The Role of Serum NT-proBNP for Predicting Left Ventricular Systolic Dysfunction in Hospitalized Patients in Sri Lanka

B M Chaminda Rathnayake; Rasika Pawiththra Illeperuma; Sakunthala Jayasinghe; Tonks N Fawcett; Kalana Maduwage; W A Thilak Jayalath; Udaya Ralapanawa

The Role of Serum NT-proBNP for Predicting Left Ventricular Systolic Dysfunction in Hospitalized Patients in Sri Lanka

EJIFCC. 2023 Dec 21;34(4):287-296. eCollection 2023 Dec.

Authors

B M Chaminda Rathnayake¹, Rasika Pawiththra Illeperuma², Sakunthala Jayasinghe³, Tonks N Fawcett⁴, Kalana Maduwage⁵, W A Thilak Jayalath⁶, Udaya Ralapanawa⁷

Affiliations

¹ Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka, chameeshrath@ahs.pdn.ac.lk.
² Center for Research in Oral Cancer, Faculty of Dental Science, University of Peradeniya, Peradeniya, Sri Lanka, rpilleperuma@yahoo.com.
³ Department of Pathology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka, sakunthala.jayasinghe@med.pdn.ac.lk.
⁴ Nursing Studies, The School of Health in Social Science, The Medical School, University of Edinburgh, Edinburgh, The United Kingdom, T.N.Fawcett@ed.ac.uk.
⁵ Discipline of Biomedical Sciences, University of New England, New South Wales, Australia, kalanapm@gmail.com.
⁶ Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka, thilak.jayalath@med.pdn.ac.lk.
⁷ Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka, udaya.ralapanawa@med.pdn.ac.lk.

PMID: 38303755
PMCID: PMC10828538

Abstract

Background/aims: Only a few studies have addressed the role of NT-proBNP in identifying Left Ventricular Systolic Dysfunction (LVSD) in South Asian populations. Therefore, the current study was aimed at assessing the use of serum NT-proBNP in predicting LVSD in a hospitalized population in Sri Lanka.

Methods: A random sample of 278 individuals referred for echocardiography at a major Teaching Hospital consented for venous blood samples to be collected for serum NT-proBNP assay by sandwich ELISA. Based on the ejection fraction (LVEF) and fractional shortening (FS), participants were differentiated as LVSD (LVEF<50%, FS≤ 29%) and non-LVSD individuals (LVEF>60%). According to inclusion/exclusion criteria, the final study sample consisted of 100 LVSD patients and 41 non-LVSD individuals.

Results: The mean ages of the LVSD and non-LVSD groups were 69.1 (±6.2 years) and 71.4 (±2.4 years) (p=0.066) respectively. The median NT-proBNP value (with IQR) among LVSD patients (528.2 pg/mL,355.2-924.2) was comparatively higher than that of non-LVSD individuals (207.3 pg/mL,177.5-343.0). Strong correlations of NT-proBNP level with LVEF (Spearman rho= -0.84, p<0.001) and FS (rho= -0.81, p<0.001) suggested that serum NT-proBNP concentration increases in parallel to deteriorating left ventricular functions. The AUROC of serum NT-proBNP for differentiating LVSD was 0.859 (95% CI:0.79 - 0.92) and the optimal cut-off level for predicting LVSD was 265pg/mL, with 90% sensitivity and 70% specificity.

Conclusion: Current Sri Lankan study revealed a considerable correlation of serum NT-proBNP level with LVSD and utilizing such an assay for screening will facilitate adequate evidence to rule-out LVSD among high-risk residents.

Keywords: Left Ventricular Ejection Fraction; Left Ventricular Systolic Dysfunction; NT-proBNP; Natriuretic Peptides; Serum.