Plasma N-Terminal Pro-Brain Natriuretic Peptide Levels Identifying Left Ventricular Diastolic Dysfunction in Patients With Preserved Ejection Fraction.
Circ J. 2012 Aug 7;
Authors: Sonoda H, Ohte N, Goto T, Wakami K, Fukuta H, Kikuchi S, Tani T, Kimura G
Background:?Diagnosis of left ventricular (LV) diastolic dysfunction by blood testing is expedient in the clinical setting. Methods and Results:?In 98 patients with LV ejection fraction ?50% who underwent cardiac catheterization for evaluation of coronary artery disease, LV pressure (LVP) was measured using a catheter-tipped micromanometer. A time constant, ?, of LV relaxation was computed from LVP decay; the inertia force (IF) of late systolic aortic flow, a surrogate index of LV elastic recoil, was also computed from the LVP-dP/dt relation (phase loop). Patients were classified into 2 groups: those with impaired LV relaxation (? ?48ms) and those with preserved LV relaxation (? <48ms). Patients were also classified into another 2 groups: those with IF (?0.5mmHg) and those without (<0.5mmHg). Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) ?56.5pg/ml had a sensitivity of 100%, specificity of 52.5%, and negative predictive value of 100% for identifying impaired LV relaxation. NT-proBNP ?244.5pg/ml had a sensitivity of 62.5% and specificity of 93.9% for detecting lack of IF. Conclusions:?NT-proBNP level <56.5pg/ml could be used as a value to sensitively identify patients with preserved LV systolic and diastolic function among those with coronary artery disease. NT-proBNP level ?244.5pg/ml is able to specifically detect a lack of IF and has potential for specifically diagnosing LV isolated diastolic dysfunction.
PMID: 22878353 [PubMed - as supplied by publisher]