Post-Stress Nt-Pro BNP Levels Can Predict a Diastolic Heart Failure in Hypertensives With Microvascular Disease: Pp.1.15

The utility of N-terminal pro brain natriuretic peptide (NT-proBNP) for detecting a diastolic heart failure (HF) in hypertensives is unclear. We investigated the relation between post-stress concentration of NT-proBNP and left ventricular diastolic HF in asymptomatic hypertensives with microvascular disease. 122 (82 females, 68%, age 46–65 years, mean age 55.2 ± 8.6 years) ambulatory adequately-controlled hypertensives with microvascular disease (ischemic ST segment changes on stress electrocardiography (SECG) but normal coronary angiography, and negative myocardial perfusion scintigraphy). Color M-Mode was used for the identification of the diastolic dysfunction, that was determed as a ratio of early peak diastolic transmitral E wave velocity to intraventricular flow propagation velocity Vp (data suggest that E/Vp>2.5 correlates with significant diastolic HF). NT-proBNP level measured within 5 minutes in the recovery period of SECG was used as a biomarker of HF. Patients with E/Vp<2.5 (n=82) had a mean post-stress NT-proBNP concentration of 326 ± 84 ng/l (level within the normal range); those with E/Vp>2.5 (n = 40) had a significantly elevated mean post-stress NT-proBNP level of 986 ± 96 ng/l (p < 0.05). The assessment of the blood concentration of NT-proBNP in a rapid assay during SECG in asymptomatic hypertensives with microvascular disease might be of potential value for identification of those with early stage of diastolic HF.