• Carsten Tschöpe, Mario Kasner, Dirk Westermann, Thomas Walther, Regina Gaub, Wolfgang C Poller, and Heinz-Peter Schultheiss.
• Department of Cardiology and Pneumology, Charité-University Medicine Berlin, Campus Benjamin Franklin, Germany.
• J. Card. Fail. 2005 Jun 1; 11 (5 Suppl): S28-33.

BackgroundThe role of brain natriuretic peptides in the detection of mild forms of isolated diastolic dysfunction is still uncertain. We therefore investigated the plasma levels of the N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with heart failure symptoms during exercise, despite preserved systolic cardiac function.Methods And ResultsFifteen control subjects and 15 symptomatic patients with preserved left ventricular ejection fraction of > or =50%, near normal Doppler echocardiographic indices, and left and right heart catheter indices at rest but increased filling pressures during exercise were studied. Plasma NT-proBNP levels and surrogate parameters of diastolic function were determined simultaneously. The median NT-proBNP plasma level was elevated (median, 145.2 pg/mL [range, 69.7-273.4 pg/mL] vs 38.3 pg/mL [range, 22.1-64.7 pg/ml]; P < .0001) in patients with increased filling pressure during exercise and correlated strongly with the pulmonary capillary wedge pressure (r = 0.78; P < .001).ConclusionNT-proBNP levels are increased in patients with increased filling pressures during exercise and useful for the detection of diastolic dysfunction in patients with exertional dyspnea.

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