OBJECTIVE

Natriuretic peptides are increasingly used in clinical practice to diagnose myocardial dysfunction in heart failure (HF) with preserved ejection fraction (HFpEF). Recent studies indicate that plasma brain natriuretic peptide (BNP) may have a role in the diagnosis and management of HF. However, there is marked heterogeneity in BNP levels among subjects with HFpEF, which is only partially explained by differences in left ventricular (LV) dimensions or systolic function. This study aims to investigate if N-terminal proBNP (NT-proBNP) can be a useful tool to guide management in patients with HFpEF when echocardiography is not easily accessible.

N-terminal proBNP in patients admitted in Chong Hua Hospital from July 2019 to July 2020 was collected from the hospital laboratory. Data of patients with HF symptoms with preserved LV systolic function and other echocardiographic parameters were collected from the hospital records. The correlation between the different echocardiographic parameters and NT-proBNP was determined.

The NT-proBNP levels increased significantly in HFpEF as the values of left atrial volume index (P < 0.001), E/A ratio (P = 0.042), E/e′ (P < 0.001), and tricuspid regurgitation velocity (P < 0.001) increased. The mean NT-proBNP level was 5588 pg/mL. Highest levels were seen predominantly in diastolic dysfunction grade II.

Our findings indicate that NT-proBNP is positively correlated to echocardiographic parameters, namely, left atrial volume index, E/A ratio, E/e′, and tricuspid regurgitation velocity in patients with preserved LV systolic function.