The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements
Aims Diastolic heart failure is a frequent entity but difficult to diagnose. N-terminal pro-B type natriuretic peptide (NT-proBNP) was therefore investigated as a possible non-invasive parameter to diagnose isolated diastolic dysfunction. Methods and results Sixty-eight symptomatic patients with iso...
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| Veröffentlicht in: | European heart journal 2005-11, Vol.26 (21), p.2277-2284 |
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| creator | Tschöpe, Carsten Kašner, Mario Westermann, Dirk Gaub, Regina Poller, Wolfgang C. Schultheiss, Heinz-Peter |
| description | Aims Diastolic heart failure is a frequent entity but difficult to diagnose. N-terminal pro-B type natriuretic peptide (NT-proBNP) was therefore investigated as a possible non-invasive parameter to diagnose isolated diastolic dysfunction. Methods and results Sixty-eight symptomatic patients with isolated diastolic dysfunction and preserved left ventricular ejection fraction (LVEF) (≥50%) and 50 patients with regular left ventricular (LV) function were examined by conventional echocardiography, tissue Doppler imaging (TDI), and left and right heart catheterization. Plasma NT-proBNP levels were determined simultaneously. Median NT-proBNP plasma levels were elevated [189.54 pg/mL (86.16–308.27) vs. 51.89 pg/mL (29.94–69.71); P |
| doi_str_mv | 10.1093/eurheartj/ehi406 |
| format | Article |
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N-terminal pro-B type natriuretic peptide (NT-proBNP) was therefore investigated as a possible non-invasive parameter to diagnose isolated diastolic dysfunction. Methods and results Sixty-eight symptomatic patients with isolated diastolic dysfunction and preserved left ventricular ejection fraction (LVEF) (≥50%) and 50 patients with regular left ventricular (LV) function were examined by conventional echocardiography, tissue Doppler imaging (TDI), and left and right heart catheterization. Plasma NT-proBNP levels were determined simultaneously. Median NT-proBNP plasma levels were elevated [189.54 pg/mL (86.16–308.27) vs. 51.89 pg/mL (29.94–69.71); P<0.001] and increased with greater severity of the diastolic dysfunction (R=0.67, P<0.001). According to the recevier operating characteristic analysis, LV end-diastolic pressure [area under the curve (AUC) 0.84] was the most specific parameter, which had a low sensitivity (61%), however. The reliability of NT-proBNP was similar to TDI indices (AUC 0.83 vs. 0.81) and improved when compared with conventional echocardiography (AUC 0.59–0.70). NT-proBNP levels had the best negative predictive value of all methods (94%) and correlated strongly with indices of LV filling pressure, as determined by invasive measurements. Multivariable linear regression analysis confirmed NT-proBNP as an independent predictor of diastolic dysfunction with an Odds ratio of 1.2 (1.1–1.4, CI 95%) for every unit increase of NT-proBNP. Conclusion NT-proBNP can reliably detect the presence of isolated diastolic dysfunction in symptomatic patients and is an useful tool to rule out patients with reduced exercise tolerance of non-cardiac origin.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehi406</identifier><identifier>PMID: 16014646</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Biological and medical sciences ; Biomarker ; Biomarkers - blood ; Cardiology. Vascular system ; Case-Control Studies ; Diastole ; Echocardiography - methods ; Female ; Heart ; Heart failure ; Heart Failure - diagnosis ; Heart Failure - physiopathology ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Humans ; Left ventricular diastolic dysfunction ; Male ; Medical sciences ; Middle Aged ; N-terminal pro-B type natriuretic peptide ; Natriuretic Peptide, Brain - blood ; Peptide Fragments - blood ; Prospective Studies ; Stroke Volume ; Ventricular Dysfunction, Left - diagnosis ; Ventricular Dysfunction, Left - physiopathology</subject><ispartof>European heart journal, 2005-11, Vol.26 (21), p.2277-2284</ispartof><rights>2005 INIST-CNRS</rights><rights>Copyright Oxford University Press(England) Nov 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c434t-6d01aa84b9b00ba4104df4157bb4f0b1f8b8a1a4864d761f587aa876ae2f32c03</citedby><cites>FETCH-LOGICAL-c434t-6d01aa84b9b00ba4104df4157bb4f0b1f8b8a1a4864d761f587aa876ae2f32c03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27933,27934</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17213922$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16014646$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tschöpe, Carsten</creatorcontrib><creatorcontrib>Kašner, Mario</creatorcontrib><creatorcontrib>Westermann, Dirk</creatorcontrib><creatorcontrib>Gaub, Regina</creatorcontrib><creatorcontrib>Poller, Wolfgang C.