Is B-type natriuretic peptide a useful screening test for systolic or diastolic dysfunction in patients with coronary disease? Data from the Heart and Soul Study.
Am J Med
; 116(8): 509-16, 2004 Apr 15.
Article
em En
| MEDLINE
| ID: mdl-15063811
ABSTRACT
BACKGROUND:
Whether B-type natriuretic peptide (BNP) levels can be used to screen for ventricular dysfunction in patients at risk of heart failure but without overt symptoms is not known. We examined the characteristics of a BNP test for identifying systolic and diastolic dysfunction in outpatients with stable coronary disease.METHODS:
In a cross-sectional study of 293 outpatients who had stable coronary disease and no history of heart failure, we compared elevations in plasma BNP levels with echocardiography for the diagnosis of systolic dysfunction (ejection fraction <55%) and diastolic dysfunction (diastolic dominant pulmonary vein flow with ejection fraction > or =55%).RESULTS:
A total of 48 patients (16%) had systolic dysfunction, and among the remaining 245 with preserved systolic function, 31 (13%) had diastolic dysfunction. At the standard cutpoint of >100 pg/mL, an elevated BNP level was 38% sensitive (80% specific) for systolic dysfunction and 55% sensitive (85% specific) for diastolic dysfunction. Negative likelihood ratios were 0.8 (95% confidence interval [CI] 0.6 to 1.0) for systolic dysfunction and 0.5 (95% CI 0.4 to 0.8) for diastolic dysfunction. Positive likelihood ratios were 1.9 (95% CI 1.2 to 2.9) for systolic dysfunction and 3.8 (95% CI 2.4 to 5.9) for diastolic dysfunction. Areas under the receiver operating characteristic curves were 0.59 (95% CI 0.49 to 0.69) for systolic dysfunction and 0.79 (95% CI 0.71 to 0.87) for diastolic dysfunction.CONCLUSION:
These data suggest that BNP is not a useful screening test for asymptomatic ventricular dysfunction in patients with stable coronary disease.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Disfunção Ventricular
/
Doença das Coronárias
/
Peptídeo Natriurético Encefálico
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
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Prevalence_studies
/
Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Aged
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2004
Tipo de documento:
Article