High Intraindividual Variation of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP in Patients with Stable Chronic Heart Failure

Bruins, Sanne; Fokkema, Marieke L.; Römer, Jeroen W.; DeJongste, Mike J. L.; Dijs, Fey P. L. van der; Ouweland, Jody M.W. van den; Muskiet, Frits A. J.

doi:10.1373/clinchem.2004.038752

Cited by 201 publications

(170 citation statements)

References 31 publications

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“…NT‐proBNP variability has been reported in healthy dogs,34 heart failure patients,35 and among breeds,36 but these factors were not specifically considered in our analyses. Economic considerations precluded centralized evaluation of radiographic and echocardiographic data.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Plasma N‐terminal Pro‐brain Natriuretic Peptide Concentrations to Heart Failure Classification and Cause of Respiratory Distress in Dogs Using a 2nd Generation ELISA Assay

Fox

Oyama

Hezzell

et al. 2014

Veterinary Internal Medicne

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BackgroundCardiac biomarkers provide objective data that augments clinical assessment of heart disease (HD).Hypothesis/ObjectivesDetermine the utility of plasma N‐terminal pro‐brain natriuretic peptide concentration [NT‐proBNP] measured by a 2nd generation canine ELISA assay to discriminate cardiac from noncardiac respiratory distress and evaluate HD severity.AnimalsClient‐owned dogs (n = 291).MethodsMulticenter, cross‐sectional, prospective investigation. Medical history, physical examination, echocardiography, and thoracic radiography classified 113 asymptomatic dogs (group 1, n = 39 without HD; group 2, n = 74 with HD), and 178 with respiratory distress (group 3, n = 104 respiratory disease, either with or without concurrent HD; group 4, n = 74 with congestive heart failure [CHF]). HD severity was graded using International Small Animal Cardiac Health Council (ISACHC) and ACVIM Consensus (ACVIM‐HD) schemes without knowledge of [NT‐proBNP] results. Receiver‐operating characteristic curve analysis assessed the capacity of [NT‐proBNP] to discriminate between dogs with cardiac and noncardiac respiratory distress. Multivariate general linear models containing key clinical variables tested associations between [NT‐proBNP] and HD severity.ResultsPlasma [NT‐proBNP] (median; IQR) was higher in CHF dogs (5,110; 2,769–8,466 pmol/L) compared to those with noncardiac respiratory distress (1,287; 672–2,704 pmol/L; P < .0001). A cut‐off >2,447 pmol/L discriminated CHF from noncardiac respiratory distress (81.1% sensitivity; 73.1% specificity; area under curve, 0.84). A multivariate model comprising left atrial to aortic ratio, heart rate, left ventricular diameter, end‐systole, and ACVIM‐HD scheme most accurately associated average plasma [NT‐proBNP] with HD severity.Conclusions and Clinical ImportancePlasma [NT‐proBNP] was useful for discriminating CHF from noncardiac respiratory distress. Average plasma [NT‐BNP] increased significantly as a function of HD severity using the ACVIM‐HD classification scheme.

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Section: Discussionmentioning

confidence: 99%

Relationship of Plasma N‐terminal Pro‐brain Natriuretic Peptide Concentrations to Heart Failure Classification and Cause of Respiratory Distress in Dogs Using a 2nd Generation ELISA Assay

Fox

Oyama

Hezzell

et al. 2014

Veterinary Internal Medicne

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“…On the other hand, the high intraindividual variability of BNP was defined in several studies. 20,21 This variability seems to preclude the assessment of its concentration in the individual patient with either hypertension or obesity and/or insulin resistance. The assessment of the changes in BNP concentration in longitudinal studies may enlight this issue.…”

Section: Discussionmentioning

confidence: 99%

The association of brain natriuretic peptide and insulin resistance in obesity-related hypertension

Cikim

2007

J Hum Hypertens

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Hypertension is frequently associated with obesity and natriuretic peptide levels are reported to decrease in obese subjects. Both the lower brain natriuretic peptide (BNP) concentration and insulin resistance are suggested to be associated with hypertension. However, their involvement in obesity-related hypertension has not been clearly defined. Forty-four obese women (21 normotensive and 23 hypertensive) and 25 healthy women matched for age were included in the study. Anthropometrical parameters were determined. Serum BNP, fasting insulin and glucose concentrations, and lipid parameters were evaluated. Insulin resistance was calculated using Homeostasis Model Assessment (HOMA) and Quantative Insulin Sensitivity Check Index (QUICKI) formulations. Within the obese groups, HOMA and QUICKI reflected the increased insulin resistance in hypertensive obese subjects with a significant correlation to blood pressure. The decrease in BNP in the obese groups was in favour of the hypertensive obese subjects (31.4376.43; 26.3674.29; and 17.5173.08 pg/ ml, respectively) with a fractional statistical significance between the hypertensive obese group and the controls (P ¼ 0.047). Only for the obese hypertensive group, fasting glucose, HOMA and QUICKI were significantly correlated with BNP. Moreover, fasting plasma glucose (R 2 ¼ 0.22, P ¼ 0.007) and fasting plasma insulin (R 2 ¼ 0.39, P ¼ 0.03) were independently correlated with BNP only for the obese hypertensive group. It can be concluded that the decrease in BNP concentrations in the obese hypertensive subjects seem to be well correlated with the insulin resistance.

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“…Since the coefficient of variation of neurohormones is reported to be about 100%, we chose not to repeat the neurohormone sampling. 9 For determination of levels of (NT-pro)BNP, a 5 µl aprotinin solution was adjusted to the 250 µl plasma samples in EDTA and to 250 µl serum samples. At the clinical chemical laboratory (CCL) of the UMCG both were frozen at -20°C and stored in batches for a maximum of ten months.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides

Barents¹,

Horst²,

Voors³

et al. 2008

NHJL

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Background/objectives. Without knowing the exact CHF prevalence, chronic heart failure (CHF) occurs frequently in elderly people both inside and outside nursing homes. For a diagnosis we have to rely on physical examination and additional tests. We therefore run the risk of missing CHF diagnoses or of diagnosing CHF when we should not. Natriuretic peptide assays have emerged as a diagnostic test but their use in nursing home residents is limited. We examined the number of misdiagnoses, the CHF prevalence and the role of natriuretic peptide. Method. Residents in one centre without aphasia, cognitive impairments or metastatic cancer were screened for CHF; the natriuretic peptide levels were measured separately.

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High Intraindividual Variation of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP in Patients with Stable Chronic Heart Failure

Cited by 201 publications

References 31 publications

Relationship of Plasma N‐terminal Pro‐brain Natriuretic Peptide Concentrations to Heart Failure Classification and Cause of Respiratory Distress in Dogs Using a 2nd Generation ELISA Assay

Relationship of Plasma N‐terminal Pro‐brain Natriuretic Peptide Concentrations to Heart Failure Classification and Cause of Respiratory Distress in Dogs Using a 2nd Generation ELISA Assay

The association of brain natriuretic peptide and insulin resistance in obesity-related hypertension

Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides

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