Plasma BNP screening for preclinical ventricular dysfunction yielded AUCs of 0.51-0.74 for any systolic and 0.52-0.68 for any diastolic dysfunction, making it a suboptimal population screening test.
Cross-Sectional (n=2,042)
No
Does plasma brain natriuretic peptide (BNP) measurement accurately detect preclinical ventricular systolic or diastolic dysfunction in adults aged 45 years or older?
BNP is a suboptimal screening test for preclinical ventricular dysfunction in the general population due to high false positive and false negative rates.
BACKGROUND: Preclinical systolic or diastolic dysfunction is associated with increased morbidity and mortality. We postulated that plasma brain natriuretic peptide (BNP) might serve as a biomarker for preclinical ventricular dysfunction (PCVD) but that the discriminatory values for BNP may vary with age and sex. METHODS AND RESULTS: We measured BNP, systolic and diastolic ventricular function, and clinical parameters in 2042 randomly selected residents of Olmsted County, Minn, aged 45 years or older. For preclinical systolic dysfunction, the areas under the receiver operating characteristics curve were higher for those with more severe (0.82 to 0.92) than any (0.51 to 0.74) systolic dysfunction and were similar in men and women and in younger and older persons. For preclinical diastolic dysfunction, the areas under the receiver operating characteristics curve were higher for those with moderate-to-severe (0.74 to 0.79) than any (0.52 to 0.68) diastolic dysfunction and were similar regardless of age or sex. Optimal discriminatory values of BNP varied with age and sex. Considering the prevalence of preclinical systolic or diastolic dysfunction and the predictive characteristics observed, using BNP to screen for PCVD would necessitate echo in 10% to 40% of those screened, with most confirmatory echocardiograms being negative, and would miss 10% to 60% of those affected. CONCLUSIONS: BNP is a suboptimal screening test for PCVD in the population.
Redfield et al. (2004) conducted a cross-sectional in Preclinical ventricular systolic or diastolic dysfunction (n=2,042). Plasma brain natriuretic peptide (BNP) was evaluated on Detection of preclinical systolic or diastolic dysfunction. Plasma BNP screening for preclinical ventricular dysfunction yielded AUCs of 0.51-0.74 for any systolic and 0.52-0.68 for any diastolic dysfunction, making it a suboptimal population screening test.