B-Type Natriuretic Peptide Testing for Structural Heart Disease Screening: A General Population-Based Study

Nakamura, Motoyuki; Tanaka, Fumitaka; Sato, Koetsu; Segawa, Toshie; Nagano, Masahide

doi:10.1016/j.cardfail.2005.06.436

Cited by 27 publications

(16 citation statements)

References 25 publications

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“…The burden of systolic dysfunction (6%) we observed was similar to that reported by other researchers, including the MONICA Glasgow study [3] 7.7%, the Olmsted County study [5] 6.0%, ECHOES [15] For the purposes of screening, the role of natriuretic peptides is not yet established [48,49] and their inclusion in screening is not recommended by major guidelines. While a low plasma NT-proBNP level essentially excludes structural heart disease [39], Murtagh and the STOP-HF investigators examined the proportion of diastolic dysfunction responsible for the high rates of false positives when using BNP to screen for systolic dysfunction in an asymptomatic population (≥40 years + HF risk factor) [51].…”

Section: Discussionsupporting

confidence: 82%

NT-proB natriuretic peptide, risk factors and asymptomatic left ventricular dysfunction: Results of the SCReening Evaluation of the Evolution of New Heart Failure Study (SCREEN-HF)

McGrady

Reid

Shiel

et al. 2013

International Journal of Cardiology

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Section: Discussionsupporting

confidence: 82%

NT-proB natriuretic peptide, risk factors and asymptomatic left ventricular dysfunction: Results of the SCReening Evaluation of the Evolution of New Heart Failure Study (SCREEN-HF)

McGrady

Reid

Shiel

et al. 2013

International Journal of Cardiology

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“…Further, they showed that BNP values above the 80th percentile of normal (20.0 pg/ml in men, 23.3 pg/ml in women) were associated with multivariate hazard ratios of 1.62 for death, 1.76 for first CV event, and 3.07 for heart failure. Despite this, other studies have shown that BNP is not a cost-effective screening tool to assess for preclinical heart failure or LV dysfunction [60,61], though it may have some utility in highly selected populations [62].…”

Section: Bnp and Congestive Heart Failurementioning

confidence: 99%

Interpretation of B-type natriuretic peptide in cardiac disease and other comorbid conditions

Burke

Cotts²

2007

Heart Fail Rev

102

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B-Type natriuretic peptide (BNP) is elevated in states of increased ventricular wall stress. BNP is most commonly used to rule out congestive heart failure (CHF) in dyspneic patients. BNP levels are influenced by age, gender and, to a surprisingly large extent, by body mass index (BMI). In addition, it can be elevated in a wide variety of clinical settings with or without CHF. BNP is elevated in other cardiac disease states such as the acute coronary syndromes, diastolic dysfunction, atrial fibrillation (AF), amyloidosis, restrictive cardiomyopathy (RCM), and valvular heart disease. BNP is elevated in non-cardiac diseases such as pulmonary hypertension, chronic obstructive pulmonary disease, pulmonary embolism, and renal failure. BNP is also elevated in the setting of critical illness such as in acute decompensated CHF (ADHF) and sepsis. This variation across clinical settings has significant implications given the increasing frequency with which BNP testing is being performed. It is important for clinicians to understand how to appropriately interpret BNP in light of the comorbidities of individual patients to maximize its clinical utility. We will review the molecular biology and physiology of natriuretic peptides as well as the relevant literature on the utilization of BNP in CHF as well as in other important clinical situations, conditions that are commonly associated with CHF and or dyspnea.

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“…All participants were examined by transthoracic echocardiography as reported previously. 16) Subjects with structural heart disease (previous myocardial infarction, severe valvular heart disease, left ventricular ejection fraction < 50%) documented by echocardiography were also excluded from the analysis, as were those with an abnormally high serum CRP level > 10 mg/L since they were assumed to be suffering from clinically infectious diseases. 17) Measurements: The subjects used a self-reporting questionnaire to document Vol 47 No 6 their medical history, which included drugs prescribed for hypertension, diabetes, hypercholesterolemia, stroke, angina, and myocardial infarction.…”

Section: Study Populationmentioning

confidence: 99%

Association of Decreased Variation of R-R Interval and Elevated Serum C-Reactive Protein Level in a General Population in Japan

et al. 2006

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SUMMARYSeveral studies have suggested that an increased high sensitivity C-reactive protein (hsCRP) level is a strong independent predictor of increased risk for atherosclerotic cardiovascular mortality and morbidity. Reduced heart rate variability (HRV) has also been reported to predict cardiovascular events such as sudden death and myocardial infarction in apparently healthy subjects. The aim of this cross-sectional study was to test the possible correlation between variation of the R-R interval as one of the markers of HRV and serum hsCRP levels in a general population in Japan.Resting, supine, 2-minute, beat-to-beat heart rate data were collected in 823 randomly selected participants enrolled in our cohort study. The coefficient of variation of the R-R interval (CVrr) was obtained as a parameter of HRV. To determine which factors predict the presence of low CVrr (below the 5 percentile) in this group, we performed a multivariate logistic regression analysis using cardiovascular risk factors and an elevated hsCRP level as independent variables.The lowest CVrr group showed significantly higher hsCRP levels compared to those of other quartiles (P < 0.01). After adjustment for confounding factors such as age, heart rate, obesity, hypercholesterolemia, and hypertension by multivariate logistic analysis, an elevated hsCRP level (OR = 3.11, 95%CI; 1.27-7.60: P < 0.02) was a significant independent predictor of low CVrr.The results of the present study indicate that an increased serum hsCRP level is significantly associated with reduced CVrr in this general population. It is conceivable that the parasympathetic nerve withdrawal and inflammation could interact with each other, resulting in the progression of atherosclerotic cardiovascular disease. (Int Heart J 2006; 47: 867-876)

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B-Type Natriuretic Peptide Testing for Structural Heart Disease Screening: A General Population-Based Study

Cited by 27 publications

References 25 publications

NT-proB natriuretic peptide, risk factors and asymptomatic left ventricular dysfunction: Results of the SCReening Evaluation of the Evolution of New Heart Failure Study (SCREEN-HF)

NT-proB natriuretic peptide, risk factors and asymptomatic left ventricular dysfunction: Results of the SCReening Evaluation of the Evolution of New Heart Failure Study (SCREEN-HF)

Interpretation of B-type natriuretic peptide in cardiac disease and other comorbid conditions

Association of Decreased Variation of R-R Interval and Elevated Serum C-Reactive Protein Level in a General Population in Japan

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