Plasma Levels of N-terminal pro-brain Natriuretic Peptide (NT-proBNP) and Left Ventricular Function in Patients with Chronic Renal Failure.
- Author:
So Yeon CHOI
1
;
Jung Ah KIM
;
Jung Eun LEE
;
Yeon Sil DO
;
Eun Hee JANG
;
Hyun Jeong BAE
;
Jung In KIM
;
Jung Ho DO
;
Sung Chul CHOI
;
Dae Joong KIM
;
Wooseong HUH
;
Ha Young OH
;
Seung Woo PARK
;
Eunseok JEON
;
Chang Seok KI
;
Yoon Goo KIM
Author Information
1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea. yoongoo.kim@samsung.com
- Publication Type:Original Article
- Keywords:
CRF;
Left ventricular function;
NT-proBNP
- MeSH:
Echocardiography;
Heart Diseases;
Humans;
Hypertrophy, Left Ventricular;
Kidney Failure, Chronic*;
Plasma*;
ROC Curve;
Ventricular Dysfunction, Left;
Ventricular Function, Left*
- From:Korean Journal of Nephrology
2006;25(3):413-421
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Circulating levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) have been used to identify and monitor myocardial dysfunction in patients with various cardiac diseases. However, its clinical significance in patients with chronic renal failure (CRF) is uncertain because NT-proBNP clearance may be affected by renal function. METHODS: We studied 331 patients with CRF (eGFR <60 mL/min/1.73m2) admitted to Samsung Medical Center between March 2003 and March 2005, in whom both NT-proBNP measurement and echocardiography were performed within a week. RESULTS: Mean value of eGFR was 29+/-15 mL/ min/1.73m2 and median value of NT-proBNP was 6,971 pg/mL. NT-proBNP levels increased with declining eGFR (p<0.05). NT-proBNP levels were also elevated in patients with left ventricular hypertrophy (LVH), systolic dysfunction and diastolic dysfunction. In multiple regression analysis, ejection fraction (beta=-0.373, p>0.01) was strong independent correlate of NT-proBNP, eGFR (beta=-0.358, p<0.01), left ventricular mass index (beta=0.126, p>0.01) and diastolic dysfunction 2 or higher (beta=0.171, p< 0.05) were also independent correlates of NT-proBNP. Receiver-operating characteristic (ROC) analyses demonstrated NT-proBNP to be 75% sensitive and 76% specific for the detection of left ventricular systolic dysfunction, as indicated by area under the ROC curve of 0.78 (p<0.05), with NT-proBNP cutoff concentration of 25,000 pg/mL. CONCLUSION: Circulating NT-proBNP levels increased with declining renal function. However, its level were significantly correlated with LVH, systolic and diastolic dysfunction in patients with CRF. The measurement of NT-proBNP levels might be useful to predict left ventricular dysfunction in patients with CRF.
