Plasma Bnp Level In Chronic Hemodialysis Patients: A Good Indicator Of Left Ventricular Diastolic Dysfunction?

Background. Plasma brain natriuric peptide (BNP) level reportedly reflects left ventricular (LV) diastolic dysfunction in patients with heart failure. However, it is still unknown whether plasma BNP level reflects LV diastolic function in patients undergoing hemodialysis (HD).Methods. We measured the plasma concentrations of atrial natriuric peptide (ANP) and BNP, simultaneously assessing LV systolic and diastolic function by electrocardiographic-gated 99mTc-MIBI myocardial single-photon emission computed tomography both before and after HD in 31 patients. We determined the relationship between plasma ANP and BNP levels and LV systolic and diastolic function.Results. The rate of decrease in body weight positively correlated with the plasma ANP level, but not with the plasma BNP level. The LV ejection fraction (LVEF) was negatively correlated with the plasma BNP level both before and after HD. The peak filling rate negatively correlated with the plasma BNP level both before and after HD. When patients were divided into groups of those with normal LV systolic function (LVEF > 50%, n = 9) and those with poor LV function (LVEF <= 50%, n = 22), the plasma BNP level after HD negatively correlated with the LVEF in the poor group, but not in the normal group. The plasma BNP level negatively correlated with the peak filling rate in both groups.Conclusion. We suggest that plasma concentration of BNP is a good indicator of LV diastolic dysfunction in patients undergoing chronic HD.