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NT-proBNP levels, as predictor of left ventricular systolic and diastolic dysfunction in patients with chronic heart failure

Background: Heart failure (HF) is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. Diastolic and systolic heart failure are the two clinical subsets of the syndrome of heart failure (HF), Regardless of ejection fraction (EF) the severity of HF and its prognosis and degree of exercise intolerance are closely related to the degree of diastolic filling abnormalities. Echocardiography parameters and the amino-terminal pro-B-type natriuretic peptides ( NT-proBNPs) provide powerful incremental assessment of left ventricular (LV) diastolic and systolic functions.

Aim: The objective was to assess the correlation between echocardiographic parameters and plasma N-terminal pro brain natriuretic peptide (NT- proBNP) level in patient with systolic or diastolic dysfunction. Method: The study included 109 heart failure patients. They underwent conventional and tissue Doppler imaging (TDI) echocardiography and NT-proBNP level was measured at the same time.

Results: Significant correlations were found between NT-proBNP level and late diastolic mitral annulus velocity Am (r=-0.72, P=0.0001), systolic mitral annulus velocity Sm (r=-0.72, p=0.0001), early diastolic mitral annulus velocity Em (r =- 0.51, p=0.0001), early transmitral to Em velocity ratio (r=0.51, p= 0,0001), LV ejection fraction (r=-0.83, p=0.0001). In multiple regression, log NT-proBNP levels were independently related to age, LV ejection fraction, Am velocity and Em velocity (R2=0.78, P=0.0001), the relation to ejection fraction was the strongest (β= -0.56).

Conclusions: NT-proBNP levels correlate with echocardiographic parameters, and are simple, accurate markers of systolic and diastolic heart failure.

Author(s): Faida O., MBBS, MS, Said A., MT, Samir P., MBBS, D. Car., Oteh M. MBBCh, MRCP, A. Latif M., MD,MRCP, PhD, and Fadilah A., MD, PhD

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