gms | German Medical Science

28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

24. bis 27.11.2004, Hannover

Role of NTPro-BNP in the diagnostic of isolated diastolic dysfunction

Die Rolle von NT-Pro BNP in der Diagnostik der isolierten diastolischen Dysfunktion

Meeting Abstract (Hypertonie 2004)

  • C. Tschöpe - Charité-CBF (Berlin, D)
  • M. Kasner - Charité-CBF (Berlin, D)
  • D. Westermann - Charité-CBF (Berlin, D)
  • H. Schultheiss - Charité-CBF (Berlin, D)

Hypertonie 2004. 28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Hannover, 24.-27.11.2004. Düsseldorf, Köln: German Medical Science; 2005. Doc04hochP79

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hoch2004/04hoch079.shtml

Published: August 10, 2005

© 2005 Tschöpe et al.
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Outline

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Background: We investigated N-terminal pro-B type natriuretic peptide (NT-proBNP) in its effectiveness in the diagnostic of diastolic dysfunction compared to conventional and tissue Doppler echocardiography (TDI) and invasive heart catheterisation.

Methods: 88 patients with isolated diastolic dysfunction and preserved LVEF and 80 controls were examined by conventional echocardiography (transmitral inflow ratio (E/A), deceleration time (DT), isovolumic relaxation time (IVRT)), tissue Doppler (E`/Am`) and right/left heart catheterization (end-diastolic pressure (LVEDP), dP/dtmin, Tau, pulmonary wedge pressure (PCP)). Simultaneously plasma NT-proBNP levels (Elecsys 2010, Roche Diagnostics, Germany) were determined.

Results: Patients (56 men 41 w, 56 m) with diastolic dysfunction had significantly elevated NT-pro BNP levels compared to controls (214.72 [106.49-386.21] vs. 52.34 [31.98-74.35] pg/ml, p<0.0001). According to ROC analysis, the invasive parameters LVEDP and PCP were the most specific but with low sensitivity. Reliability of NT-proBNP was similar to TDI and higher compared to conventional echocardiography (AUC 0.86 vs. 0.73) and had the highest negative predictive value of all parameters (96%). NT-pro-BNP plasma levels also correlated with the echo-classes of diastolic dysfunction. Linear regressions analysis confirmed it to be a strong predictor of diastolic dysfunction with an Odds Ratio 9.75.

Conclusions: Neither of echocardiography method reaches the reliability of NT-proBNP in detecting isolated diastolic dysfunction. Thus, ProBNP serves as an accurate plasma biomarker to detect diastolic dysfunction within patients with previously estimated preserved systolic function.