Diagnostic and Prognostic Performance of N-Terminal ProBNP in Primary Care Patients With Suspected Heart Failure

Gustafsson, Finn; Steensgaard-Hansen, Frank; Badskjaer, J; Poulsen, Allan H.; Corell, Pernille; Hildebrandt, Per

doi:10.1016/j.cardfail.2005.04.022

Cited by 138 publications

(91 citation statements)

References 30 publications

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“…By ROC analysis, BNP showed good diagnostic power to detect HF (area under the curve, 0.94 -0.98), with similar performance described for NTproBNP in 2 previous studies involving primary care patients with dyspnea referred for echocardiography (33,34 ). Furthermore, our data confirm that decisional values should vary also according to the population of patients tested (35 ).…”

Section: Discussionsupporting

confidence: 85%

Rapid Brain Natriuretic Peptide Test and Doppler Echocardiography for Early Diagnosis of Mild Heart Failure

Aspromonte

Ceci

et al. 2006

Clinical Chemistry

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Section: Discussionsupporting

confidence: 85%

Rapid Brain Natriuretic Peptide Test and Doppler Echocardiography for Early Diagnosis of Mild Heart Failure

Aspromonte

Ceci

et al. 2006

Clinical Chemistry

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“…The cut-off values for NT-pro BNP and BNP assigned at the maximal specificity and maximal sensitivity were assessed at values of 367 pg/ml and 172 pg/ml. The assessed cut-off values for NT-pro BNP and BNP do not differ significantly from the cut-off values presented in other studies presenting the cut-off values at the levels of 125-895 pg/ml for NT-proBNP 14,15 and of 32-295 pg/ml for the BNP 15,16 according to the age, gender, assay and diagnosis. The discrepancy in the cut-off values and modest AUC levels and negative predictive values found in our study for both natriuretic peptides are due to the fact, that other cardiac patients with normal ventricular systolic function (LVEF > 60 %) were taken as a control group.…”

Section: Discussioncontrasting

confidence: 64%

NT-proBNP AND BNP VALUES IN CARDIAC PATIENTS WITH DIFFERENT DEGREE OF LEFT VENTRICULAR SYSTOLIC DYSFUNCTION

Kotaška¹,

Popelová²,

Tiserova³

et al. 2006

BIOMED PAP

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We investigated the performance of brain natriuretic peptides (BNP and NT-proBNP) in detecting various degrees of left ventricular systolic dysfunction. The NT-proBNP assay (Roche) and the BNP assay (Bayer Shionoria) were performed in 46 patients (mean age 50 years; range 20-79 years) with various types of heart disease (chronic heart failure due to coronary artery disease, cardiomyopathy, acquired valve disease, congenital heart diseases) and different impairment of left ventricular systolic dysfunction was assessed by echocardiography. Patients were divided into four groups according to the left ventricular ejection fraction (LVEF) correlated with clinical severity. Significant differences in medians of NT-proBNP and BNP values between all groups were determined (P= 0.0161 for NT-proBNP and P=0.0180 for BNP). For identifying patients with severe systolic dysfunction (LVEF<40%), receiver operating characteristic (ROC) analysis for both BNP and NT-proBNP was performed. The diagnostic performances expressed as areas under the curve were of 0.69 for NT-proBNP (cut off value 367 pg/ml) and 0.60 for BNP (cut off value 172 pg/ml). However, the BNP showed higher sensitivity (85 % vs. 63 %) and a higher positive predictive value (69 % vs 55 %) than the NT-proBNP. The negative predictive values of BNP and NT-proBNP were similar (70 % and 71 % respectively).Brain natriuretic peptides are promising markers for the diagnosis of severe left ventricular systolic dysfunction.

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“…In 34 patients (41%), baseline NT-proBNP level was elevated (≥125 pg/mL). 13 Only 1 patient had reduced renal function (glomerular filtration rate, 56 mL/min). The average cESS on echocardiography was 143±35 kdyne/cm 2 .…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…NTproBNP level ≥125 pg/mL was considered abnormal. 13 The estimated glomerular filtration rate (mL/min per 1.73 m 2 ) was calculated to exclude renal dysfunction as a cause for increased NT-proBNP concentrations.…”

Section: N-terminal Probnpmentioning

confidence: 99%

Fatigue as Presenting Symptom and a High Burden of Premature Ventricular Contractions Are Independently Associated With Increased Ventricular Wall Stress in Patients With Normal Left Ventricular Function

Taxis

Piers

Silva

et al. 2015

Circ: Arrhythmia and Electrophysiology

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Background-High idiopathic premature ventricular contractions (PVC) burden has been associated with PVC-induced cardiomyopathy. Patients may be symptomatic before left ventricular (LV) dysfunction develops. N-terminal pro-B-type natriuretic peptide (NT-proBNP) and circumferential end-systolic wall stress (cESS) on echocardiography are markers for increased ventricular wall stress. This study aimed to evaluate the relation between presenting symptoms, PVC burden, and increased ventricular wall stress in patients with frequent PVCs and preserved LV function. Methods and Results-Eighty-three patients (41 men; 49±15 years) with idiopathic PVCs and normal LV function referred for PVC ablation were included. Type of symptoms (palpitations, fatigue, and [near-]syncope), PVC burden on 24-hour Holter, NT-proBNP levels, and cESS on echocardiography were assessed before and 3 months after ablation. Sustained successful ablation was defined as ≥80% PVC burden reduction during follow-up. Patients were symptomatic for 24 months (Q1-Q3, 16-60); 73% reported palpitations, 47% fatigue, and 30% (near-)syncope. Baseline PVC burden was 23±13%, median NT-proBNP 92 pg/mL (Q1-Q3 50-156), and cESS 143±35 kdyne/cm 2 . Fatigue was associated with higher baseline NT-proBNP and cESS (P<0.001, P=0.011, respectively). After sustained successful ablation, achieved in 81%, NT-proBNP and cESS decreased significantly (P<0.001 and P=0.036, respectively). Fatigue was independently associated with a significantly larger reduction in NT-proBNP. In patients with nonsuccessful ablation, NT-proBNP and cESS remained unchanged. Conclusions-In patients with frequent PVCs and preserved LV function, fatigue was associated with higher baseline NT-proBNP and cESS, and with a significantly larger reduction in NT-proBNP after sustained successful ablation. These findings support a link between fatigue and PVC-induced increased ventricular wall stress, despite preserved LV function.

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Diagnostic and Prognostic Performance of N-Terminal ProBNP in Primary Care Patients With Suspected Heart Failure

Cited by 138 publications

References 30 publications

Rapid Brain Natriuretic Peptide Test and Doppler Echocardiography for Early Diagnosis of Mild Heart Failure

Rapid Brain Natriuretic Peptide Test and Doppler Echocardiography for Early Diagnosis of Mild Heart Failure

NT-proBNP AND BNP VALUES IN CARDIAC PATIENTS WITH DIFFERENT DEGREE OF LEFT VENTRICULAR SYSTOLIC DYSFUNCTION

Fatigue as Presenting Symptom and a High Burden of Premature Ventricular Contractions Are Independently Associated With Increased Ventricular Wall Stress in Patients With Normal Left Ventricular Function

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