NT-proBNP and the diagnosis of exercise-induced myocardial ischaemia.
BACKGROUND
Amino terminal pro-B-type natriuretic peptide (NT-proBNP) is a sensitive marker of ventricular dysfunction. Exercise causes an increase in the secretion of NTproBNP, and with myocardial ischaemia the increase is more pronounced. This increase has been found to improve the diagnostic sensitivity of the stress ECG in diagnosing myocardial ischaemia in subjects with normal ventricular function.


OBJECTIVE
To assess whether the change in NT-proBNP can be used to diagnose effort-induced myocardial ischaemia in an unselected population.


METHODS
We enrolled a total of 51 consecutive patients, referred for exercise stress 99mTc-sestamibi SPECT MPI (single-photon emission computed tomography myocardial perfusion imaging) to diagnose inducible myocardial ischaemia. NT-proBNP was determined at rest and 30 minutes after cessation of exercise.


RESULTS
Of the 51 patients, 28 had normal perfusion scans, seven had scans with fixed perfusion defects (previous myocardial infarction with no inducible ischaemia) and 16 had reversible perfusion defects (inducible ischaemia). There was no correlation between ischaemia and resting NT-proBNP, post-stress NT-proBNP or the change in NTproBNP (delta-NT-proBNP).


CONCLUSIONS
In an unselected population the change in NTproBNP cannot be used to diagnose effort-induced myocardial ischaemia.
De Greef
Jacques
J
Department of Chemical Pathology, University of Pretoria, Pretoria. jdegr@gwisa.com
Funk
Maryke
M
Vermaak
William J H
WJ
Perumal
Nalini S
NS
Libhaber
Carlos D
CD
Vangu
Mboyo-Di-Tamba
MD
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004562:Electrocardiography; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D055414:Myocardial Perfusion Imaging; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain