Usefulness of Echocardiogram to Predict NT-proBNP ≥300 pg/mL

Abstract

Introduction and objectives: Although elevated natriuretic peptide levels form part of the universal definition of heart failure, values of echocardiographic parameters indicating congestion have not yet been defined. Our research aims to demonstrate the correlation between different echocardiographic parameters and NT-proBNP levels ≥300 pg/mL, the diagnostic threshold for heart failure in decompensated and hospitalized patients.
Methods: We performed a retrospective observational analysis of echocardiographic parameters and NT-proBNP levels from patients admitted to the cardiology inpatient unit of a tertiary hospital in Madrid, Spain, with a suspected diagnosis of decompensated heart failure during 18 months.
Results: A total of 134 patients (68 female) were included. LV thickness, E/E’ lat, E/E’ med, E/E’ average, S-wave, E-wave, and IVC diameter were significantly associated with NT-proBNP levels ≥300 pg/ml. In contrast, LVEF, A-wave, and TAPSE were negatively correlated with NT-proBNP levels ≥300 pg/ml. E/E’ ratio >15 was found to be significantly related to NT-proBNP ≥300 pg/ml (p = 0.007), with a positive predictive value of 95%. The model with the highest predictive power for NT-proBNP levels of ≥300 pg/ml included LA diameter, A1, E/E’ mean, S-wave, LV thickness, and LVEF ((AUC 0.88 (0.81 – 0.94)).
Conclusion: Our research presents an accurate model that uses echocardiographic parameters to predict NT-proBNP ≥300 pg/ml, a diagnostic criterion for heart failure. Strong predictors of NT-proBNP ≥300 pg/ml included LA diameter, A-wave, E/E’ mean, S-wave, LV thickness, and LVEF. Our research defines echocardiographic parameters suggestive of cardiogenic pulmonary or systemic congestion that apply to the complete phenotypical spectrum of heart failure.