title: Plasma pro-B-type natriuretic peptide testing as a screening method for hypertrophic cardiomyopathy.
abstract: BACKGROUND
  Clinical multistage risk assessment associated with electrocardiogram (ECG) and NT-proBNP may be a feasible strategy to screen hypertrophic cardiomyopathy (HCM). We investigated the effectiveness of a screening based on ECG and NT-proBNP in first-degree relatives of patients with HCM.
  
  
  RESULTS
  A total of 106 first-degree relatives were included. All individuals were evaluated by echocardiography, ECG, NT-proBNP, and molecular screening (available for 65 individuals). From the 106 individuals, 36 (34%) had diagnosis confirmed by echocardiography. Using echocardiography as the gold standard, ECG criteria had a sensitivity of 0.71, 0.42, and 0.52 for the Romhilt-Estes, Sokolow-Lyon, and Cornell criteria, respectively. Mean values of NT-ProBNP were higher in affected as compared with nonaffected relatives (26.1 vs. 1290.5, P < .001). The AUC of NT-proBNP was 0.98. Using a cutoff value of 70 pg/mL, we observed a sensitivity of 0.92 and specificity of 0.96. Using molecular genetics as the gold standard, ECG criteria had a sensitivity of 0.67, 0.37, and 0.42 for the Romhilt-Estes, Sokolow-Lyon, and Cornell criteria, respectively. Using a cutoff value of 70 pg/mL, we observed a sensitivity of 0.83 and specificity of 0.98.
  
  
  CONCLUSIONS
  Values of NT-proBNP above 70 pg/mL can be used to effectively select high-risk first-degree relatives for HCM screening.
authors: Instituto do Coração, University of São Paulo, São Paulo, Brazil.
authors: Fabio
authors: F
authors: Fernandes
authors: Edmundo
authors: E
authors: Arteaga-Fernandez
authors: Murillo de Oliveira
authors: Mde O
authors: Antunes
authors: Paula
authors: P
authors: Buck
authors: Julia Daher Carneiro
authors: JD
authors: Marsiglia
authors: Afonso
authors: A
authors: Matsumoto
authors: Luciano
authors: L
authors: Nastari
authors: Jose Eduardo
authors: JE
authors: Krieger
authors: Alexandre Costa
authors: AC
authors: Pereira
authors: Charles
authors: C
authors: Mady
mesh_terms: D000328:Adult; D024741:Cardiomyopathy, Hypertrophic, Familial / Q000097:blood* / Q000175:diagnosis*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain