Diagnostic and prognostic value of urine NT-proBNP levels in heart failure patients.
BACKGROUND
Plasma NT-proBNP levels are sensitive markers of ventricular dysfunction. However, studies of natriuretic peptides in urine are limited.


OBJECTIVE
To compare urine and plasma NT-proBNP levels and to investigate the diagnostic and prognostic value of urine levels in heart failure (HF).


METHODS
Urinary and plasma NT-proBNP levels were measured in 96 HF patients and 20 control subjects. The patients were functionally classified according to the NYHA criteria.


RESULTS
Urine NT-proBNP was higher in HF patients than in control subjects (94+/-31 pg/ml vs. 67+/-6 pg/ml, p<0.0001), correlating with plasma NT-proBNP levels (r=0.78, p<0.0001). Urinary levels were elevated in the more severe functional classes and diminished in obese patients. Urine NT-proBNP was a good tool for diagnosis of HF, the area under the curve (AUC) being 0.96+/-0.02 (p<0.0001), and for predicting 12-month cardiac events (p=0.011). To determine the prognostic power of urinary NT-proBNP in detecting 12-month cardiac mortality, we obtained an AUC of 0.75+/-0.10 (p=0.015).


CONCLUSIONS
Urinary NT-proBNP, a relatively simple non-invasive test, is a new candidate marker for the diagnosis and evaluation of prognosis in HF and for the characterization of functional status in these patients.
Cortés
Raquel
R
Research Center La Fe Hospital, Valencia, Spain.
Portolés
Manuel
M
Salvador
Antonio
A
Bertomeu
Vicente
V
García de Burgos
Fernando
F
Martínez-Dolz
Luis
L
Lletí
Esther Roselló
ER
Climent
Vicente
V
Jordán
Alejandro
A
Payá
Rafael
R
Sogorb
Francisco
F
Rivera
Miguel
M
D000368:Aged; D015415:Biomarkers; D002303:Cardiac Output, Low / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood / Q000652:urine*; D010446:Peptide Fragments / Q000097:blood / Q000652:urine*; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000652:urine
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain