title: The detection of left ventricular diastolic dysfunction in hypertensive patients: Performance of N-terminal probrain natriuretic peptide.
abstract: OBJECTIVE
  Diastolic dysfunction (DD) results in increased cardiovascular risk in hypertensives. We studied the performance of N-terminal probrain natriuretic peptide (NT-proBNP) in detecting DD.
  
  
  METHODS
  241 hypertensive patients admitted to cardiology polyclinics were included in this study. They were grouped according to the presence of DD. Group 1: Essential hypertensive patients without DD (n= 119); group 2: essential hypertensive patients with DD (n= 122). All underwent trans-thoracic echocardiography for the evaluation of transvalvular flow, morphology, left ventricular wall motion abnormalities and ejection fraction. NT-proBNP levels were measured by an electrochemiluminescence immunoassay.
  
  
  RESULTS
  The systolic blood pressure (BP) (mean+/-SD) was 140+/-12 mmHg in group 1 and 144+/-16 mmHg in group 2 (p=0.049), the diastolic BP (mean+/-SD) was 88+/-10 mmHg in group 1 and 90+/-14 mmHg in group 2 (p=0.043). The median (1st-3rd quartile) NT-proBNP level in group 2 was significantly higher than group 1 [121.05 (61.03-207.66) and 31.17 (17.07-54.09) pg/ml, respectively (p<0.001)]. In the receiver operating characteristics analysis, the area under the curve was 0.862 (95% CI 0.816-0.908). At the cut-off of 45 pg/ml, sensitivity was 86.9%, specificity was 62.4%, and at the cut-off 65 pg/ml, sensitivity was 74.6%, specificity was 83.8%.
  
  
  CONCLUSIONS
  Plasma NT-proBNP levels may be useful for identifying patients with DD and it is conceivable to use a cut-off level 65 pg/ml as a "rule in" test.
authors.affiliation: Department of Clinical Biochemistry, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey. burcu.barutcuoglu@ege.edu.tr
authors.forename: Burcu
authors.initials: B
authors.lastname: Barutçuoglu
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Parildar
authors.forename: Güneş
authors.initials: G
authors.lastname: Başol
authors.forename: Cemil
authors.initials: C
authors.lastname: Gürgün
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Tekin
authors.forename: Oya
authors.initials: O
authors.lastname: Bayindir
mesh_terms: D003971:Diastole; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000175:diagnosis* / Q000000981:diagnostic imaging
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain