Use of natriuretic peptides in pre-participation screening of college athletes

Daniels, Lori B.; Allison, Matthew A.; Clopton, Paul; Redwine, Laura; Siecke, Neil; Taylor, Kenneth S.; Fitzgerald, Robert L.; Bracker, Mark D.; Maisel, Alan S.

doi:10.1016/j.ijcard.2006.12.076

Cited by 30 publications

(20 citation statements)

References 9 publications

(8 reference statements)

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“…Then, to determine if there were significant associations with a relevant clinical cut-point for NT-proBNP (i.e. > 70 pg/mL[14, 15]), we conducted multivariable logistic regression analyses using both the continuous and categorical forms of leptin and total adiponectin. For all regression analyses, the initial model 1 was adjusted for age, sex and race.…”

Section: Methodsmentioning

confidence: 99%

Adiponectin is independently associated with NT-proBNP: The Multi-Ethnic Study of Atherosclerosis

Allison¹,

Criqui²,

Maisel³

et al. 2015

Nutrition, Metabolism and Cardiovascular Diseases

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Background and Aims To investigate the associations between selected adipokines and the N-terminal prohormone of B-type natriuretic peptide (NT-proBNP). Methods and Results 1489 individuals enrolled in the Multi-Ethnic Study of Atherosclerosis were evaluated at 4 clinic visits about every 2 years. The evaluation included fasting venous blood, which was analyzed for NT-proBNP (at visits 1 and 3) and the adipokines adiponectin and leptin (at visits 2 and 3). The mean age was 64.8 ± 9.6 years and 48% were female. After multivariable adjustment, a 1-SD increment in adiponectin was associated with a 14 pg/ml higher NT-proBNP level (p < 0.01), while, compared to the 1st quartile of adiponectin, the 2nd, 3rd and 4th quartiles had 28, 45 and 67% higher NT-proBNP levels (p < 0.01 for all). For changes in NT-proBNP over the follow-up period, and after multivariable adjustment including baseline NT-proBNP, a 1-SD increment in adiponectin was associated with a 25 pg/ml absolute increase in NT-proBNP (p < 0.01), while those in the 2nd, 3rd and 4th quartiles of adiponectin were associated with increases of 5, 28 and 65 pg/ml (p = 0.74, 0.09 and < 0.01, respectively). There was a significant interaction between adiponectin and sex for visit 3 NT-proBNP (p-interaction < 0.01), with significantly stronger associations in men. Leptin was not associated with NT-proBNP. Conclusion Higher adiponectin, but not leptin, is significantly associated with higher levels of NT-proBNP, as well as with greater longitudinal increases in NT-proBNP. The associations were stronger in men.

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Section: Methodsmentioning

confidence: 99%

Adiponectin is independently associated with NT-proBNP: The Multi-Ethnic Study of Atherosclerosis

Allison¹,

Criqui²,

Maisel³

et al. 2015

Nutrition, Metabolism and Cardiovascular Diseases

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“…As a general guideline, in young, healthy adults, 90% will have BNP Ͻ25 pg/ml and NTproBNP Յ70 pg/ml (15). For acutely dyspneic patients, some have suggested cutoffs of BNP Ͻ100 pg/ml and NTproBNP Ͻ300 pg/ml to rule out HF ( Fig.…”

Section: The Basicsmentioning

confidence: 99%

Natriuretic Peptides

Daniels

Maisel

2007

Journal of the American College of Cardiology

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927

733

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Natriuretic peptides (NPs) are released from the heart in response to pressure and volume overload. B-type natriuretic peptide (BNP) and N-terminal-proBNP have become important diagnostic tools for assessing patients who present acutely with dyspnea. The NP level reflects a compilation of systolic and diastolic function as well as right ventricular and valvular function. Studies suggest that using NPs in the emergency department can reduce the consumption of hospital resources and can lower costs by either eliminating the need for other, more expensive tests or by establishing an alternative diagnosis that does not require hospital stay. Caveats such as body mass index and renal function must be taken into account when analyzing NP levels. Natriuretic peptide levels have important prognostic value in multiple clinical settings, including in patients with stable coronary artery disease and with acute coronary syndromes. In patients with decompensated heart failure due to volume overload, a treatment-induced drop in wedge pressure is often accompanied by a rapid drop in NP levels. Knowing a patient's NP levels might thus assist with hemodynamic assessment and subsequent treatment titration. Monitoring NP levels in the outpatient setting might also improve patient care and outcomes.

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“…BNPs are elevated in DHF and systolic heart failure (SHF), and mean BNP levels are 20 times greater in patients with DHF than in matched control normal subjects [32] . Natriuretic peptide levels are clearly ageand gender-specific, the normal value in 90% of young, healthy adults is BNP < 25 pg/mL and NT-proBNP ≤ 70 pg/mL [33] . The European criteria recommend that natriuretic peptide, when used for diagnostic purposes, should be implemented with echocardiographic indices of LV DD, but they can also be used for exclusion based on the high negative predictive value, which is 96% and 93% when using a cut-off value of 100 pg/mL for BNP and 120 pg/mL for NT-proBNP, respectively [23] .…”

Section: Diagnosis Of Dhfmentioning

confidence: 99%

Advances in diastolic heart failure

Yang

Sun²

2010

WJC

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More than 50% of people living with congestive heart failure have diastolic heart failure (DHF). Most of them are older than 70 years, and female. The prevalence of DHF has increased with time. DHF is caused by left ventricular (LV) diastolic dysfunction (DD) which is induced by diastolic dyssynchrony. Cardiac and extracardiac factors play important roles in the development of heart failure (HF) symptoms. The diagnosis of DHF is generally based on typical symptoms and signs of HF, preserved or normal LV ejection fraction, DD and no valvular abnormalities on examination, using noninvasive and invasive methodologies. The outcomes with pharmacological therapy in patients with DHF are frequently neutral in clinical trials, and prognosis still remains poor with a 5-year mortality of 42.3% after hospitalization for HF. Further trials are necessary.

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Use of natriuretic peptides in pre-participation screening of college athletes

Cited by 30 publications

References 9 publications

Adiponectin is independently associated with NT-proBNP: The Multi-Ethnic Study of Atherosclerosis

Adiponectin is independently associated with NT-proBNP: The Multi-Ethnic Study of Atherosclerosis

Natriuretic Peptides

Advances in diastolic heart failure

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