title: N-terminal B-type natriuretic peptide and the association with left ventricular diastolic function in a population at high risk of incident heart failure: results of the SCReening Evaluationof the Evolution of New-Heart Failure Study (SCREEN-HF).
abstract: OBJECTIVE
  Impaired diastolic function is associated with increased morbidity and mortality, but antecedents and predictors of progression to heart failure (HF) are not well understood. We examined associations between NT-proBNP, HF risk factors, and diastolic function in a population at high risk for incident HF.
  
  
  RESULTS
  A total of 3550 subjects at high risk for incident HF (≥60 years plus ≥1 HF risk factor), but without pre-existing HF or LV dysfunction were recruited. Participants at highest risk (n = 664) (NT-proBNP in the highest quintile >254 pg/mL) underwent echocardiography. Moderate or severe diastolic dysfunction was observed in 25% [95% confidence interval (CI) 21-29%] of participants. Age (P = 0.001), male gender (P = 0.03), diabetes (P = 0.03), and NT-proBNP (P = 0.002) were associated with severity of diastolic dysfunction after adjustment for HF risk factors and LVEF. In regression analysis, log-transformed NT-proBNP was also associated with LV mass index (P = 0.05), left atrial size (P < 0.0001), and Doppler ratio of the mitral valve E/e' (P = 0.001). Multiple HF risk factors were present in the majority of participants (>70%), but no association was observed between diastolic dysfunction and the number of risk factors reported (P = 0.3).
  
  
  CONCLUSIONS
  Diastolic dysfunction was observed in one in four of these high risk subjects (≥ 60 years, HF risk factor, NT-proBNP >254 pg/mL). NT-proBNP, age and diabetes were strongly associated with severity of diastolic dysfunction, whereas other HF risk factors and LVEF were not. More targeted surveillance using a combination of risk factors and biomarkers may improve identification of those at great risk of incident HF.
authors: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. michele.mcgrady@centralsydneycardiology.com.au
authors: Michele
authors: M
authors: McGrady
authors: Christopher M
authors: CM
authors: Reid
authors: Louise
authors: L
authors: Shiel
authors: Rory
authors: R
authors: Wolfe
authors: Umberto
authors: U
authors: Boffa
authors: Danny
authors: D
authors: Liew
authors: Duncan J
authors: DJ
authors: Campbell
authors: David
authors: D
authors: Prior
authors: Henry
authors: H
authors: Krum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003971:Diastole / Q000502:physiology*; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000503:physiopathology; D020257:Ventricular Remodeling / Q000502:physiology
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain