Diagnostic and prognostic significance of plasma N-terminal-pro-brain natriuretic peptide in decompensated heart failure with preserved ejection fraction

Heart Lung Circ. 2008 Dec;17(6):497-501. doi: 10.1016/j.hlc.2008.06.001. Epub 2008 Aug 21.


Background: Preserved ventricular function is increasingly recognised in CHF. Although, NTpro-BNP is a well-established diagnostic marker in heart failure with impaired EF, its significance in heart failure with preserved EF is unclear. NT pro-BNP is secreted from the ventricular wall and plasma levels correlate to ventricular function. This study sought to determine the diagnostic and prognostic significance of plasma NTpro-BNP in patients with preserved EF heart failure.

Methods: We recruited 133 consecutive patients with decompensated HF. The primary end point was death or hospital readmission.

Results: Median (IQR) NTpro-BNP level at admission was elevated at 5043 ng/L (2693-10,784) and was significantly lower in preserved EF, 3569 ng/L (1707-6340) than in impaired EF, 6363 ng/L (3648-13,250) (P=0.001). Eight (6%) and 19 (14%) patients died after 1 and 6 months, respectively. In a regression analysis, worsening of NTpro-BNP levels after treatment was not predictive of mortality in heart failure with preserved EF (P=0.83). Levels at discharge correlated with readmission rates at 6 months in both groups, i.e. impaired (P=0.03) and preserved EF (P=0.02).

Conclusion: NTpro-BNP is a reliable diagnostic marker of decompensation. However, in preserved EF heart failure, the plasma levels are significantly lower and a worsening in levels after treatment is not predictive of mortality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Heart Failure / blood*
  • Heart Failure / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Odds Ratio
  • Patient Readmission
  • Peptide Fragments / blood*
  • Prognosis
  • Stroke Volume / physiology*
  • Survival Analysis


  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain