| Diagnostic accuracy of NT-proBNP ratio (BNP-R) for early diagnosis of tachycardia-mediated cardiomyopathy: a pilot study. | |
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MedLine Citation:
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PMID: 21538234 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: When heart failure and tachycardia occur simultaneously, a useful diagnostic tool for early discrimination of patients with benign tachycardia-mediated cardiomyopathy (TMC) versus major structural heart disease (MSHD) is not available. Such a tool is required to prevent unnecessary and wearing diagnostics in patients with reversible TMC. Moreover, it could lead to early additional diagnostics and therapeutic approaches in patients with MSHD. METHODS: A total of 387 consecutive patients with supraventricular arrhythmia underwent assessment at a single center. Of these patients, 40 fulfilled the inclusion criteria with a resting heart rate ≥100 bpm and an impaired left ventricular ejection fraction <40%. In all patients, successful electrical cardioversion was performed. At baseline, day 1 and weekly for 4 weeks, levels of NT-proBNP and echocardiographic parameters were evaluated. An NT-proBNP ratio (BNP-R) was calculated as a quotient of baseline NT-proBNP/follow-up NT-proBNP. After 4 weeks, cardiac catheterization was performed to identify patients with a final diagnosis of TMC versus MSHD. RESULTS: Initial NT-proBNP concentrations were elevated and consecutively decreased after cardioversion in all patients. Multivariate regression and ROC analysis revealed that BNP-R discriminated between patients with TMC versus MSHD independent and superior to all other variables. The area under the ROC curve for BNP-R to detect TMC was 0.90 (95% CI 0.79-1.00; p < 0.001) after 1 week and 0.995 (95% CI 0.99-1.00; p < 0.0001) after 4 weeks. One week after cardioversion already, a BNP-R cutoff ≥2.3 was useful for TMC diagnosis indicated by an accuracy of 90%, sensitivity of 84% and specificity of 95%. CONCLUSION: BNP-R was found to be highly accurate for the early diagnosis of TMC. |
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Authors:
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Amir M Nia; Natig Gassanov; Kristina M Dahlem; Evren Caglayan; Martin Hellmich; Erland Erdmann; Fikret Er |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-5-3 |
Journal Detail:
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Title: Clinical research in cardiology : official journal of the German Cardiac Society Volume: - ISSN: 1861-0692 ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-5-3 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101264123 Medline TA: Clin Res Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Internal Medicine III, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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