NT-proBNP levels, echocardiographic findings, and outcomes in breathless patients: Results from the ProBNP Investigation of Dyspnoea in the Emergency Department (PRIDE) echocardiographic substudy

Annabel A. Chen, Malissa J. Wood, Daniel G. Krauser, Aaron L. Baggish, Roderick Tung, Saif Anwaruddin, Michael H. Picard, James L. Januzzi

Research output: Contribution to journalArticlepeer-review

123 Scopus citations

Abstract

Aims: The objective of this study was to determine the integrative utility of measuring plasma NT-proBNP levels with echocardiography in the evaluation of dyspnoeic patients. Methods and results: Of 599 emergency department patients enrolled in a clinical study of NT-proBNP at a tertiary-care hospital, 134 (22%) had echocardiographic results available for analysis. Echocardiographic parameters correlating with NT-proBNP levels were determined using multivariable linear-regression analysis. Independent predictors of 1-year mortality were determined using Cox-proportional hazard analysis. Independent relationships were found between NT-proBNP levels and ejection fraction (P = 0.012), tissue Doppler early and late mitral annular diastolic velocities (P = 0.007 and 0.018), right ventricular (RV) hypokinesis (P = 0.006), and tricuspid regurgitation severity (P < 0.001) and velocity (P = 0.007). An NT-proBNP level <300 pg/mL had a negative predictive value of 91% for significant left ventricular systolic and diastolic dysfunction. Overall 1-year mortality was 20.1% and was independently predicted by NT-proBNP level [HR 8.65, 95% confidence interval (CI) 2.7-27.8, P = 0.0003], ejection fraction (HR 0.95, 95% CI 0.91-0.99, P = 0.009), RV dilation (HR 2.98, 95% CI 1.05-12.8, P = 0.04), and systolic blood pressure (HR 0.97, 95% CI 0.96-0.99, P = 0.01). Conclusion: NT-proBNP levels correlate with, and provide important prognostic information beyond, echocardiographic parameters of cardiac structure and function. Routine NT-proBNP testing may thus be useful to triage patients to more timely or deferred echocardiographic evaluation.

Original languageEnglish (US)
Pages (from-to)839-845
Number of pages7
JournalEuropean Heart Journal
Volume27
Issue number7
DOIs
StatePublished - Apr 2006
Externally publishedYes

Keywords

  • Echocardiography
  • Heart failure
  • Natriuretic peptides

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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