The Amino-terminal Precursor Of Brain Natriuretic Peptide And Left Ventricular Diastolic Function Studies

AIM:To investigate the relationship between N-terminal pro-brain natriuretic peptide(NT-proBNP) and left ventricular diastolic function.METHODS:①Fifty-three patients with isolated diastolic dysfunction and preserved left ventricular ejection fraction and thirty-four patients with regular left ventricular function as normal control were examined by conventional echocardiography, tissue Doppler imaging,and left heart catheterization.②All the subjects were studied via electrochemical radiation to test NT-proBNP levels;Echocardiogram,tissue Doppler imaging and left heart catheterization were applied to detect the parameters to reflect left ventricular diastolic function;the correlation of NT-proBNP levels and the diastolic function parameters was also analyzed.RESULTS:①NT-proBNP plasma levels were elevated[1064.01±589.85pg/ml (22.32-45.69pg/ml) vs.61.79±45.76pg/ml(6.84-132.2pg/ml);p＜0.001]and increased with greater severity of the diastolic dysfunction(R=0.71,p＜0.001).②Left ventricular end-diastolic pressure(area under the curve(AUC) 0.82) was the most specific parameter, which had a low sensitivity(73%),however.The reliability of NT-proBNP was similar to tissue Doppler imaging indices(AUC 0.76vs.0.77) and improved when compared with conventional echocardiography(AUC 0.60-0.75).NT-proBNP levels had the best negative predictive value of all methods(93%) and correlated strongly with indices of left ventricular end-diastolic pressure(R=0.48,p＜0.001),as determined by invasive measurements.Multivariable linear regression analysis confirmed NT-proBNP as an independent predictor of diastolic dysfunction with an Odds ratio of 1.237(1.019-1.427, CI 95%).CONCLUSIO:NT-proBNP can reliably detect the presence of isolated diastolic dysfunction in symptomatic patients.