</creatorcontrib><creatorcontrib>Schultheiss, Heinz-Peter</creatorcontrib><title>The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>Aims Diastolic heart failure is a frequent entity but difficult to diagnose. N-terminal pro-B type natriuretic peptide (NT-proBNP) was therefore investigated as a possible non-invasive parameter to diagnose isolated diastolic dysfunction. Methods and results Sixty-eight symptomatic patients with isolated diastolic dysfunction and preserved left ventricular ejection fraction (LVEF) (≥50%) and 50 patients with regular left ventricular (LV) function were examined by conventional echocardiography, tissue Doppler imaging (TDI), and left and right heart catheterization. Plasma NT-proBNP levels were determined simultaneously. Median NT-proBNP plasma levels were elevated [189.54 pg/mL (86.16–308.27) vs. 51.89 pg/mL (29.94–69.71); P<0.001] and increased with greater severity of the diastolic dysfunction (R=0.67, P<0.001). According to the recevier operating characteristic analysis, LV end-diastolic pressure [area under the curve (AUC) 0.84] was the most specific parameter, which had a low sensitivity (61%), however. The reliability of NT-proBNP was similar to TDI indices (AUC 0.83 vs. 0.81) and improved when compared with conventional echocardiography (AUC 0.59–0.70). NT-proBNP levels had the best negative predictive value of all methods (94%) and correlated strongly with indices of LV filling pressure, as determined by invasive measurements. Multivariable linear regression analysis confirmed NT-proBNP as an independent predictor of diastolic dysfunction with an Odds ratio of 1.2 (1.1–1.4, CI 95%) for every unit increase of NT-proBNP. Conclusion NT-proBNP can reliably detect the presence of isolated diastolic dysfunction in symptomatic patients and is an useful tool to rule out patients with reduced exercise tolerance of non-cardiac origin.</description><subject>Biological and medical sciences</subject><subject>Biomarker</subject><subject>Biomarkers - blood</subject><subject>Cardiology. Vascular system</subject><subject>Case-Control Studies</subject><subject>Diastole</subject><subject>Echocardiography - methods</subject><subject>Female</subject><subject>Heart</subject><subject>Heart failure</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - physiopathology</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Humans</subject><subject>Left ventricular diastolic dysfunction</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>N-terminal pro-B type natriuretic peptide</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Peptide Fragments - blood</subject><subject>Prospective Studies</subject><subject>Stroke Volume</subject><subject>Ventricular Dysfunction, Left - diagnosis</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0U9rFDEYBvAgil2rd08SBL2NTTKZzIy3Wv-sWKrCCqWX8E7mTSfr7GRNMtV-Az-2WXZpwVNI3l8eEh5CnnP2hrO2PME5DAghrU9wcJKpB2TBKyGKVsnqIVkw3laFUs3lEXkS45ox1iiuHpMjrhiXSqoF-bsakAY_IvWWXqyKbfDvLr5RN9GUB72D68nH5EzczV30IyTsd-cx-dEZ2t9GO08mOT-9pcaHgFnkDf3t0kDRDN5A6J2_DrAdsoepz-E3EN0N0g1CnANucErxKXlkYYz47LAekx8fP6zOlsX510-fz07PCyNLmQrVMw7QyK7tGOtAciZ7K3lVd520rOO26RrgIBsl-1pxWzV15rUCFLYUhpXH5PU-N__014wx6Y2LBscRJvRz1KpRTStYneHL_-Daz2HKb9OCV7IVrdylsT0ywccY0OptcBsIt5ozvatI31Wk9xXlKy8OuXO3wf7-wqGTDF4dAEQDow0wGRfvXS142QqRXbF3Lib8czeH8FOruqwrvby80qp9v6yvvn_Rq_If1cqu1A</recordid><startdate>20051101</startdate><enddate>20051101</enddate><creator>Tschöpe, Carsten</creator><creator>Kašner, Mario</creator><creator>Westermann, Dirk</creator><creator>Gaub, Regina</creator><creator>Poller, Wolfgang C.