The Relationship between Serum NT– Pro-BNP Levels and Prognosis in Patients with Systolic Heart Failure

Most studies reported using N-terminal pro-brain natriuretic peptide (NT-proBNP) in diagnosis of heart failure but there is controversy about use of thesetests in determining prognosis and classification of severity of heart failure. Theobjective of this study was to determine the value of plasma NT-proBNP levelsassessment in evaluation of mortality and morbidity of patients with systolic leftventricular dysfunction. A cohort study was performed in 150 patients with heartfailure since September 2009 until February 2010. The patients were followedfor 6 months to assess their prognosis. Patients were divided into two good andbad prognosis groups according to severity of heart failure in New York HeartAssociation (NYHA) class and frequency of hospital admission and mortalitydue to cardiac causes. Patients with good prognosis had .1 admission or nomortality or NYHA class.2 and patients that had one of this criteria consideredas bad prognosis groups. Pro-BNP levels were measured at baseline and leftventricular ejection fraction (LVEF) was estimated with echocardiography. Datawas analyzed with using Chi-square, t-test, ANOVA, Kruskal-Wallis tests. Inpatients with heart failure that enrolled in this clinical study, ten patients werelost during follow-up. The mean of NT-proBNP is significantly correlated withejection fraction (p=0. 003) and NYHA class (p 0/001). In our study among 140patients who were follow-up for 6 months, 11(9. 7%) of individuals died withmean NT-proBNP of 8994. 8 }8375 pg/ml, in survived patients mean NT-proBNP was 3756. 8 }5645. 6 pg/ml that was statistically significant (P=0. 02).Mean NT-proBNP in the group with good prognosis was 2723. 8 }4845. 2 pg/mland in the group with bad prognosis was 5420. 3 }6681 pg/ml, difference wasstatistically significant (P=0. 0001). Our study in consistent with other studiesconfirms that NT-proBNP is significantly correlated with mortality andmorbidity. This could be predicting adverse out come and stratification inpatients with heart failure. It is recommended that more research be performed inIran.