Usefulness of B-Type Natriuretic Peptide Levels to Predict Left Ventricular Filling Pressures in Patients With Body Mass Index &gt;35, 31 to 35, and ≤30 kg/m2

Dokainish, Hisham; González, Rosa María Álvarez; Hartley, W. Bryan; Caldera, Angel; Koshy, Santosh; Sengupta, Ranjita; Lakkis, Nasser

doi:10.1016/j.amjcard.2007.04.059

Cited by 11 publications

(9 citation statements)

References 25 publications

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“…Our study, which provides robust adjusted findings on a large database, raises serious questions about the use of NT-proBNP levels for risk stratification in obese patients. In patients with very high BMI (>35), BNP was not related to left ventricular filling pressures, in contrast to patient with normal BMI, which strengthens the hypothesis that there is an alternative way of regulation in high BMI patients 9 27. Consistent data from our study showed that in obesity, traditional determinants of propeptide levels only accounted for 15% of variance whereas in normal-weight patients they accounted for 40%.…”

Section: Discussionsupporting

confidence: 87%

Impact of obesity on the prognostic value of the N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute myocardial infarction

Lorgis¹,

Cottin²,

Danchin³

et al. 2011

Heart

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Section: Discussionsupporting

confidence: 87%

Impact of obesity on the prognostic value of the N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute myocardial infarction

Lorgis¹,

Cottin²,

Danchin³

et al. 2011

Heart

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“…To our knowledge, 14 studies have investigated the effect of obesity on BNP and NT-proBNP concentrations. Six studies investigated the relationship between BNP and BMI (12)(13)(14)(15)(16)(17), 2 studies correlated obesity with NT-proBNP (18 -20 ), and 6 others included both BNP and NT-proBNP (7,18,(21)(22)(23)(24). Of the 12 studies that assessed BNP concentrations, 11 found reduced concentrations in obese and overweight patients; a single study showed that BNP concentrations were unaffected by BMI (21 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of Increased Body Mass Index on Accuracy of B-Type Natriuretic Peptide (BNP) and N-Terminal proBNP for Diagnosis of Decompensated Heart Failure and Prediction of All-Cause Mortality

Christenson

Azzazy

Duh³

et al. 2010

Clinical Chemistry

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Background: BNP and N-terminal proBNP (NT-proBNP) concentrations may be depressed in patients with increased body mass index (BMI). Whether increased BMI affects accuracy of these biomarkers for diagnosing decompensated heart failure (HF) and predicting outcomes is unknown. Methods: We measured BNP and NT-proBNP in 685 patients with possible decompensated HF in a free-living community population subdivided by BMI as obese, overweight, and normal weight. HF diagnosis was adjudicated by a cardiologist blinded to BNP and NT-proBNP results. We tabulated all-cause mortality over a median follow-up of 401 days and assessed marker accuracy for HF diagnosis and mortality by ROC analysis. Results: Of the 685 patients, 40.9% were obese (n = 280), 28.2% were overweight (n = 193), and 30.9% had normal BMI (n = 212). Obese patients had lower BNP and NT-proBNP compared with overweight or normal-weight individuals (P < 0.001) and decreased mortality compared with normal-weight individuals (P < 0.001). Both biomarkers added significantly to a multivariate logistic regression model for diagnosis of decompensated HF across BMI categories. NT-proBNP outperformed BNP for predicting all-cause mortality in normal-weight individuals (χ2 for BNP = 6.4, P = 0.09; χ2 for NT-proBNP = 16.5, P < 0.001). Multivariate regression showed that both biomarkers remained significant predictors of decompensated HF diagnosis in each BMI subgroup. Conclusions: In this study population, obese patients had significantly lower BNP and NT-proBNP that reflected lower mortality. BNP and NT-proBNP can be used in all BMI groups for decompensated HF diagnosis, although BMI-specific cutpoints may be necessary to optimize sensitivity.

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“…Although much existing literature suggests that both modalities offer similar diagnostic conclusions, no studies that we are aware of directly compare the results from BNP testing to ICG parameters. Furthermore, studies are increasingly questioning the accuracy of BNP testing, finding in some cases that additional factors such as body mass index, presenting complaints, and associated comorbidities significantly affect accuracy (3,18,19).…”

Section: Discussionmentioning

confidence: 99%

Correlation Between Impedance Cardiography and B-Type Natriuretic Peptide Levels in Dyspneic Patients

Havelka¹,

Rzechula²,

Bryant³

et al. 2011

The Journal of Emergency Medicine

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Usefulness of B-Type Natriuretic Peptide Levels to Predict Left Ventricular Filling Pressures in Patients With Body Mass Index >35, 31 to 35, and ≤30 kg/m2

Cited by 11 publications

References 25 publications

Impact of obesity on the prognostic value of the N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute myocardial infarction

Impact of obesity on the prognostic value of the N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute myocardial infarction

Impact of Increased Body Mass Index on Accuracy of B-Type Natriuretic Peptide (BNP) and N-Terminal proBNP for Diagnosis of Decompensated Heart Failure and Prediction of All-Cause Mortality

Correlation Between Impedance Cardiography and B-Type Natriuretic Peptide Levels in Dyspneic Patients

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