</creator><creator>Schultheiss, Heinz-Peter</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20051101</creationdate><title>The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements</title><author>Tschöpe, Carsten ; Kašner, Mario ; Westermann, Dirk ; Gaub, Regina ; Poller, Wolfgang C. ; Schultheiss, Heinz-Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c434t-6d01aa84b9b00ba4104df4157bb4f0b1f8b8a1a4864d761f587aa876ae2f32c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Biological and medical sciences</topic><topic>Biomarker</topic><topic>Biomarkers - blood</topic><topic>Cardiology. Vascular system</topic><topic>Case-Control Studies</topic><topic>Diastole</topic><topic>Echocardiography - methods</topic><topic>Female</topic><topic>Heart</topic><topic>Heart failure</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - physiopathology</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Humans</topic><topic>Left ventricular diastolic dysfunction</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>N-terminal pro-B type natriuretic peptide</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Peptide Fragments - blood</topic><topic>Prospective Studies</topic><topic>Stroke Volume</topic><topic>Ventricular Dysfunction, Left - diagnosis</topic><topic>Ventricular Dysfunction, Left - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tschöpe, Carsten</creatorcontrib><creatorcontrib>Kašner, Mario</creatorcontrib><creatorcontrib>Westermann, Dirk</creatorcontrib><creatorcontrib>Gaub, Regina</creatorcontrib><creatorcontrib>Poller, Wolfgang C.</creatorcontrib><creatorcontrib>Schultheiss, Heinz-Peter</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tschöpe, Carsten</au><au>Kašner, Mario</au><au>Westermann, Dirk</au><au>Gaub, Regina</au><au>Poller, Wolfgang C.</au><au>Schultheiss, Heinz-Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>2005-11-01</date><risdate>2005</risdate><volume>26</volume><issue>21</issue><spage>2277</spage><epage>2284</epage><pages>2277-2284</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Aims Diastolic heart failure is a frequent entity but difficult to diagnose. N-terminal pro-B type natriuretic peptide (NT-proBNP) was therefore investigated as a possible non-invasive parameter to diagnose isolated diastolic dysfunction. Methods and results Sixty-eight symptomatic patients with isolated diastolic dysfunction and preserved left ventricular ejection fraction (LVEF) (≥50%) and 50 patients with regular left ventricular (LV) function were examined by conventional echocardiography, tissue Doppler imaging (TDI), and left and right heart catheterization. Plasma NT-proBNP levels were determined simultaneously. Median NT-proBNP plasma levels were elevated [189.54 pg/mL (86.16–308.27) vs. 51.89 pg/mL (29.94–69.71); P<0.001] and increased with greater severity of the diastolic dysfunction (R=0.67, P<0.001). According to the recevier operating characteristic analysis, LV end-diastolic pressure [area under the curve (AUC) 0.84] was the most specific parameter, which had a low sensitivity (61%), however. The reliability of NT-proBNP was similar to TDI indices (AUC 0.83 vs. 0.81) and improved when compared with conventional echocardiography (AUC 0.59–0.70). NT-proBNP levels had the best negative predictive value of all methods (94%) and correlated strongly with indices of LV filling pressure, as determined by invasive measurements. Multivariable linear regression analysis confirmed NT-proBNP as an independent predictor of diastolic dysfunction with an Odds ratio of 1.2 (1.1–1.4, CI 95%) for every unit increase of NT-proBNP. Conclusion NT-proBNP can reliably detect the presence of isolated diastolic dysfunction in symptomatic patients and is an useful tool to rule out patients with reduced exercise tolerance of non-cardiac origin.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>16014646</pmid><doi>10.1093/eurheartj/ehi406</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Biological and medical sciences Biomarker Biomarkers - blood Cardiology. Vascular system Case-Control Studies Diastole Echocardiography - methods Female Heart Heart failure Heart Failure - diagnosis Heart Failure - physiopathology Heart failure, cardiogenic pulmonary edema, cardiac enlargement Humans Left ventricular diastolic dysfunction Male Medical sciences Middle Aged N-terminal pro-B type natriuretic peptide Natriuretic Peptide, Brain - blood Peptide Fragments - blood Prospective Studies Stroke Volume Ventricular Dysfunction, Left - diagnosis Ventricular Dysfunction, Left - physiopathology |
| title | The role of NT-proBNP in the diagnostics of isolated diastolic dysfunction: correlation with echocardiographic and invasive measurements |
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