolic dysfunction. NT-proBNP is a sensitive biomarker of ventricular dysfunction.


OBJECTIVE
To evaluate NT-proBNP in non heart failure beta-thalassaemic patients.


METHODS
Fifty-two beta-thalassaemia major patients (mean age: 27.2+/-12.5 years) with normal LV systolic function, underwent NT-proBNP measurement and a thorough Doppler-echocardiographic and pulsed tissue-Doppler study, 4 days following blood transfusion. Fifty-two age matched healthy controls were also studied.


RESULTS
NT-proBNP and E/E' ratio were increased in thalassaemic patients compared with controls [(469+/-171 vs 262+/-51 pmol/l, p<0.001) and (10.8+/-4.0 vs 6.6+/-1.1, p<0.001)] and were well correlated (r: 0.54, p<0.01). Although NT-proBNP levels were increased in patients with higher E/E' ratios (E/E' <8: 354+/-119, 8-15: 516+/-177, >15: 565+/-114 pmol/l, ANOVA p: 0.002) this increase only became statistically significant in the 3rd decade of life, while E/E' ratio increased in the 4th decade.


CONCLUSIONS
NT-proBNP increases in beta-thalassaemia major patients and is related to age and LV diastolic dysfunction. NT-proBNP appears to be an early biomarker of LV diastolic dysfunction, compared with the conventional Echo-Doppler indexes.
Kremastinos
Dimitrios Th
DT
2nd University Department of Cardiology, Attikon General Hospital, Athens, Greece.
Tsiapras
Dimitrios P
DP
Kostopoulou
Anna G
AG
Hamodraka
Eftihia S
ES
Chaidaroglou
Antigoni S
AS
Kapsali
Evangelia D
ED
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D005293:Ferritins / Q000097:blood; D006115:Greece; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015588:Observer Variation; D010446:Peptide Fragments / Q000097:blood*; D012107:Research Design; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D017725:Ventricular Pressure; D017086:beta-Thalassemia / Q000097:blood* / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*
D015415:Biomarkers; D006454:Hemoglobins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D005293:Ferritins