P176 Left ventricular diastolic function by gated myocardial perfusion SPECT strongly reflects NT-ProBNP

European Heart Journal

13 January 2020
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ESC Journals

Abstract

AbstractBackground

The importance of left ventricle diastolic dysfunction (LVDD) has been recognized widely, as it is well established that heart failure with preserved ejection fraction has a poor prognosis. Furthermore, N-terminal pro–B-type natriuretic peptide (NT-ProBNP) is used as a marker of heart failure. However, the association between LVDD and NT-proBNP is unclear. 

Purpose

The aim of this study was to clarify the association between LVDD and NT-ProBNP. 

Methods

In this study, an index based on gated myocardial perfusion SPECT using CardioREPO software for the diagnosis of LVDD was used. Out of the 171 patients who underwent myocardial perfusion imaging (MPI) between January 2015 and December 2018, 163 individuals (116 men and 47 women) completed MPI and NT-ProBNP. Patients were classified into 4 groups: NT-ProBNP levels below 125 pg/ml (n = 52), NT-ProBNP levels 125 to 400 pg/ml (n = 33), NT-ProBNP levels 400 to 900 pg/ml (n = 23), and NT-ProBNP levels over 900 pg/ml (n = 37). CardioREPO parameters (peak filling rate (PFR), 1/3 mean filling rate (MFR), and time to peak filling rate/R-R (TTPFR)) were compared between the 4 NT-ProBNP groups. 

Results

Of the 163 patients, 55 had LVDD. The PFR and 1/3MFR were associated with LVDD. There was a statistically significant difference in PFR and 1/3 MFR between the NT-ProBNP levels below 125 pg/ml group and the NT-ProBNP levels 400 to 900 pg/ml group (PFR = 2.51+/-1.11 vs. 1.80+/-0.65, p = 0.001; 1/3 MFR = 1.41+/-0.55 vs. 1.06+/-0.47, p = 0.006, Table).

Conclusions

The MPI indices obtained by CardioREPO software were useful in the diagnosis of LVDD. The evaluation of LVDD by MPI correlated with NT-Pro BNP level is thought to have a clinical utility in the diagnosis and management of LVDD.

Variable: NT-ProBNP 0-125 (n = 52)125-400 (n = 33)400-900 (n = 23)900- (n = 37)p
Age66 ± 1172 ± 1168 ± 1770 ± 120.133
Male40 (77%)22 (12%)18 (78%)23 (62%)0.36
Left ventricular diastolic dysfunction8 (15%)4 (12%)10 (43%)27 (73%)<0.001
E/A0.9 ± 0.30.8 ± 0.21.1 ± 0.71.4 ± 0.9 (35)<0.001
E/e"10.27 ± 3.69 (20)8.83 ± 3.56 (10)12.46 ± 3.75 (12)20.25 ± 8.30 (25)<0.001
rest-PFR/s2.51 ± 1.112.06 ± 0.582.16 ± 0.651.80 ± 0.650.001
rest-1/3 MFR/s1.41 ± 0.551.19 ± 0.411.16 ± 0.501.06 ±0.470.008
rest-TTPFRms177 ± 53181 ± 69198 ± 80166 ± 850.38
rest-TTPFR / R-R 0.19 ± 0.060.20 ± 0.110.21 ±0.090.21 ± 0.150.92

Contributors