Value of echocardiography combined with brain natriuretic peptide or N-Terminal pro-BNP level in diastolic heart failure assessment

Tóm tắt

Background

Echocardiography and B-type natriuretic peptide are important diagnostic tools used in heart failure evaluation.This study aimed to evaluate combined clinical and echocardiographic parameters and B type natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP) in diastolic heart failure (DHF) evaluation.

Methods

 In this study, 167 patients with DHF (EF>40%) who visited our hospital from August to October 2021 were included. Plasma levels of BNP, serum levels of NT-pro BNP, and other parameters were measured, and echocardiography was used to examine left ventricular function.

Results

Age; 74.3±13.5 years, BMI; 24.2 ± 14.1 kg/m², men/women; 91 (54.5%) /76(45.5%), NYHA I/II/III//IV; 115 (68.9%)/ 37(22.2%)/ 10(6.0%)/ 5(3.0%), hypertension; 117 (70.0%), DM; 48 (28.7%), AF; 44(26.3%), BNP; 106.8±194.8pg/mL, log BNP; 1.653±0.548, NT-pro BNP; 1500.7±3388.9 pg/mL, log NT-pro BNP, hemoglobin; 12.2±2.0 g/dL, albumin; 3.7±0.7 g/dL, eGFR; 58.7±20.9 mL/min/1.73m², LVEF; 64.3±8.4%, left atrial volume index (LAVI); 39.1±17.4 mL/m², E/e’; 12.9±6.6, estimated systolic pulmonary artery pressure; 29.7±12.1, E/A; 0.86±0.41, and estimated left ventricular endo-diastolic pressure; 9.5±3.0mmHg.

Though one-way analysis of variance (ANOVA) detected significant LVEF differences between the NYHA sub groups (only NYHA I vs II and V, p <0.02, 0.001 respectively.), it detected significant log BNP and log NTpro-BNP differences between NYHA sub groups (NYHS I vs II and III, V, II vs III and IV, p <0.0001).

Multivariate regression analysis showed log BNP=1.828+0.353×LAVI-0.350× albumin+0.280E/e’+0.241×AF.

Log NT-proBNP=4.044-0.501× albumin + 0.325 × LAVI -0.226 × eGFR + 0.227 × E/e’.

Conclusion

The model including BNP, NH-proBNP, LAVI, E/e’, serum albumin levels, and history of atrial fibrillation was highly predictive on severity of DHF.