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Updated: Aug 5, 2026
Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
Published on: February 20, 2017
Left ventricular dimension as an independent factor associated with amino-terminal pro-brain natriuretic peptide
Julio Núñez1, Josep Lupón2, Freya Sophie Jenkins3
1Cardiology Department, Hospital Clínico Universitario, INCLIVA, Valencia, Spain; Department of Medicine, Universitat de Valencia, Valencia, Spain; CIBER Cardiovascular, Madrid, Spain.
Background:
The specific contribution of left ventricular chamber dimensions to amino-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations in heart failure remains underexplored. We evaluated the association between left ventricular end-diastolic diameter (LVEDD) and circulating NT-proBNP levels across the spectrum of acute and chronic heart failure.
Methods:
We conducted a multicenter retrospective analysis of 8,361 patients (4,374 with acute heart failure and 3,987 with chronic heart failure) from four independent cohorts. NT-proBNP levels and echocardiographic measurements were collected during hospitalization or ambulatory visits. Quantile regression models were used to assess the independent association between LVEDD and NT-proBNP.
Results:
Larger LVEDD was consistently associated with higher NT-proBNP concentrations across the four heart failure cohorts (P < 0.05). This direct linear relationship persisted after multivariable adjustment and across left ventricular ejection fraction categories. A 10 mm increase in LVEDD was associated with an increase in NT-proBNP of 444 pg/mL (95% CI: 266-623, P < 0.001) at admission in the acute heart failure derivation cohort of 158 pg/ml (95% CI: 10-305, P = 0.036) in the chronic heart failure derivation cohort. In the subset of patients in which CMR was performed, CMR-iLVEDV was also positive and linearly associated with NT-proBNP levels. For each 10 ml/m2 increase, NT-proBNP on admission increased by 290 pg/ml (95% CI: 122-458, P < 0.001). Conversely, patients with smaller left ventricular chambers consistently exhibited lower NT-proBNP concentrations.
Conclusions:
Left ventricular chamber size is an independent factor associated with NT-proBNP levels in both acute and chronic heart failure. These findings underscore the importance of incorporating left ventricular dimensions into the interpretation of natriuretic peptide concentrations.
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