Additive Value of B-Type Natriuretic Peptide on Rest Tl-Dipyridamole Stress Tc-Sestamibi Gated Myocardial SPECT in Patients with Normal Left Ventricular Systolic Function.
We evaluated whether BNP has additive value to SPECT in patients with normal left ventricular (LV) systolic function. Data from 224 consecutive patients who underwent rest (201)Tl-dipyridamole stress (99m)Tc-sestamibi gated SPECT and coronary angiography due to chest pain were analyzed. Patients with true positive SPECT showed significant higher BNP level than those with false positive defect (38.5 (19.0-79.8) versus 19.0 (9.3-35.8), P = .01). Patients with true negative SPECT also showed significantly lower BNP level than those with false negative SPECT (39.0 (23.0-77.0) versus 22.0 (15.0-43.0), P = .002). In multivariate analyses, elevated BNP level (using a cut-off value of 23.0 pg/mL) was the strongest and independent predictor of CAD in overall patients (OR 2.75, 95% CI: 1.50-5.023, P = .001) and patients with positive SPECT (OR 3.34, 95% CI: 1.51-7.37, P = .003). The area under the receiver-operating characteristic curve for CAD in overall patients and patients with positive SPECT was 0.673 (95% CI: 0.603-0.743, P < .001) and 0.694 (95% CI: 0.602-0.786, P < .001), respectively. This study suggests that BNP level has additive diagnostic value to SPECT findings in predicting CAD in patients with normal LV systolic function.
Sir
Jung-Ju
JJ
Department of Internal Medicine, Inje University College of Medicine, Busan 614-735, South Korea.
Cho
Young-Seok
YS
Chung
Woo-Young
WY
Koo
Bon-Kwon
BK
Chae
In-Ho
IH
Choi
Dong-Ju
DJ
Kim
Hyo-Soo
HS
Oh
Byung-Hee
BH
Park
Young-Bae
YB
Heart. 2006 Apr;92(4):487-9
16216865
Am Heart J. 2002 Nov;144(5):834-9
12422152
Am J Card Imaging. 1992 Mar;6(1):42-57; discussion 58
10147614
Prog Cardiovasc Dis. 2001 Jan-Feb;43(4):281-302
11235845
J Am Coll Cardiol. 1997 Nov 1;30(5):1256-63
9350924
Clin Chem. 2004 Jan;50(1):33-50
14633912
Coron Artery Dis. 2005 Jun;16(4):225-9
15915074
J Am Coll Cardiol. 2004 Nov 16;44(10):1980-7
15542280
FASEB J. 2003 Jun;17(9):1105-7
12709407
Clin Nucl Med. 1979 Jun;4(6):225-8
477151
Ann Clin Lab Sci. 2006 Summer;36(3):299-306
16951271
Am J Cardiol. 2005 Dec 15;96(12):1705-10
16360361
Am Heart J. 2004 Oct;148(4):612-20
15459591
Circulation. 2003 Dec 16;108(24):2987-92
14662720
N Engl J Med. 2005 Feb 17;352(7):666-75
15716560
Circulation. 1998 Feb 17;97(6):535-43
9494023
J Am Coll Cardiol. 2004 Nov 16;44(10):1988-95
15542281
Int J Cardiol. 2007 Apr 25;117(2):157-64
16997398
J Am Coll Cardiol. 2003 Oct 1;42(7):1318-33
14522503
Am Heart J. 2006 Jun;151(6):1223-30
16781223
FASEB J. 2004 Dec;18(15):1928-30
15576492