Longitudinal changes of left ventricular filling pressure and N-terminal pro-brain natriuretic peptide on chronic hemodialysis

Clin Nephrol. 2010 Sep;74(3):190-7. doi: 10.5414/cnp74190.


Background: Left ventricular filling pressure (LVFP) is related to the long-term prognosis in end-stage renal disease. The aims of this study were to evaluate the time course of the changes in LVFP, the predictors for the changes of LVFP, and the plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels as indicators for the changes of LVFP in chronic hemodialysis (HD).

Methods: This study was designed prospectively. Doppler echocardiographic examinations and measurement of plasma NT-proBNP levels were performed in 37 consecutive patients on chronic HD and repeated at median of 43 months later. A ratio of peak early transmitral flow velocity to peak early diastolic mitral annular velocity (E/Em), an estimate of LVFP, was calculated.

Results: E/Em ratios were significantly increased during the follow-up period. In multivariate analysis, age and changes of LVMI were independently associated with the changes of E/Em ratios. The plasma NT-proBNP levels were independently associated with E/Em at baseline and at the end of follow-up. The changes of plasma NT-proBNP levels were independently associated with changes of E/Em ratios (b-coefficient 0.453, p = 0.003).

Conclusions: Our data suggest that the deterioration of LVFP parallels with the progression of LV hypertrophy. Monitoring the plasma NT-proBNP levels might be useful for the detection of the LVFP changes in chronic HD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Pressure Monitoring, Ambulatory
  • Disease Progression
  • Echocardiography, Doppler
  • Female
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / metabolism*
  • Hypertrophy, Left Ventricular / physiopathology*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / metabolism*
  • Peptide Fragments / metabolism*
  • Prognosis
  • Prospective Studies
  • Regression Analysis
  • Renal Dialysis*
  • Statistics, Nonparametric
  • Ventricular Pressure / physiology*


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