METHODS: From Oct. 2002 to July 2003, 3830 patients were analyzed. The patients were divided into the 3 groups: control, systolic (SHF) and diastolic heart failure (DHF) patient groups, via an echocardiography and the Framingham clinical criteria. The BNP was measured with a Triage(R) kit. Both the clinical and echocardiography profiles were analyzed.

RESULTS: The mean age of the patients was 62.8 years, with 49.0% males. The control group included 661, the SHF group 475 and the DHF group 287 patients. In the control group, the mean BNP level was 31.5±24.0 pg/mL, with the BNP level in the women higher than in the men (28.0±23.8 vs. 34.9±23.7 pg/mL, p=0.041). The SHF patients group had significantly higher BNP levels than the other groups (p=0.008). In the patients with SHF, the BNP levels, according to the NYHA grade, showed significant differences (I: 169.3±138.7, II: 391.1±231.4, III: 780.1±698.3 and IV: 1078.9±946.2 pg/mL, p=0.009). In the patients with diastolic dysfunction (n=787) according to the diastolic dysfunction, the BNP levels, showed significant differences (relaxation abnormality: 108.2±78.2, pseudo-normal: 419.0±109.8 and restrictive physiology: 510.4±231.6 pg/mL, p=0.009). The accuracy in the BNP level when separating the SHF from the control patients was 0.98 (AUC=0.98), with 92.5% sensifivity and 86.1% specificity at a cut-off of 108 pg/mL.

CONCLUSIONS: The levels of blood BNP were present in various ranges according to the clinical situation and extent of heart failure.