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

Background and aims Obesity is associated with lower N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration, possibly because obese patients become symptomatic with less severe left ventricular dysfunction. We explored the relation among body mass index (BMI), left ventricular ejection fraction (LVEF), symptoms, NT-proBNP and mortality in ambulatory patients investigated for suspected heart failure (HF). Methods Between 2001 and 2023, patients referred to a community HF clinic had age, sex, BMI, plasma NT-proBNP, serum creatinine, LVEF, New York Heart Association (NYHA) class, cardiac rhythm and systolic blood pressure recorded. Patients were categorised as ‘lean’ BMI