title: [Value of NTproBNP concentration in an out-of-hospital adult population].
abstract: BACKGROUND
  The diagnosis of chronic heart failure (CHF) is based on demonstrating the cardiac origin of clinical manifestations. Echocardiography is the method of choice for the detection of left ventricular systolic dysfunction (LVSD). Brain natriuretic peptide (BNP) rises during LVSD.
  
  
  OBJECTIVE
  To analyze the plasma concentration of N-terminal brain natriuretic propeptide (NTproBNP) in a general adult population in relation to different spontaneous circumstances and to study its capacity for identifying patients with LVSD.Methods. A cardiological examination was made and plasma NTproBNP levels were measured in a randomized group of 203 people (49-81 years old) from the Community of Valencia.
  
  
  RESULTS
  The average NTproBNP concentration was 52.2 98.2 pmol/l. NTproBNP levels varied with age, gender and functional stage (NYHA). The highest NTproBNP values were observed in people who had previously suffered from acute pulmonary edema or who had an ejection fraction (EF) of less than 40%. There was also a significant elevation in patients with nocturnal dyspnea, orthopnea, atrial fibrillation, EF < or = 50%, angina, and ankle edema. The best concentration of NTproBNP for differentiating EF < or = 50% was 37.7 pmol/l, with 92% sensitivity and 68% specificity.
  
  
  CONCLUSIONS
  The elevation of NTproBNP concentration indicates the cardiac origin of clinical manifestations and serves to select patients for echocardiographic examination. Low NTproBNP concentrations help to rule out LVSD.
authors.affiliation: Unidad de Investigación Cardiocirculatoria. Centro de Investigación. Hospital La Fe. Valencia. España. hermandiz_amp@gva.es
authors.forename: Juan
authors.initials: J
authors.lastname: Cosín Aguilar
authors.forename: Amparo
authors.initials: A
authors.lastname: Hernándiz Martínez
authors.forename: José Luis
authors.initials: JL
authors.lastname: Díez Gil
authors.forename: Carmen
authors.initials: C
authors.lastname: Capdevila Carbonell
authors.forename: Antonio
authors.initials: A
authors.lastname: Salvador Sanz
authors.forename: José Luis
authors.initials: JL
authors.lastname: Diago Torrent
authors.forename: Miguel
authors.initials: M
authors.lastname: Rivera Otero
authors.forename: Rafael
authors.initials: R
authors.lastname: Payá Serrano
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu Martínez
authors.forename: Francisco
authors.initials: F
authors.lastname: Sogorb Garri
authors.forename: Alejandro
authors.initials: A
authors.lastname: Jordán Torrent
authors.forename: Luis
authors.initials: L
authors.lastname: Mainar Latorre
authors.forename: Guillermo
authors.initials: G
authors.lastname: Grau Jornet
authors.forename: Segundo
authors.initials: S
authors.lastname: Martí Llinares
authors.forename: Vicente
authors.initials: V
authors.lastname: Miró Palau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; C099254:N-terminal proatrial natriuretic peptide; D011498:Protein Precursors; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor