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January 14, 2003HeartOpen Access

NT-proBNP: a new diagnostic screening tool to differentiate between patients with normal and reduced left ventricular systolic function

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Why the study?

Does NT-proBNP measurement accurately identify reduced left ventricular ejection fraction in unselected hospital inpatients?

Population

2,193 unselected consecutive hospital inpatients

Comparison

N-terminal pro-brain natriuretic peptide blood… vs Echocardiographic evaluation of left ventricular…

Design

Cross-sectional

Authors

MBM. BayCentro Científico Tecnológico - La Plata

Discussion

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Implication

Supports ruling out reduced LVEF via low NT-proBNP in hospital inpatients; leaves open prospective validation before routine use.

Key Points

  • To determine whether NT-proBNP levels can effectively differentiate between normal and reduced left ventricular ejection fraction in an unselected population of hospital inpatients.
  • Conducted a prospective evaluation of 2,230 consecutive admissions to a general hospital in Copenhagen, Denmark, obtaining clinical evaluations, echocardiograms, and blood samples within 24 hours of admission.
  • Analyzed 2,193 patients with interpretable echocardiograms to assess left ventricular ejection fraction in relation to NT-proBNP concentrations adjusted for age, sex, and serum creatinine.
  • An NT-proBNP level ≥ 357 pmol/l identified an LVEF ≤ 40% (n = 157) with 73% sensitivity, 82% specificity, and a negative predictive value of 98%.
  • NT-proBNP concentrations increased with advancing age and with decreasing LVEF (p < 0.05).
  • Patients with measured NT-proBNP below their predicted concentration had a > 97% probability of having an LVEF > 40%, which dropped to 70% when measured levels reached 150% of predicted.

Structured PICO

Does NT-proBNP measurement accurately identify reduced left ventricular ejection fraction in unselected hospital inpatients?

P
Population
2,193 unselected consecutive hospital inpatients
I
Intervention
N-terminal pro-brain natriuretic peptide (NT-proBNP) blood analysis within 24 hours of admission
C
Comparator
Echocardiographic evaluation of left ventricular function
O
Outcome
Identification of reduced left ventricular ejection fraction (LVEF ≤ 40%)surrogate

A single NT-proBNP measurement at hospital admission has a high negative predictive value for ruling out reduced left ventricular systolic function in unselected patients.

Cite This Study

M. Bay (2003) studied this question.

synapsesocial.com/papers/6a7c8eb52bc3e5689c4c715fhttps://doi.org/10.1136/heart.89.2.150

Topics

Echocardiography
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Rapid Estimation of Left Ventricular Ejection Fraction in Acute Myocardial Infarction by Echocardiographic Wall Motion Analysis2008 · 123 citations
  2. 2Mechanisms of atrial and brain natriuretic peptide release from rat ventricular myocardium: effect of stretching1993 · 88 citations
  3. 3The Natural History of Congestive Heart Failure: The Framingham Study1971 · 3,492 citations
  4. 4Development of a novel, N-Terminal-proBNP (NT-proBNP) assay with a low detection limit1999 · 174 citations
  5. 5Plasma Brain Natriuretic Peptide as an Indicator of Left Ventricular Systolic Function and Long-term Survival After Acute Myocardial Infarction1996 · 702 citations