Heart failure & cardiomyopathies
Association between body mass index, plasma N-terminal pro-B-type natriuretic peptide, symptoms and outcome in patients referred for investigation of suspected heart failure
Authors' conclusion
In ambulatory patients with suspected HF, higher BMI is associated with lower NT-proBNP concentrations but does not attenuate the prognostic value of NT-proBNP. Lowering guideline-recommended NT-proBNP thresholds for obese patients is unlikely to identify individuals at higher mortality risk.
Study context
- Population
- Ambulatory patients referred to a community heart failure (HF) clinic for investigation of suspected heart failure (HF), 2001–2023mean age 71±11 years, 63% men
- Participants
- 2,866 patients
- Comparison
- relation among body mass index (BMI), left ventricular ejection fraction (LVEF), symptoms, NT-proBNP and mortality
Main finding
As reported in the abstract
NT-proBNP concentration by BMI
NT-proBNP concentrations inversely related to BMI
p<0.001
Each 5 kg/m² increase in BMI: lower NT-proBNP
13%
95% CI 10% to 17%
Further findings
NT-proBNP by BMI within New York Heart Association (NYHA) class and LVEF
- Within each NYHA class and across most LVEF values, patients with higher BMI had lower NT-proBNP concentrations
Mortality by BMI within NT-proBNP strata
- BMI not associated with mortality within NT-proBNP strata
Mortality with NT-proBNP <125 ng/L · 1 year
- 1-year mortality, irrespective of BMI, in patients with NT-proBNP <125 ng/L
- <1%
Original publication
Association between body mass index, plasma N-terminal pro-B-type natriuretic peptide, symptoms and outcome in patients referred for investigation of suspected heart failure. Heart. Published 9 February 2026. doi:10.
Summarised from the published abstract; every number is checked against it