Biological Variation of N-Terminal Pro-Brain Natriuretic Peptide in Healthy Individuals

d’Eril, Gianvico Melzi; Tagnochetti, Tiziana; Nauti, A.; Klersy, Catherine; Papalia, Antonia; Vadacca, Giovanbattista; Moratti, Remigio; Merlini, Giampaolo

doi:10.1373/49.9.1554

Cited by 50 publications

(23 citation statements)

References 5 publications

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“…The increasing interest in the application of biological variation data has prompted the study of several ''esoteric'' analytes, such as N-terminal pro-brain natriuretic peptide (28), blood vitamins (29) or asymmetric dimethylarginine (30). However, to our knowledge, no previous specifically designed studies on biological variation have been reported for free plasma amino acids.…”

Section: Discussionmentioning

confidence: 99%

Biological variation of free plasma amino acids in healthy individuals

Corte

Venta²

2009

Clinical Chemistry and Laboratory Medicine

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Background: Biological variation data for free plasma amino acids are lacking from the more comprehensive databases. Therefore, we determined the intra-and inter-individual components of variation in healthy subjects. These data were used to define desirable goals for imprecision, bias and total error, indices of individuality and reference change values. Methods: Plasma samples were collected from 11 volunteers at weekly intervals over 5 weeks. Free plasma amino acids were analyzed by reversed-phase HPLC and analytical and biological variation data were derived using ANOVA. Results: Intra-individual coefficients of variation ranged from 9.5% to 46.4%, with lower values among the essential amino acids. The mean inter-individual coefficient of variation was 46.6% and was higher than intra-individual values for all amino acids. Thus, indices of individuality were below 0.8. Reference change values ranged from 30.9% to 128.4% and total error values ranged from 15.2% to 61.0%. Conclusions: Plasma amino acids exhibit relatively low intra-individual coefficients of variation, with essential amino acids showing tighter homeostatic control. Analytical quality goals can be reasonably achieved with current methods. Reference intervals are of limited value in the detection of unusual results in an individual. Therefore, comparison of serial results by means of the reference change values is recommended. Clin Chem Lab Med 2010;48:99-104.

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Section: Discussionmentioning

confidence: 99%

Biological variation of free plasma amino acids in healthy individuals

Corte

Venta²

2009

Clinical Chemistry and Laboratory Medicine

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“…In patients in whom baseline iFLCs were less than 100 mg/L and who had a measurable more than 5 g/L serum monoclonal component, hematologic response was defined as a more than 50% reduction of the monoclonal component. Based on the biologic variability of NT-proBNP 13,14 and on previous studies in AL amyloidosis, 6,15 response and progression of NT-proBNP were defined as changes both more than 30% and more than 300 ng/L. A baseline NT-proBNP more than or equal to 650 ng/L was required for NT-proBNP response to be evaluable.…”

Section: Patientsmentioning

confidence: 99%

The combination of high-sensitivity cardiac troponin T (hs-cTnT) at presentation and changes in N-terminal natriuretic peptide type B (NT-proBNP) after chemotherapy best predicts survival in AL amyloidosis

Palladini

Barassi

Klersy

et al. 2010

Blood

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In light-chain (AL) amyloidosis, prognosis is dictated by cardiac dysfunction. N-terminal natriuretic peptide type B (NT-proBNP) and cardiac troponins (cTn) are used to assess the severity of cardiac damage. We evaluated the prognostic relevance of a high-sensitivity (hs) cTnT assay, NT-proBNP, and cardiac troponin I in 171 consecutive patients with AL amyloidosis at presentation and 6 months after treatment. Response and progression of NT-proBNP were defined as more than 30% and more than 300 ng/L changes. All 3 markers predicted survival, but the best multivariable model included hs-cTnT. The hs-cTnT prognostic cutoff was 77 ng/L (median survival 10.6 months for patients with hs-cTnT above the cutoff). After treatment, response and progression of NT-proBNP and a more than 75% increase of hs-cTnT were independent prognostic determinant. In AL amyloidosis, hs-cTnT is the best baseline prognostic marker. Therapy should be aimed at preventing progression of cardiac biomarkers, whereas NT-proBNP response confers an additional survival benefit. (Blood. 2010; 116(18):3426-3430)

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“…Information about variability is also important for the correct interpretation of serial test results, for example, when BNP-guided therapy in patients with congestive heart failure is considered. 5 Several small studies analysed the variability of BNP concentrations either in healthy individuals 6 or in patients with stable congestive heart failure. [7][8][9] These studies found a high coefficient of variation for BNP measurements at different points in time.…”

Section: Introductionmentioning

confidence: 99%

Substantial intraindividual variability of BNP concentrations in patients with hypertension

2006

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Plasma concentrations of B-type natriuretic peptides (BNP) independently predict the risk of death and cardiovascular events. In the present study, we investigated the intraindividual variability of BNP concentrations, a potential confounder of risk prediction. Consecutive outpatients with blood pressure (BP) values of at least 140/90 mm Hg and not taking BP lowering therapy were asked to participate. Exclusion criteria were renal insufficiency, structural heart disease on echocardiography, except left ventricular hypertrophy and any other severe concomitant illness. Plasma BNP levels were determined on two different days using the same assay. In total, 77 patients were included. Mean age was 54712 years, 55% were male and mean systolic/diastolic BP was 163716/ 9678 mm Hg. Mean creatinine was 70714 lmol/l. The median interval between the two BNP assays was 10 days (interquartile range 1-23 days). Median BNP concentrations were 17 and 16 pg/ml for the first and second visit, respectively (P ¼ 0.48). However, there was a wide range of differences in BNP values among individual patients, 34 patients (44%) having an absolute difference of at least 10 pg/ml. When patients were categorized according to tertiles of BNP levels, 25 (32%) changed from one tertile at the first visit to another at the second visit. In conclusion, these data indicate that BNP levels may be used on a population level. However, the high intraindividual variability seems to preclude useful risk stratification in the individual patient. Care should be taken in the interpretation of single BNP values below the currently accepted thresholds for heart failure.

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Biological Variation of N-Terminal Pro-Brain Natriuretic Peptide in Healthy Individuals

Cited by 50 publications

References 5 publications

Biological variation of free plasma amino acids in healthy individuals

Biological variation of free plasma amino acids in healthy individuals

The combination of high-sensitivity cardiac troponin T (hs-cTnT) at presentation and changes in N-terminal natriuretic peptide type B (NT-proBNP) after chemotherapy best predicts survival in AL amyloidosis

Substantial intraindividual variability of BNP concentrations in patients with hypertension

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