Utility of B-natriuretic peptide in the evaluation of left ventricular diastolic function and diastolic heart failure.
OBJECTIVE
Heart failure with preserved ejection fraction or diastolic heart failure is an increasingly prevalent disease process today. Natriuretic peptides have been shown to provide diagnostic and prognostic utility in patients with systolic heart failure. Here we review current publications exploring the relationship between B-natriuretic peptide (BNP) and diastolic dysfunction.


RESULTS
Investigators have found significant correlations between echocardiographic parameters for diastolic dysfunction and serum BNP levels in diagnosing diastolic heart failure. This relationship is linear with respect to severity of left ventricular dysfunction. Newer echocardiographic modalities like tissue Doppler imaging provide measures of elevated left ventricular filling pressures, which are associated with higher plasma BNP levels. Admission and predischarge BNP levels in patients with decompensated diastolic heart failure have been prognostic with respect to in-hospital mortality, short-term mortality, and hospital readmission.


CONCLUSIONS
Review of current literature shows that BNP can be useful in providing diagnostic and prognostic data in patients with symptomatic and asymptomatic diastolic dysfunction. These data, combined with other values such as echocardiographic indices and cardiovascular risk factors, can augment the sensitivity and specificity of BNP.
Parekh
Niraj
N
Department of Cardiology, Veterans Affairs Hospital, University of California at San Diego, San Diego, CA, USA.
Maisel
Alan S
AS
D015415:Biomarkers; D003971:Diastole; D004452:Echocardiography; D054144:Heart Failure, Diastolic / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D008403:Mass Screening; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D018487:Ventricular Dysfunction, Left / Q000097:blood*; D016277:Ventricular Function, Left
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain