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Correlation between brain natriuretic peptide levels and the prognosis of patients with left ventricular diastolic
Hui Gong1, Xin Wang2, Yi-Jun Shi2
1Department of Internal Medicine, Division of Cardiology, Huashan Hospital of Fudan University, Shanghai 200040, P.R. China.
Insights
Elevated brain natriuretic peptide (BNP) levels indicate a worse prognosis in cardiovascular disease patients with left ventricular diastolic dysfunction. Higher BNP levels correlate with increased mortality and shorter survival times, suggesting BNP as a predictive biomarker.
Area of Science:
- Cardiology
- Biomarkers
- Prognostic Indicators
Background:
- Left ventricular (LV) diastolic dysfunction is a common complication in cardiovascular disease.
- Brain natriuretic peptide (BNP) is a hormone released in response to cardiac stress.
- The prognostic value of BNP in patients with LV diastolic dysfunction requires further investigation.
Purpose of the Study:
- To investigate the association between brain natriuretic peptide (BNP) levels and prognosis in patients with left ventricular (LV) diastolic dysfunction.
- To determine if BNP can serve as a predictive biomarker for cardiovascular disease outcomes.
Main Methods:
- A cohort of 708 cardiovascular disease inpatients was analyzed.
- Patients were grouped based on initial BNP levels (≤80 pg/ml vs. >80 pg/ml).
- Follow-up occurred for 20-51 months, with endpoints including mortality and cardiovascular readmission. Echocardiography was performed on 677 patients.
Main Results:
- Patients with BNP >80 pg/ml had a significantly higher endpoint occurrence rate (26.28% vs. 16.14%) and shorter survival durations.
- A significant negative correlation between BNP levels and survival time was found in patients with LV diastolic dysfunction (E/A≤1).
- No significant correlation was observed in patients with normal LV diastolic function (E/A>1).
Conclusions:
- Elevated BNP levels are associated with a worse prognosis in cardiovascular disease patients.
- BNP levels demonstrate significant predictive value for prognosis specifically in patients with LV diastolic dysfunction.
- BNP may serve as a valuable biomarker for predicting outcomes in this patient population.
Abstract:
The present study aimed to investigate the association between brain natriuretic peptide (BNP) levels and the prognosis of patients with left ventricular (LV) diastolic dysfunction. A total of 708 inpatients with cardiovascular disease (mean age, 66 years; 395 males and 313 females) were grouped according to initial BNP and were followed-up for 20-51 months (average, 30.86 months) until endpoint events occurred. Endpoints were defined as mortality or readmission due to cardiovascular disease, or mortality due to any other reason. A total of 67 and 77 events were reported in the BNP ≤80 pg/ml and BNP >80 pg/ml groups, respectively. The occurrence rate of the endpoint was significantly higher in the BNP >80 pg/ml group, as compared with the BNP ≤80 pg/ml group (26.28 vs. 16.14%; relative risk=1.63). Furthermore, the durations of patient survival were significantly shorter in the BNP >80 pg/ml group, as compared with the BNP ≤80 pg/ml group (P=0.0006), and patient survival decreased as BNP levels rose (P=0.0074). Among the 708 patients, 677 underwent echocardiographic detection at the same time. No significant correlation was detected between BNP levels and survival time in 178 patients with normal LV diastolic function [mitral Doppler flow, early diastolic (E)/late diastolic (A)>1] (P=0.2165); whereas a negative correlation was determined in 499 patients with LVD dysfunction (E/A≤1) (Spearman's rho=-0.0899; P=0.0447). The prognoses of patients with elevated BNP levels were correspondingly worse in the present study and these correlations were demonstrated to be significant in patients with LV diastolic dysfunction. Therefore, BNP levels may be used to predict the prognosis of patients with cardiovascular disease.
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