Hemodynamic improvement of acutely decompensated heart failure patients is associated with decreasing levels of NT-proBNP

BackgroundSuccessful therapy in chronic clinically stable heart failure is reflected by decreasing serum NT-proBNP levels. This study evaluates therapy monitoring by NT-proBNP in comparison to invasively measured hemodynamic parameters in acutely decompensated heart failure patients.Methods and resultsIn 25 acutely decompensated chronic heart failure patients (NYHA III–IV, Cardiac Index (CI) ≤ 2.5 l/min/m2 and a PCWP ≥ 15 mm Hg) changes in NT-proBNP and invasive hemodynamics were compared. Hemodynamic improvement in the first 24 h (CI ≥ 30% and PCWP ≤ 30%, compared to baseline) was associated with decreasing NT-proBNP levels; which was not seen in patients without hemodynamic improvement. To discriminate between responders and non-responders, a decline to < 80% of the baseline NT-proBNP in the first 24 h was the best cut-off.ConclusionHemodynamic improvement in acutely decompensated heart failure patients is associated with decreasing NT-proBNP levels.