Serum NT pro-BNP: relation to systolic and diastolic function in cardiomyopathies and pericardiopathies.
BACKGROUND
NT pro-BNP is a marker of systolic and diastolic dysfunction.


OBJECTIVE
To determine NT pro-BNP levels in patients with chagasic, hypertrophic, and restrictive heart diseases, as well as with pericardial diseases, and their relation to echocardiographic measurements of systolic and diastolic dysfunction.


METHODS
A total of 145 patients were divided into the following groups: 1) Chagas' heart disease (CHD)--14 patients; 2) hypertrophic cardiomyopathy (HCM)--71 patients; 3) endomyocardial fibrosis (EMF)--26 patients; 4) pericardial effusion (PE)--18 patients; and 5) constrictive pericarditis (CP)--16 patients. The control group was comprised of 40 individuals with no heart disease. The degree of myocardial impairment and pericardial effusion were assessed by two-dimensional echocardiography and the degree of restriction by pulsed Doppler transmitral flow. The diagnosis of CP was confirmed through magnetic resonance imaging. NT pro-BNP levels were determined through electrochemiluminescence immunoassay.


RESULTS
NT pro-BNP was increased (p < 0.001) in CHD (median = 513.8 pg/ml), HCM (median = 848 pg/ml), EMF (median = 633 pg/ml), CP (median = 568 pg/ml), and PE (median = 124 pg/ml), when compared with the control group (median = 28 pg/ml). No statistically significant differences were found between CP and EMF (p = 0.14). In the hypertrophic group, NT pro-BNP was correlated with left atrial size (r = 0.40; p < 0.001) and with E/Ea ratio (p < 0.01). In the restrictive group, there was a trend of correlation with E-wave peak velocity (r = 0.439; p = 0.06).


CONCLUSIONS
NT pro-BNP is increased in the different cardiomyopathies and pericardial diseases and is correlated with the degree of systolic and diastolic dysfunction.
Mady
Charles
C
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. cmady@cardiol.br
Fernandes
Fábio
F
Arteaga
Edmundo
E
Ramires
Felix José Alvarez
FJ
Buck
Paula de Cássia
Pde C
Salemi
Vera Maria Cury
VM
Ianni
Barbara Maria
BM
Nastari
Luciano
L
Dias
Ricardo Ribeiro
RR
D000328:Adult; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000097:blood / Q000175:diagnosis*; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000503:physiopathology; D002313:Cardiomyopathy, Restrictive / Q000175:diagnosis / Q000503:physiopathology; D016022:Case-Control Studies; D002598:Chagas Cardiomyopathy / Q000175:diagnosis / Q000503:physiopathology; D003971:Diastole / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood* / Q000502:physiology; D010446:Peptide Fragments / Q000097:blood* / Q000502:physiology; D010490:Pericardial Effusion / Q000175:diagnosis / Q000503:physiopathology; D010494:Pericarditis, Constrictive / Q000097:blood / Q000175:diagnosis*; D010496:Pericardium / Q000000981:diagnostic imaging; D011446:Prospective Studies; D013599:Systole; D014463:Ultrasonography; D018754:Ventricular Dysfunction / Q000175:diagnosis* / Q000503:physiopathology
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain