Journal of the Indonesian Medical Association
Vol. 59 No. 9 September 2009

Natriuretic Peptide (NT-proBNP) Levels From Heart Failure Patients with NYHA Functional Class III and IV in Cipto Mangunkusumo Hospital

Immanuel, Suzanna ( Faculty of Medicine University of Indonesia, Jakarta )
Legoh, Grace Nerry ( Faculty of Medicine University of Indonesia, Jakarta )
Makmun, Lukman H. ( Faculty of Medicine University of Indonesia, Jakarta )

Article Info

Publish Date
30 Sep 2009


The diagnosis of heart failure is currently made based on clinical symptoms, physical examination and objective data of heart dysfunction. The current gold standard in detecting heart dysfunction is echocardiography. However, it is usually not available in current general practice or rather difficult to be performed in acute and severe conditions. Fast test with acceptable sensitivity and specificity is needed. Currently, several hormones of the natriuretic peptides especially รข type natriuretic peptide (BNP) and amino terminal proBrain-type natriuretic peptide (NTproBNP) has been shown very useful in clinical contexts including in the differential diagnosis of acute dyspneu, and in diagnosis, stratification, monitoring, or determining prognosis of heart failure. The aim of the study was to evaluate the level of NT-proBNP according to age, gender and left ventricular ejection fraction in heart failure patients with NYHA functional class III and IV determined by echocardiography. Forty patients were included in the study. The level of NTproBNP increased according to the severity of heart failure. The levels of NT-proBNP in NYHA IV subjects were significantly higher compared to the NYHA III, i.e. 9157 pg/mL to 2559 pg/mL, p<0.05. Increasing NT-proBNP levels according to age were observed in NYHA III and IV, but not in the >75 yrs age group. The levels of NT-proBNP in NYHA III and IV patients with LVEF <40% were higher than patients with LVEF >40-50% i.e. 7316 pg/mL compared to 2797 pg/mL, however, in the NYHA IV patients, it was not statistically significant (p>0.05).Keywords: NT-proBNP, Heart failure, NYHA III and IV, LVEF.

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