A prospective study in search of an optimal B-natriuretic peptide level to screen patients for cardiac dysfunction

American Heart Journal
Dunya AtishaAlan S Maisel

Abstract

Although echocardiography is the gold standard test for suspected left ventricular dysfunction, its cost and availability limits its use as a routine screening tool. The high negative predictive value of B-natriuretic peptide (BNP) in dyspneic patients suggests its possible utility in screening patients prior to echocardiography. Determining an appropriate BNP level below which the need for echocardiography is precluded would be valuable. We hypothesized that a fixed plasma BNP level of 20 pg/mL and simple clinical parameters are an effective pre-echocardiographic screening tool for left ventricular dysfunction. Two hundred and two patients at a Veterans Administration facility with symptoms suggestive of heart disease (male to female ratio 193:9, mean age 65 years) were screened prior to echocardiography. Patients with known cardiac dysfunction were excluded. BNP levels of > or =20 pg/mL were 79% sensitive and 44% specific in screening for any abnormality of ventricular function. The negative predictive value was 69%. When broken down into categories of dysfunction, the cutoff point of 20 pg/mL had a better negative predictive value for those with systolic dysfunction (96%) or systolic plus diastolic dysfunction (100%) if pati...Continue Reading

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Citations

Aug 13, 2011·Expert Reviews in Molecular Medicine·Asma EjazLeena Pradhan
Jan 5, 2006·Nature Clinical Practice. Cardiovascular Medicine·Alan S MaiselEugene Braunwald
May 26, 2011·British Journal of Anaesthesia·C J PayneD B Kingsmore
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Jul 16, 2015·Diabetic Medicine : a Journal of the British Diabetic Association·I KishimotoH Ogawa
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Aug 16, 2005·American Journal of Obstetrics and Gynecology·Jamie L ResnikAlan Maisel
Jan 3, 2006·Journal of the American College of Cardiology·Alan Maisel
Oct 14, 2008·Archives of Cardiovascular Diseases·Damien Logeart
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