Details

Autor(en) / Beteiligte

• de Lemos, James A., MD
• McGuire, Darren K., MD, MHSc
• Khera, Amit, MD, MSc
• Das, Sandeep R., MD, MPH
• Murphy, Sabina A., MPH
• Omland, Torbjorn, MD, PhD, MPH
• Drazner, Mark H., MD, MSc

Titel

Screening the population for left ventricular hypertrophy and left ventricular systolic dysfunction using natriuretic peptides: Results from the Dallas Heart Study

Ist Teil von

• The American heart journal, 2009-04, Vol.157 (4), p.746-753.e2

Ort / Verlag

New York, NY: Mosby, Inc

Erscheinungsjahr

2009

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Background Identification of individuals in the community with left ventricular systolic dysfunction (LVSD) or left ventricular hypertrophy (LVH) may allow earlier initiation of disease-modifying treatment. We performed a comprehensive evaluation of the screening performance of B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) for LVSD or LVH. Methods In 2,429 subjects without a history of heart failure, myocardial infarction, valvular abnormalities, or a serum creatinine >2.0 mg/dL enrolled in the Dallas Heart Study, measurement of BNP and NT-proBNP and cardiovascular magnetic resonance imaging were performed. Results B-type natriuretic peptide and NT-proBNP were robustly associated with magnetic resonance imaging–defined LVH and LVSD (ejection fraction <55%) among men and women ( P < .0001 for each). In the overall population, neither test discriminated well for LVH or LVSD (area under the receiver operating characteristic curve [AUROC] <0.7). Among women, no differences in AUROC were observed between BNP and NT-proBNP. Among men, AUROCs were similar between BNP and NT-proBNP in the overall population, but among subgroups age 50 or older, or with hypertension, the AUROCs for NT-proBNP (0.73-0.79) were higher than for BNP (0.63-0.69, P < .05 for each comparison). Compared with subjects with isolated BNP elevation (>97.5th percentile), those with isolated NT-proBNP elevation had worse renal function and more LVH and coronary calcium ( P < .05 for each). Conclusions Overall, neither BNP nor NT-proBNP accurately discriminated subjects with LVH or LVSD in this predominately young and healthy population-based cohort. However, among high-risk men, NT-proBNP performed slightly better than BNP and comparably with other routinely used screening tests such as prostate-specific antigen measurement for prostate cancer.