Document Detail

Use of B-type natriuretic peptide in the detection of myocardial ischemia.
MedLine Citation:
PMID:  16781223     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Exercise electrocardiography (ECG) has high specificity but limited sensitivity for the detection of myocardial ischemia. The aim of this study was to determine whether measurement of B-type natriuretic peptide (BNP) can improve the diagnostic accuracy of exercise ECG. METHODS: A total of 256 consecutive patients with suspected myocardial ischemia referred for rest/ergometry myocardial perfusion single-photon emission computed tomography were enrolled. Levels of BNP were determined before and 1 minute after maximal exercise. RESULT: Inducible myocardial ischemia on perfusion images was detected in 127 patients (49.6%). Median BNP levels at rest and after peak exercise were higher in patients with than without inducible ischemia (71 pg/mL vs 38 pg/mL, P < .001; and 88 vs 52 pg/mL, P < .001, respectively). Compared with patients in the lowest peak exercise BNP quartile, those in the highest quartile of peak exercise BNP had more than 3 times the risk of inducible ischemia (adjusted relative risk 3.3, 95% CI 1.3-8.6, P = .015). Using 110 pg/mL as a cutoff, the combination of exercise ECG and peak exercise BNP level distinguished between ischemic and nonischemic patients more accurately than the exercise ECG alone (67% vs 60%, P = .024). Although the increase in accuracy was similar for the combination of exercise ECG with baseline BNP or DeltaBNP, overall, peak exercise BNP seemed to be the preferred measurement. CONCLUSIONS: B-type natriuretic peptide levels are associated with inducible myocardial ischemia. The use of BNP levels improves the diagnostic accuracy of exercise ECG.
Daniel Staub; Charly Nusbaumer; Michael J Zellweger; Nils Jonas; Damian Wild; Matthias E Pfisterer; Jan Mueller-Brand; André P Perruchoud; Christian Mueller
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  151     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-19     Completed Date:  2006-07-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1223-30     Citation Subset:  AIM; IM    
Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
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MeSH Terms
Echocardiography, Stress*
Middle Aged
Myocardial Ischemia / blood*,  diagnosis*
Natriuretic Peptide, Brain / blood*
Reproducibility of Results
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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