Application of BNP and NT-proBNP in diagnosis of diastolic heart failure

Abstract

Objective To investigate the plasma levels of BNP and NT-proBNP in patients with chronic heart failure(CHF),and to evaluate the capabilities of them to discriminate diastolic heart failure(DHF)from systolic heart failure(SHF).Methods One hundred and twenty nine patients with DHF and109 patients with SHF were subjected to plasma BNP and NT-proBNP determination in Beijing PLA general hospital from the year of 2004 to 2006.The factors influencing the levels of BNP and NT-proBNP were analyzed through the comparison with results from 77 age and gender-matched healthy volunteers.ROC was used to evaluate the mles of BNP and NT-proBNP in the diagnosis of Diastolic heart failure.Results Compared with the controls.plasma BNP and NT-proBNP concentrations were upregulated significantly in DHF and SHF patients,with the median of 254.16 ng/L and 899 ng/L in DHF and 923.08 ng/L and 3 695 ng/L in SHF respectively.The increase extent of BNP and NT-proBNP was exclusively related to NYHA classification of heart function(β=0.201 and 0.323 respectively,P<0.001).BNP and NT-proBNP showed AUCs of 0.906(95% CI: 0.865-0.946)and 0.956(95% CI:0.932-0.980)respectively for diagnosis of CHF.BNP and NT-proBNP showed AUCs of 0.781(95% CI: 0.710-0.815)and 0.757(95% CI: 0.686-0.828)respectively for diagnosis of DHF and SHF.Conclusions BNP and NT-proBNP are upregnlated significantly in CHF patients and associated with the NYHA classification significantly and exclusively.BNP and NT-proBNP can be used to identify CHF rather than DHF. Key words: Heart failure,diastolic; Natriuretic peptide,brain; Peptide fragments; Stroke volume