Combined Use of Amino Terminal-Pro-Brain Natriuretic Peptide Levels and QRS Duration to Predict Left Ventricular Systolic Dysfunction in Patients With Dyspnea

Sakhuja, Rahul; Chen, Annabel A.; Anwaruddin, Saif; Baggish, Aaron L.; Januzzi, James L.

doi:10.1016/j.amjcard.2005.03.056

Cited by 10 publications

(4 citation statements)

References 12 publications

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“…We did not find QRS width to be a more specific marker than NT-proBNP for the detection of LVSD (see Fig. 2a) contrary to previous papers [20,21]. This may be due to the modest numbers in our study or those patients with broad QRS due to RBBB and LV pacing but in whom major cardiac disease was absent.…”

Section: Discussioncontrasting

confidence: 97%

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Ruling out heart failure in primary-care: The cost-benefit of pre-screening using NT-proBNP and QRS width

Goode

Clark

Cleland

2008

International Journal of Cardiology

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Section: Discussioncontrasting

confidence: 97%

“…The combination of QRS width and natriuretic peptides may improve the accuracy of diagnosing impaired LV-function in an outpatient HF-clinic setting [20] and in dyspnoeic patients presenting to an emergency department [21].…”

Section: Introductionmentioning

confidence: 99%

Ruling out heart failure in primary-care: The cost-benefit of pre-screening using NT-proBNP and QRS width

Goode

Clark

Cleland

2008

International Journal of Cardiology

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“…Intermittent claudication and stroke were defined by standard questionnaires 15,16 . Heart failure was ascertained by a B-type natriuretic pep-tide level ≥ 100pgmL and electrocardiographic QRS duration ≥ 120ms 17 . Infection with T. cruzi was assessed by seropositivity in three different methods run in parallel [hemaglutination (Biolab-Mérieux, France), and two enzyme-linked immunoabsorbent assays (Abbott, U.S.A. and Wierner, Argentina)].…”

Section: Explanatory Variablesmentioning

confidence: 99%

Time trends and predictors of mortality from ill-defined causes in old age: 9 year folllow-up of the Bambuí cohort study (Brazil)

et al. 2010

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Time trends and predictors of mortality from ill-defi ned causes in old age: 9 year folllow-up of the Bambuí cohort study (Brazil) Tendências e fatores associados aos óbitos por causas mal defi nidas em idosos: nove anos de seguimento da coorte de Bambuí (Brasil) 1997-1999 to 2003-2005. Deaths coded to other ill-defined conditions remained unchanged. The calendar period 2003 95%CI: 0.09-0.70) and in-hospital deaths (RR = 0.16; 95%CI: 0.08-0.34)

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“…QRS width measured manually from a surface ECG is a crude measure of the severity of left ventricular (LV) dysfunction [15,16] and has the benefit of being automatically measured on most modern ECG recorders. The combination of QRS width and natriuretic peptides may improve the accuracy of diagnosing impaired LV‐function in an outpatient HF‐clinic setting [17] and in dyspnoeic patients presenting to an emergency department [18].…”

Section: Introductionmentioning

confidence: 99%

Screening for left ventricular systolic dysfunction in high‐risk patients in primary‐care: A cost‐benefit analysis

Goode

Clark

Bristow

et al. 2007

European J of Heart Fail

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Background: Appropriate screening strategies are needed to cost effectively identify patients with undiagnosed and untreated left ventricular systolic dysfunction (LVSD). Aim: To investigate the cost-benefit of screening high-risk patients in primary-care for LVSD (EF b 40%) using various screening strategies. Methods: Patients considered at high-risk of developing LVSD were recruited from three primary-care practices. Patients with known LVSD were excluded. Echocardiography, electrocardiography and blood tests were performed blinded to an NT-proBNP result. Logistic regression (LR) and receiver-operating characteristic analysis were used to assess the univariate and multivariable utility of NT-proBNP, QRS duration, symptoms and evidence of myocardial infarction (MI) to detect LVSD. Results: 427 patients were assessed. 7.5% had undiagnosed LVSD. NT-proBNP, QRS, symptoms and MI were independent predictors of LVSD (p b 0.014) and the resultant LR-model had an area-under-the-curve of 0.89 (0.84-0.94) and specificity of 54% (51-79%) at a sensitivity of 100%. The LR-model avoided 24.1% (18.1-48.3%) of the cost and 50.1% (44.1-74.3%) of the echocardiograms compared to screening using echocardiography alone. Conclusions: Screening high-risk groups in primary-care increases the pick-up rate for undiagnosed LVSD and using an LR-model combining NT-proBNP, QRS, symptoms and evidence of MI has significant cost benefits.

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Combined Use of Amino Terminal-Pro-Brain Natriuretic Peptide Levels and QRS Duration to Predict Left Ventricular Systolic Dysfunction in Patients With Dyspnea

Cited by 10 publications

References 12 publications

Ruling out heart failure in primary-care: The cost-benefit of pre-screening using NT-proBNP and QRS width

Ruling out heart failure in primary-care: The cost-benefit of pre-screening using NT-proBNP and QRS width

Time trends and predictors of mortality from ill-defined causes in old age: 9 year folllow-up of the Bambuí cohort study (Brazil)

Screening for left ventricular systolic dysfunction in high‐risk patients in primary‐care: A cost‐benefit analysis

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