The Relationship Between Brain Natriuretic Peptide (NT-proBNP) Levels and Diastolic Heart Failure in Patients With COVID-19

Abstract

Background: Diastolic dysfunction has been reported in patients with COVID-19. Due to the role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the diagnosis of heart failure, this study investigated the relationship between serum NT-proBNP levels and diastolic heart failure in COVID-19 patients.Methods: This descriptive-analytical study was performed at Ayatollah Rouhani Hospital in Babol. Fifty-four patients with confirmed COVID-19 diagnosis who were admitted to the ICU were included in the study. The primary outcome was the relationship and predictive role of NT-proBNP and diastolic heart failure in patients with severe SARS-COV-2 infection. Patients with pro BNP >125 pg/mL underwent echocardiography and the relationship between echocardiographic indices and NT-proBNP was assessed as a secondary outcome.Results: Our study showed that plasma NT-proBNP levels in patients with increased diastolic dysfunction were associated with disease severity. It was also found that the cut-off point of NT-proBNP = 799 pg/mL could be a predictor of diastolic dysfunction grades two and three. In this study, patients with a serum NT-proBNP level equal or above 799 had 37 times higher chance of having diastolic dysfunction than those with a serum NT-proBNP level below 799. Patients with NT-proBNP above 556 had RV_EA> 2 in echocardiography, indicating increased right-sided filling pressures.Conclusion: Despite the confounding factors in the interpretation of the pro BNP level in COVID-19, its level can be used to estimate the presence of high-grade diastolic heart failure on the left and right sides of the heart and the presence of high filling pressures. Lower levels of NT-proBNP are associated with right-sided diastolic failure.