N-Terminal pro-brain natriuretic peptide as a predictor of heart failure with preserved ejection fraction in hemodialysis patients without fluid overload.

Background/aims: The diagnostic value of N-terminal pro-brain natriuretic peptide (NT-pro BNP) for heart failure with preserved ejection fraction (EF; HF-PEF) was evaluated in hemodialysis (HD) patients.

Method: In total, 83 patients were analyzed. Left-ventricular (LV) function was assessed using trans-thoracic Doppler echocardiography, and indices of hydration status were assessed using bioelectrical impedance analysis. Plasma NT-pro BNP levels were measured simultaneously.

Results: A moderate negative correlation was found between NT-pro BNP and LVEF. Subsequently, 77 HD patients who maintained their LVEF (LVEF >50%) were analyzed. Patients with a clinical suspicion of LV diastolic dysfunction (LVDD; E/A ≤0.75) showed higher NT-pro BNP levels (p = 0.021), but no significant differences in hydration status were observed between the two groups.

Conclusions: The NT-pro BNP level may be a very helpful biomarker in screening for LVDD and HF-PEF and determining the need for echocardiography or a sophisticated cardiac study, even in HD patients.