AKUT OLMAYAN DİSPNEDE N-TERMİNAL PROHORMON BEYİN NATRİÜRETİK PEPTİT SEVİYESİ İLE EKOKARDİYOGRAFİK SOL VENTRİKÜL SİSTOLİK VEYA DİYASTOLİK İŞLEV BOZUKLUĞU İLİŞKİSİ

Abstract

Objective: The aim of the study was to evaluate serum N-terminal prohormone brain natriuretic peptide (NT-proBNP) level and evidence of left ventricular (LV) systolic dysfunction (SD) or diastolic dysfunction (DD) in non-obese patients with non-acute dyspnea. Methods: This study retrospectively evaluated the serum NT-proBNP level and LV SD or DD from transthoracic echocardiography (TTE) in patients with non-acute dyspnea between October 2020 and October 2021. The normal limit for the serum NT-proBNP level (125 pg/ml) was used as the cut-off value. Results: Ultimately, 435 patients were included in the study. In 61% of the patients (n=264), the NT-proBNP level was elevated (≥ 125 pg/ml). There was no evidence of SD or DD in 56% of the patients (n=147) with ≥ 125 pg/ml. The patients whose NT-proBNP ≥ 125 but who had no SD or DD had a significantly higher H2FPEF score ≥ 6, atrial fibrillation, malignancy, previous COVID-19, and need for hospitalization than the patients whose NT-proBNP < 125 and who had no SD or DD (13% vs. 4%; 5% vs. 1%; 16% vs. 9%; 29% vs. 5%; and 25% vs. 11%, respectively). An NT-proBNP value < 752.1 pg/ml excluded SD with 72.5% sensitivity and 83.1% specificity and < 350.3 pg/ml excluded DD with 71.3% sensitivity and 75.5% specificity. Conclusion: A high NT-proBNP value does not always indicate SD or DD. NT-proBNP measurement may detect not only overt heart failure but also subclinical LV dysfunction in various clinical entities, in addition to adding prognostic significance in non-acute dyspnea.