title: NT-proBNP and BNP values in cardiac patients with different degree of left ventricular systolic dysfunction.
abstract: We investigated the performance of brain natriuretic peptides (BNP and NT-proBNP) in detecting various degrees of left ventricular systolic dysfunction. The NT-proBNP assay (Roche) and the BNP assay (Bayer Shionoria) were performed in 46 patients (mean age 50 years; range 20-79 years) with various types of heart disease (chronic heart failure due to coronary artery disease, cardiomyopathy, acquired valve disease, congenital heart diseases) and different impairment of left ventricular systolic dysfunction was assessed by echocardiography. Patients were divided into four groups according to the left ventricular ejection fraction (LVEF) correlated with clinical severity. Significant differences in medians of NT-proBNP and BNP values between all groups were determined (P= 0.0161 for NT-proBNP and P=0.0180 for BNP). For identifying patients with severe systolic dysfunction (LVEF<40%), receiver operating characteristic (ROC) analysis for both BNP and NT-proBNP was performed. The diagnostic performances expressed as areas under the curve were of 0.69 for NT-proBNP (cut off value 367 pg/ml) and 0.60 for BNP (cut off value 172 pg/ml). However, the BNP showed higher sensitivity (85 % vs. 63 %) and a higher positive predictive value (69 % vs 55 %) than the NT-proBNP. The negative predictive values of BNP and NT-proBNP were similar (70 % and 71 % respectively). Brain natriuretic peptides are promising markers for the diagnosis of severe left ventricular systolic dysfunction.
authors.affiliation: Department of Clinical Biochemistry and Pathobiochemistry, 2nd Medical Faculty, Charles University, Faculty Hospital Motol, Prague, Czech Republic. kotaska@email.cz
authors.forename: Karel
authors.initials: K
authors.lastname: Kotaska
authors.forename: Jana
authors.initials: J
authors.lastname: Popelova
authors.forename: Marie
authors.initials: M
authors.lastname: Tiserova
authors.forename: Peter
authors.initials: P
authors.lastname: Telekes
authors.forename: Marie
authors.initials: M
authors.lastname: Vrzanova
authors.forename: Jiri
authors.initials: J
authors.lastname: Bronsky
authors.forename: Milada
authors.initials: M
authors.lastname: Halacova
authors.forename: Jiri
authors.initials: J
authors.lastname: Kukacka
authors.forename: Richard
authors.initials: R
authors.lastname: Prusa
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain