title: Plasma N-terminal pro-brain natriuretic peptide levels identifying left ventricular diastolic dysfunction in patients with preserved ejection fraction.
abstract: BACKGROUND
  Diagnosis of left ventricular (LV) diastolic dysfunction by blood testing is expedient in the clinical setting.
  
  
  RESULTS
  In 98 patients with LV ejection fraction ≥50% who underwent cardiac catheterization for evaluation of coronary artery disease, LV pressure (LVP) was measured using a catheter-tipped micromanometer. A time constant, τ, of LV relaxation was computed from LVP decay; the inertia force (IF) of late systolic aortic flow, a surrogate index of LV elastic recoil, was also computed from the LVP-dP/dt relation (phase loop). Patients were classified into 2 groups: those with impaired LV relaxation (τ ≥48 ms) and those with preserved LV relaxation (τ <48 ms). Patients were also classified into another 2 groups: those with IF (≥0.5 mmHg) and those without (<0.5 mmHg). Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) ≥56.5 pg/ml had a sensitivity of 100%, specificity of 52.5%, and negative predictive value of 100% for identifying impaired LV relaxation. NT-proBNP ≥244.5 pg/ml had a sensitivity of 62.5% and specificity of 93.9% for detecting lack of IF.
  
  
  CONCLUSIONS
  NT-proBNP level <56.5 pg/ml could be used as a value to sensitively identify patients with preserved LV systolic and diastolic function among those with coronary artery disease. NT-proBNP level ≥244.5 pg/ml is able to specifically detect a lack of IF and has potential for specifically diagnosing LV isolated diastolic dysfunction.
authors.affiliation: Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Sonoda
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohte
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Goto
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Wakami
authors.forename: Hidekatsu
authors.initials: H
authors.lastname: Fukuta
authors.forename: Shohei
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Tani
authors.forename: Genjiro
authors.initials: G
authors.lastname: Kimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D006328:Cardiac Catheterization; D003324:Coronary Artery Disease / Q000097:blood / Q000503:physiopathology; D003971:Diastole; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain