[Value of NTproBNP concentration in an out-of-hospital adult population].
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.
Cosín Aguilar
Juan
J
Unidad de Investigación Cardiocirculatoria. Centro de Investigación. Hospital La Fe. Valencia. España. hermandiz_amp@gva.es
Hernándiz Martínez
Amparo
A
Díez Gil
José Luis
JL
Capdevila Carbonell
Carmen
C
Salvador Sanz
Antonio
A
Diago Torrent
José Luis
JL
Rivera Otero
Miguel
M
Payá Serrano
Rafael
R
Bertomeu Martínez
Vicente
V
Sogorb Garri
Francisco
F
Jordán Torrent
Alejandro
A
Mainar Latorre
Luis
L
Grau Jornet
Guillermo
G
Martí Llinares
Segundo
S
Miró Palau
Vicente
V
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
D015415:Biomarkers; C099254:N-terminal proatrial natriuretic peptide; D011498:Protein Precursors; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor