title: N-terminal pro-B-type natriuretic peptide as an indicator of possible cardiovascular disease in severely obese individuals: comparison with patients in different stages of heart failure.
abstract: BACKGROUND
  Mild stages of heart failure might be difficult to diagnose in severely obese individuals with a body mass index (BMI) >40 kg/m(2). Measurement of the N-terminal fragment of pro-B-type natriuretic peptide (NT-proBNP) is feasible for detecting cardiac impairment. The aims of our study were to measure NT-proBNP in plasma of severely obese patients and to compare the results with results for patients in different stages of manifest cardiac dysfunction.
  
  
  METHODS
  In 61 severely obese individuals (median BMI, 43.2 kg/m(2)) and 96 nonobese patients with existing heart failure [classified into New York Heart Association (NYHA) classes I-IV], NT-proBNP was measured in the fasting condition. A medical history, physical examination, electrocardiography, blood chemistry, and chest x-ray were performed in the obese group. In addition, echocardiography was performed in the NYHA group.
  
  
  RESULTS
  In obese individuals, NT-proBNP was increased to a median of 356 (interquartile range, 221-458) pmol/L [854 (530-1099) ng/L] and was comparable (P >0.05) to the median value for NYHA I patients {289 (258-451) pmol/L [694 (619-1082) ng/L]}, but was significantly lower than in the other NYHA groups (P <0.001 for each).
  
  
  CONCLUSIONS
  The prognostic relevance of increased NT-proBNP for risk of developing cardiac insufficiency in severely obese patients needs to be further evaluated.
authors.affiliation: Department for Clinical and Chemical Laboratory Diagnostic, Hospital Lainz, 1130 Vienna, Austria. katharina.hermann@wienkav.at
authors.forename: Katharina-Maria
authors.initials: KM
authors.lastname: Hermann-Arnhof
authors.forename: Ursula
authors.initials: U
authors.lastname: Hanusch-Enserer
authors.forename: Thomas
authors.initials: T
authors.lastname: Kaestenbauer
authors.forename: Thomas
authors.initials: T
authors.lastname: Publig
authors.forename: Attila
authors.initials: A
authors.lastname: Dunky
authors.forename: Harald R
authors.initials: HR
authors.lastname: Rosen
authors.forename: Rudolf
authors.initials: R
authors.lastname: Prager
authors.forename: Ursula
authors.initials: U
authors.lastname: Köller
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain; D009419:Nerve Tissue Proteins / Q000097:blood*; D009765:Obesity / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors / Q000097:blood*
chemical_list: D015415:Biomarkers; D009419:Nerve Tissue Proteins; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain