Left Ventricular Dimension as an Independent Factor Associated with Amino-Terminal pro-Brain Natriuretic Peptide Values in Heart Failure.

Authors

Julio Núñez, Josep Lupón, Freya Sophie Jenkins, Gema Miñana, Enrique Santas, Miguel Lorenzo, Rafael de la Espriella, Vicent Bodí, Juan Sanchis, Markus S Anker, Kieran F Docherty, Borja Ibáñez, Christian Mueller, Antoni Bayés-Genís

Published in

The American journal of medicine. Jul 26, 2026. Epub Jul 26, 2026.

Abstract

The specific contribution of left ventricular chamber dimensions to amino-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations in heart failure remains underexplored. We evaluated the association between left ventricular end-diastolic diameter (LVEDD) and circulating NT-proBNP levels across the spectrum of acute and chronic heart failure.
We conducted a multicenter retrospective analysis of 8,361 patients (4,374 with acute heart failure and 3,987 with chronic heart failure) from four independent cohorts. NT-proBNP levels and echocardiographic measurements were collected during hospitalization or ambulatory visits. Quantile regression models were used to assess the independent association between LVEDD and NT-proBNP.
Larger LVEDD was consistently associated with higher NT-proBNP concentrations across the four heart failure cohorts (p<0.05). This direct linear relationship persisted after multivariable adjustment and across left ventricular ejection fraction categories. A 10 mm increase in LVEDD was associated with an increase in NT-proBNP of 444 pg/mL (95% CI: 266-623, p<0.001) at admission in the acute heart failure derivation cohort of 158 pg/ml (95% CI: 10-305, p=0.036) in the chronic heart failure derivation cohort. In the subset of patients in which CMR was performed, CMR-iLVEDV was also positive and linearly associated with NT-proBNP levels. For each 10 ml/m2 increase, NT-proBNP on admission increased by 290 pg/ml (95% CI: 122-458, p<0.001). Conversely, patients with smaller left ventricular chambers consistently exhibited lower NT-proBNP concentrations.
left ventricular chamber size is an independent factor associated with NT-proBNP levels in both acute and chronic heart failure. These findings underscore the importance of incorporating left ventricular dimensions into the interpretation of natriuretic peptide concentrations.

PMID:
42503388
Bibliographic data and abstract were imported from PubMed on 27 Jul 2026.

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