Relationship between NT Pro-BNP values and ejection fraction in hipertensive patients with chronic heart failure

Introduction: Diagnosis of heart failure is hard to es-tablish early because symptoms such as dyspnea, fati-gue, and swollen edema are quite unspecific and more difficult in hypertensive individuals. Although, recent studies have reported the correlation of serum levels of natriuretic type B peptide (NT-proBNP) with the seve-rity of left ventricular dysfunction, it is unclear whether it is associated with the ejection fraction value.

Objective: To analyses the correlation between serum levels of NT- proBNP and ejection fraction value, in hypertensive patients with chronic heart failure.

Methods: 357 (men 45.2%) hypertensive patients with NYHA II-IV heart failure were included in the study. The clinical and paraclinical approach was performed in accordance with the European Guidelines. The pati-ents were divided into tree groups based on left ventri-cle ejection fraction (LVEF) values: group I – patients with preserved LVEF, considered as ≥50%; group III patients with mid-range, „grey area“ LVEF 40–49% and group III – patients with reduced LVEF, termed as <40%. Cut-off values of NT-proBNP based on age and absence of chronic renal disease were: <50 years: NT-proBNP >450 pg/mL; 50-75 years: NT-proBNP> 900 pg/mL; >75 years: NT-proBNP >1800 pg/mL.

Results: Most of the hypertensive patients with pre-served LVEF (81.7% of cases) had NT-proBNP value 1824.5 ± 48.5 pg/ml, but patients with low LVEF (10.8% of cases) had the NT-proBNP higher than that in lot I (3704.3 ± 58.3 pg/ml, p≤0.01). The NT-proBNP value in patients in group III (7.5% of cases) was intermedi-ate (2921.4 ± 68.2 pg/ml). A significant difference was found between left ventricular telediastolic diameters of patients in groups I, II, III (51.2 ± 14.4 vs. 55.7 ± 12.2 vs. 59.5 ± 9.2 mm and p≤0.05 respectively). Compared to preserved LVEF, patients with redused LVEF were older (67.2 vs. 61.1ys, p≤0.05), more often women (64.4 vs. 25.3%, p≤0.001) with a history of hypertension and myocardial infarction (24.2 vs. 2.1%, p≤0.05).

Conclusions: Values of type B natriuretic peptide in NYHA II-IV hypertensive patients increase with age and have a negative correlation with the left ventricular ejection fraction.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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