TY - JOUR
T1 - N-terminal B-type natriuretic peptide and the association with left ventricular diastolic function in a population at high risk of incident heart failure: results of the SCReening Evaluationof the Evolution of New-Heart Failure Study (SCREEN-HF)
AU - McGrady, Michele
AU - Reid, Christopher Michael
AU - Shiel, Louise Mary
AU - Wolfe, Rory St John
AU - Boffa, Umberto
AU - Liew, Danny
AU - Campbell, Duncan J
AU - Prior, David
AU - Krum, Henry
PY - 2013
Y1 - 2013
N2 - Impaired diastolic function is associated with increased morbidity and mortality, but antecedents and predictors of
progression to heart failure (HF) are not well understood. We examined associations between NT-proBNP, HF
risk factors, and diastolic function in a population at high risk for incident HF.
Methods
and results
A total of 3550 subjects at high risk for incident HF (=60 years plus =1 HF risk factor), but without pre-existing
HF or LV dysfunction were recruited. Participants at highest risk (n ? 664) (NT-proBNP in the highest quintile
.254 pg/mL) underwent echocardiography. Moderate or severe diastolic dysfunction was observed in 25 [95
confidence interval (CI) 21?29 of participants. Age (P ? 0.001), male gender (P ? 0.03), diabetes (P ? 0.03),
and NT-proBNP (P ? 0.002) were associated with severity of diastolic dysfunction after adjustment for HF risk
factors and LVEF. In regression analysis, log-transformed NT-proBNP was also associated with LV mass index
(P ? 0.05), left atrial size (P , 0.0001), and Doppler ratio of the mitral valve E/e? (P ? 0.001). Multiple HF risk
factors were present in the majority of participants (.70 ), but no association was observed between diastolic
dysfunction and the number of risk factors reported (P ? 0.3).
Conclusion Diastolic dysfunction was observed in one in four of these high risk subjects (= 60 years, HF risk factor, NT-proBNP
.254 pg/mL). NT-proBNP, age and diabetes were strongly associated with severity of diastolic dysfunction, whereas
other HF risk factors and LVEF were not. More targeted surveillance using a combination of risk factors and biomarkers
may improve identification of those at great risk of incident HF
AB - Impaired diastolic function is associated with increased morbidity and mortality, but antecedents and predictors of
progression to heart failure (HF) are not well understood. We examined associations between NT-proBNP, HF
risk factors, and diastolic function in a population at high risk for incident HF.
Methods
and results
A total of 3550 subjects at high risk for incident HF (=60 years plus =1 HF risk factor), but without pre-existing
HF or LV dysfunction were recruited. Participants at highest risk (n ? 664) (NT-proBNP in the highest quintile
.254 pg/mL) underwent echocardiography. Moderate or severe diastolic dysfunction was observed in 25 [95
confidence interval (CI) 21?29 of participants. Age (P ? 0.001), male gender (P ? 0.03), diabetes (P ? 0.03),
and NT-proBNP (P ? 0.002) were associated with severity of diastolic dysfunction after adjustment for HF risk
factors and LVEF. In regression analysis, log-transformed NT-proBNP was also associated with LV mass index
(P ? 0.05), left atrial size (P , 0.0001), and Doppler ratio of the mitral valve E/e? (P ? 0.001). Multiple HF risk
factors were present in the majority of participants (.70 ), but no association was observed between diastolic
dysfunction and the number of risk factors reported (P ? 0.3).
Conclusion Diastolic dysfunction was observed in one in four of these high risk subjects (= 60 years, HF risk factor, NT-proBNP
.254 pg/mL). NT-proBNP, age and diabetes were strongly associated with severity of diastolic dysfunction, whereas
other HF risk factors and LVEF were not. More targeted surveillance using a combination of risk factors and biomarkers
may improve identification of those at great risk of incident HF
UR - http://eurjhf.oxfordjournals.org/content/15/5/573.full.pdf
U2 - 10.1093/eurjhf/hft001
DO - 10.1093/eurjhf/hft001
M3 - Article
VL - 15
SP - 573
EP - 580
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1388-9842
IS - 5
ER -