Document Detail


Biochemical diagnosis of impaired left ventricular ejection fraction--comparison of the diagnostic accuracy of brain natriuretic peptide (BNP) and amino terminal proBNP (NT-proBNP).
MedLine Citation:
PMID:  15061354     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of the present investigation was to evaluate the diagnostic accuracy of brain natriuretic peptide (BNP) and amino terminal proBNP (NT-proBNP) for the detection of mild/moderate and severe impairment of left ventricular ejection fraction (LVEF). In 180 subjects BNP and NT-proBNP were measured by two novel fully automated chemiluminescent assays (Bayer and Roche methods). LVEF as determined by echocardiography was categorized as normal (> 60%), mildly/moderately reduced (35-60%) and severely diminished (< 35%). Discriminating between patients with LVEF< 35% (n = 32) and subjects with LVEF > or = 35% (n = 148), receiver-operating characteristic (ROC) curve analysis revealed an area under the curve (AUC) of 0.912 for BNP and of 0.896 for NT-proBNP (difference 0.016, p = 0.554). In contrast, BNP displayed an AUC of 0.843 and NT-proBNP an AUC of 0.927 (difference of 0.084, p = 0.034) when comparing patients with LVEF 35-60% (n = 37) and individuals with LVEF > 60% (n = 111). Evaluation of discordant false classifications at cut-off levels with the highest diagnostic accuracy showed advantages for BNP in the biochemical diagnosis of LVEF < 35% (4 misclassifications by BNP and 25 by NT-proBNP, p < 0.001) and for NT-proBNP in the detection of LVEF 35-60% (25 misclassifications by BNP and 7 by NT-proBNP, p = 0.002). In conclusion, the present study indicates a different diagnostic accuracy of BNP and NT-proBNP for the detection of mildly/moderately reduced LVEF and severely diminished LVEF. Advantages of BNP may be advocated for the biochemical diagnosis of more severely impaired LVEF, while NT-proBNP might be a more discerning marker of early systolic left ventricular dysfunction.
Authors:
Thomas Mueller; Alfons Gegenhuber; Werner Poelz; Meinhard Haltmayer
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical chemistry and laboratory medicine : CCLM / FESCC     Volume:  42     ISSN:  1434-6621     ISO Abbreviation:  Clin. Chem. Lab. Med.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-04-05     Completed Date:  2004-10-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9806306     Medline TA:  Clin Chem Lab Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  159-63     Citation Subset:  IM    
Affiliation:
Department of Laboratory Medicine, Konventhospital Barmherzige Brueder, Linz, Austria.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biological Markers / blood
Female
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Nerve Tissue Proteins / blood*
Peptide Fragments / blood*
Predictive Value of Tests
Stroke Volume*
Ventricular Dysfunction, Left / diagnosis*
Ventricular Function, Left*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Nerve Tissue Proteins; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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