Document Detail

Value of plasma B type natriuretic peptide measurement for heart disease screening in a Japanese population.
MedLine Citation:
PMID:  11796549     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Conflict exists regarding the usefulness of measuring plasma B type natriuretic peptide (BNP) concentrations for identifying impaired left ventricular (LV) systolic function during mass screening. Various cardiac abnormalities, regardless of degree of LV dysfunction, are prone to carry a high risk of cardiovascular events.
OBJECTIVE: To examine the validity of plasma BNP measurement for detection of various cardiac abnormalities in a population with a low prevalence of coronary heart disease and LV systolic dysfunction.
DESIGN AND SETTING: Participants in this cross sectional study attended a health screening programme in Iwate, northern Japan. Plasma BNP concentrations were determined in 1098 consecutive subjects (mean age 56 years) by direct radioimmunoassay. All subjects underwent multiphasic health checkups including physical examination, ECG, chest radiography, and transthoracic echocardiography.
RESULTS: Conventional diagnostic methods showed 39 subjects to have a wide range of cardiac abnormalities: lone atrial fibrillation or flutter in 11; previous myocardial infarction in seven; valvar heart disease in seven; hypertensive heart disease in six; cardiomyopathy in six; atrial septal defect in one; and cor pulmonale in one. No subjects had a low LV ejection fraction (< 40%). To assess the utility of plasma BNP measurement for identification of such patients, receiver operating characteristic analysis was performed. The optimal threshold for identification was a BNP concentration of 50 pg/ml with sensitivity of 89.7% and specificity of 95.7%. The area under the receiver operating characteristic curve was 0.970. The positive and negative predictive values at the cutoff level were 44.3% and 99.6%, respectively.
CONCLUSION: Measurement of plasma BNP concentration is a very efficient and cost effective mass screening technique for identifying patients with various cardiac abnormalities regardless of aetiology and degree of LV systolic dysfunction that can potentially develop into obvious heart failure and carry a high risk of a cardiovascular event.
M Nakamura; H Endo; M Nasu; N Arakawa; T Segawa; K Hiramori
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  87     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-01-17     Completed Date:  2002-01-31     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  131-5     Citation Subset:  AIM; IM    
Second Department of Medicine, Iwate Medical University, Morioka, Japan.
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MeSH Terms
Aged, 80 and over
Atrial Natriuretic Factor / blood*
Biological Markers / blood
Coronary Disease / blood,  diagnosis
Cross-Sectional Studies
Electrocardiography / methods
Mass Screening / methods
Middle Aged
Natriuretic Peptide, Brain
ROC Curve
Sensitivity and Specificity
Ventricular Dysfunction, Left / blood,  diagnosis*
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor
Comment In:
Heart. 2002 Feb;87(2):97-8   [PMID:  11796533 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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