NT-proBNP levels in the evaluation of right ventricular dysfunction in patients with coronary artery disease and abnormal left ventricular wall motion: a magnetic resonance imaging study

Abstract

Data available on the correlation of N-terminal probrain natriuretic peptide (NT-proBNP) levels and right ventricular (RV) function in patients with coronary artery disease (CAD) are limited. To determine the relation between plasma NT-proBNP and RV function in patients with CAD and abnormal left ventricular (LV) wall motion. This is a cross-sectional study. We studied 176 patients with CAD and abnormal LV wall motion. All patients underwent cardiac magnetic resonance imaging for the assessment of LV and RV function and plasma NT-proBNP analysis on the same day. Multivariable analysis was performed to evaluate the independent factors associated with RV dysfunction. Receiver-operating characteristic analysis was used to assess the use of NT-proBNP levels for the diagnosis of LV and RV dysfunction. Average LV ejection fraction (LVEF) and RV ejection fraction were 37.6 and 52.0%, respectively. Median levels of NT-proBNP were 978 pg/ml. Log NT-proBNP levels had a positive correlation with age, LV and RV volume, LV and RV mass, and had a negative correlation with body size, creatinine clearance, LVEF, and RV ejection fraction. From a multivariable analysis, log NT-proBNP levels and LVEF were independently associated with RV dysfunction. From receiver-operating characteristic analysis, NT-proBNP at the levels of 1706 and 378 pg/ml was shown to detect RV dysfunction and LV dysfunction at an accuracy of 80.7 and 77.8% and area under the curve of 0.837 and 0.765, respectively. NT-proBNP levels can be used to diagnose RV dysfunction in patients with CAD and abnormal LV wall motion.