Tags

Type your tag names separated by a space and hit enter

Population-based detection of systolic and diastolic dysfunction with amino-terminal pro-B-type natriuretic peptide.
Am Heart J 2006; 152(5):941-8AH

Abstract

BACKGROUND

There is limited information regarding the clinical utility of amino-terminal pro-B-type natriuretic peptide (NT-proBNP) for the detection of left ventricular (LV) dysfunction in the community. We evaluated predictors of circulating NT-proBNP levels and determined the utility of NT-proBNP to detect systolic and diastolic LV dysfunction in older adults.

METHODS

A population-based sample of 1229 older adults (mean age 69.4 years, 50.1% women) underwent echocardiographic assessment of cardiac structure and function and measurement of circulating NT-proBNP levels.

RESULTS

Predictors of NT-proBNP included age, female sex, body mass index, and cardiorenal parameters (diastolic dysfunction [DD] severity; LV mass and left atrial volume; right ventricular overload; decreasing ejection fraction [EF] and creatinine clearance). The performance of NT-proBNP to detect any degree of LV dysfunction, including mild DD, was poor (area under the curve 0.56-0.66). In contrast, the performance of NT-proBNP for the detection of EF < or = 40% and moderate-severe DD was strong with area under the curve of > 0.90 regardless of age and sex; history of hypertension, diabetes, coronary artery disease; or body mass category. The ability of NT-proBNP to detect EF < or = 40% and/or moderate-severe DD was optimized by using age/sex-specific limits. Of "false-positive" tests, 88% (124/141) were explained after considering cardiorenal determinants of NT-proBNP levels.

CONCLUSIONS

Amino-terminal pro-B-type natriuretic peptide is a suboptimal marker of mild LV dysfunction, but performs strongly as a marker of EF < or = 40% and/or moderate-severe DD in the community. Most subjects with a positive NT-proBNP test, using age/sex-specific cutoffs, had prognostically significant abnormalities of cardiac structure or function.

Authors+Show Affiliations

The Department of Cardiology, The Canberra Hospital, Canberra, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17070165

Citation

Abhayaratna, Walter P., et al. "Population-based Detection of Systolic and Diastolic Dysfunction With Amino-terminal pro-B-type Natriuretic Peptide." American Heart Journal, vol. 152, no. 5, 2006, pp. 941-8.
Abhayaratna WP, Marwick TH, Becker NG, et al. Population-based detection of systolic and diastolic dysfunction with amino-terminal pro-B-type natriuretic peptide. Am Heart J. 2006;152(5):941-8.
Abhayaratna, W. P., Marwick, T. H., Becker, N. G., Jeffery, I. M., McGill, D. A., & Smith, W. T. (2006). Population-based detection of systolic and diastolic dysfunction with amino-terminal pro-B-type natriuretic peptide. American Heart Journal, 152(5), pp. 941-8.
Abhayaratna WP, et al. Population-based Detection of Systolic and Diastolic Dysfunction With Amino-terminal pro-B-type Natriuretic Peptide. Am Heart J. 2006;152(5):941-8. PubMed PMID: 17070165.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Population-based detection of systolic and diastolic dysfunction with amino-terminal pro-B-type natriuretic peptide. AU - Abhayaratna,Walter P, AU - Marwick,Thomas H, AU - Becker,Niels G, AU - Jeffery,Ian M, AU - McGill,Darryl A, AU - Smith,Wayne T, PY - 2005/11/29/received PY - 2006/05/15/accepted PY - 2006/10/31/pubmed PY - 2006/12/9/medline PY - 2006/10/31/entrez SP - 941 EP - 8 JF - American heart journal JO - Am. Heart J. VL - 152 IS - 5 N2 - BACKGROUND: There is limited information regarding the clinical utility of amino-terminal pro-B-type natriuretic peptide (NT-proBNP) for the detection of left ventricular (LV) dysfunction in the community. We evaluated predictors of circulating NT-proBNP levels and determined the utility of NT-proBNP to detect systolic and diastolic LV dysfunction in older adults. METHODS: A population-based sample of 1229 older adults (mean age 69.4 years, 50.1% women) underwent echocardiographic assessment of cardiac structure and function and measurement of circulating NT-proBNP levels. RESULTS: Predictors of NT-proBNP included age, female sex, body mass index, and cardiorenal parameters (diastolic dysfunction [DD] severity; LV mass and left atrial volume; right ventricular overload; decreasing ejection fraction [EF] and creatinine clearance). The performance of NT-proBNP to detect any degree of LV dysfunction, including mild DD, was poor (area under the curve 0.56-0.66). In contrast, the performance of NT-proBNP for the detection of EF < or = 40% and moderate-severe DD was strong with area under the curve of > 0.90 regardless of age and sex; history of hypertension, diabetes, coronary artery disease; or body mass category. The ability of NT-proBNP to detect EF < or = 40% and/or moderate-severe DD was optimized by using age/sex-specific limits. Of "false-positive" tests, 88% (124/141) were explained after considering cardiorenal determinants of NT-proBNP levels. CONCLUSIONS: Amino-terminal pro-B-type natriuretic peptide is a suboptimal marker of mild LV dysfunction, but performs strongly as a marker of EF < or = 40% and/or moderate-severe DD in the community. Most subjects with a positive NT-proBNP test, using age/sex-specific cutoffs, had prognostically significant abnormalities of cardiac structure or function. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/17070165/Population_based_detection_of_systolic_and_diastolic_dysfunction_with_amino_terminal_pro_B_type_natriuretic_peptide_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(06)00461-3 DB - PRIME DP - Unbound Medicine ER -