Heart failure & cardiomyopathiesCohort study
Discordance between N-terminal pro-B-type natriuretic peptide and left ventricular end-diastolic pressure in suspected heart failure with a preserved ejection fraction: implications for diagnosis and prognosis
- prospective all-comer cohort
Authors' conclusion
NT-proBNP and LVEDP are frequently discordant and provide complementary prognostic information in suspected HFpEF. Mortality risk was highest when both were elevated and was also increased with isolated NT-proBNP elevation, whereas isolated LVEDP elevation was not associated with excess mortality. These findings support integrated biomarker-haemodynamic assessment and warrant prospective validation.
Study context
- Population
- Adults undergoing elective left heart catheterisation with preserved ejection fraction (≥50%) and intermediate or high H₂FPEF score probability (suspected heart failure with preserved ejection fraction (HFpEF))mean age 70 years, 49% women
- Participants
- 514 adults
- Exposure
- Groups classified by guideline-recommended NT-proBNP thresholds and left ventricular end-diastolic pressure (LVEDP) ≥16 mm Hg, compared with Group 1
- Outcome
- All-cause mortality (multivariable Cox models, including age, sex, renal dysfunction and H2FPEF risk category)
Main finding
As reported in the abstract
Each group vs group 1Hazard ratio (95% CI)
Group 2adjusted; not significantly higher
1.34(0.45–4.02)
Group 3adjusted; significantly higher
2.26(1.02–5.01)
Group 4adjusted; significantly higher
3.33(1.54–7.20)
Observational data: associations, not effects.
Further findings
Group distribution
- Group distribution — Discordance
- 42%
Group distribution
- Clinical profiles aligned more closely with NT-proBNP than LVEDP
Original publication
Discordance between N-terminal pro-B-type natriuretic peptide and left ventricular end-diastolic pressure in suspected heart failure with a preserved ejection fraction: implications for diagnosis and prognosis. Heart. Published 15 September 2026. doi:10.1136/heartjnl-2026-328688
Summarised from the published abstract; every number is checked against it