Acute changes in N-terminal pro-brain natriuretic peptide induced by dobutamine stress echocardiography.
OBJECTIVE
Aim of the study was to determine the effect of dobutamine stress echocardiography (DSE)-induced ischemia on circulating levels of N-terminal fragment of B-type natriuretic peptide (NT-pro-BNP).


RESULTS
One hundred and twenty-eight patients underwent DSE for the evaluation of known or suspected coronary artery disease. NT-pro-BNP levels were measured before and 1h after completion of DSE. NT-pro-BNP levels were similar before and after DSE regardless of whether patients had (123+/-101.8 vs. 124.2+/-108.3, p=NS) or did not have inducible ischemia (96.5+/-70.5 vs. 100.5+/-71.1, p=NS). Patients with inducible myocardial ischemia had no different NT-pro-BNP levels compared to patients without inducible ischemia both before (123+/-101.8 vs. 96.5+/-70pg/ml, p=0.37) and after DSE (124.2+/-108.3 vs. 100.5+/-71.1pg/ml, p=0.55). Patients with severe inducible ischemia had significantly higher NT-pro-BNP levels compared to patients with mild or moderate inducible ischemia and patients without inducible ischemia, both before (208.5+/-125.5 vs. 96+/-78.9 vs. 96.5+/-70pg/ml, p=0.017 and p=0.025, respectively) and after DSE (212.5+/-138.1 vs. 94.8+/-81.1 vs. 100.5+/-71.1pg/ml, p=0.015 and p=0.023, respectively). NT-pro-BNP levels before DSE could be independently predicted by age (p<0.0001), presence of diabetes mellitus (p=0.002), and ejection fraction (p=0.005), but not DSE inducible ischemia.


CONCLUSIONS
NT-pro-BNP is not affected by DSE-induced ischemia and cannot be used in clinical practice to improve diagnostic accuracy of DSE.
Karabinos
Ilias
I
Department of Cardiology, Athens Euroclinic, 9 Athanasiadou Street, Athens 11521, Greece.
Karvouni
Evangelia
E
Chiotinis
Nicolaos
N
Papadopoulos
Anastasios
A
Simeonidis
Phevos
P
Tsolas
Orestis
O
Katritsis
Demosthenes
D
D000208:Acute Disease; D000328:Adult; D000368:Aged; D015415:Biomarkers; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000000981:diagnostic imaging*; D025401:Echocardiography, Stress; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology / Q000503:physiopathology*; D020097:Natriuretic Peptide, Brain / Q000032:analysis / Q000502:physiology*; D010446:Peptide Fragments / Q000032:analysis / Q000502:physiology*; D011446:Prospective Studies; D013318:Stroke Volume; D016277:Ventricular Function, Left
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain