NT-proB natriuretic peptide, risk factors and asymptomatic left ventricular dysfunction: results of the SCReening Evaluation of the Evolution of New Heart Failure study (SCREEN-HF).
BACKGROUND
We assessed left ventricular dysfunction in a population at high risk for heart failure (HF), and explored associations between ventricular function, HF risk factors and NT-proB natriuretic peptide (NT-proBNP).


RESULTS
3550 subjects at high risk for incident HF (≥60 years plus ≥1 HF risk factor), but without pre-existing HF or left ventricular dysfunction, were recruited. Anthropomorphic data, medical history and blood for NT-proBNP were collected. Participants at highest risk (n = 664) (NT-proBNP highest quintile; >30.0 pmol/L) and a sample (n = 51) from the lowest NT-proBNP quintile underwent echocardiography. Participants in the highest NT-proBNP quintile, compared to the lowest, were older (74 years vs. 67 years; p < 0.001) and more likely to have coronary artery disease, stroke or renal impairment. In the top NT-proBNP quintile (n = 664), left ventricular systolic impairment was observed in 6.6% (95% CI: 4 to 8%) of participants and was associated with male gender, coronary artery disease, hypertension and NT-proBNP. At least moderate diastolic dysfunction was observed in 24% (95% CI 20 to 27%) of participants and was associated with diabetes and NT-proBNP. In this high risk population, NT-proBNP was associated with left ventricular systolic impairment (p < 0.001) and moderate to severe diastolic dysfunction (p < 0.001) after adjustment for age, gender, coronary artery disease, diabetes, hypertension and obesity.


CONCLUSIONS
A high burden of ventricular dysfunction was observed in this high risk group. Combining NT-proBNP and HF risk factors may identify those with ventricular dysfunction. This would allow resources to be focused on those at greatest risk of progression to overt HF.
Monash Centre for Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Australia. Electronic address: michele.mcgrady@centralsydneycardiology.com.au.
Michele
M
McGrady
Christopher M
CM
Reid
Louise
L
Shiel
Rory
R
Wolfe
Umberto
U
Boffa
Danny
D
Liew
Duncan J
DJ
Campbell
David
D
Prior
Simon
S
Stewart
Henry
H
Krum
D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003971:Diastole / Q000235:genetics; D019143:Evolution, Molecular; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood* / Q000235:genetics; D010446:Peptide Fragments / Q000097:blood* / Q000235:genetics; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards; D013599:Systole / Q000235:genetics; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000453:epidemiology / Q000235:genetics
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
Asymptomatic left ventricular dysfunction; Epidemiology; Heart failure; NT-proBNP; Risk factors