Association between brain natriuretic peptide and invasive hemodynamics in left ventricular assist device...

We report a serum BNP cut-off of 800 pg/mL above which all patients with LVAD HeartMate-3 had elevated biventricular filling pressures, suggesting it may be used to prompt invasive ramp study during routine post-LVAD clinic visit. We found stepwise increase in BNP levels across hemodynamic groups, with the lowest levels in patients with normal filling pressures, intermediate in those with elevated right or left-sided filling pressure and highest in those with elevated biventricular filling pressures. Furthermore, most patients with BNP above median value (335 pg/mL) required speed changes for either elevated right sided or left sided filling pressures. Conversely, patients with BNP below 335 pg/mL rarely required speed change. In conclusion, elevated serum BNP in patients with durable LVAD HeartMate-3 may have clinical value in prompting invasive hemodynamic assessment.