Plasma brain natriuretic peptide to detect preclinical ventricular systolic or diastolic dysfunction: a community-based study.
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.


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
Margaret M
MM
Guggenheim 9, Mayo Clinic, 200 First St, Southwest, Rochester, MN 55905, USA. redfield.margaret@mayo.edu
Rodeheffer
Richard J
RJ
Jacobsen
Steven J
SJ
Mahoney
Douglas W
DW
Bailey
Kent R
KR
Burnett
John C
JC
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers; D003971:Diastole; D042241:Early Diagnosis; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012306:Risk; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013599:Systole; D014463:Ultrasonography; D018754:Ventricular Dysfunction / Q000097:blood* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D016276:Ventricular Function
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain