Variability and Discordance between NT-proBNP and Left Ventricular Ejection Fraction in Patients with Heart Failure: A Cross-Sectional Study

Open Access

Abstract

Background: Heart failure assessment commonly relies on left ventricular ejection fraction (LVEF) and NT-proBNP, yet discordance between these parameters may affect clinical interpretation. Aim of the study: To evaluate variability and agreement between NT-proBNP levels and LVEF in patients with heart failure. Methods & Materials: This cross-sectional study included 60 clinically diagnosed heart failure patients. NT-proBNP was measured and echocardiographic LVEF was assessed. Associations were analyzed using Pearson correlation and logistic regression. Result: Mean age was 57.88±11.90 years; 63.33% were male. Mean NT-proBNP was 4559.50±801.65 pg/mL and mean LVEF was 34.45±11.19%. Reduced EF (≤40%) was present in 70%. NT-proBNP showed weak negative correlation with LVEF (r = -0.263, p = 0.021) and positive correlation with NYHA class (r = 0.401, p = 0.003). Discordance was observed in 30% of cases. Reduced EF (OR: 3.92, 95% CI: 1.71-8.97, p = 0.001) and NYHA III-IV (OR: 4.36, 95% CI: 1.98-9.62, p = 0.001) were strong predictors of elevated NT-proBNP. Conclusion: There is significant variability and partial discordance between NT-proBNP levels and left ventricular ejection fraction in patients with heart failure. Both parameters show a weak but significant relationship and often reflect different dimensions of cardiac dysfunction. Their combined interpretation improves diagnostic clarity and enhances clinical risk stratification.