title: Biological, electrical and echocardiographic indices versus cardiac magnetic resonance imaging in diagnosing left ventricular hypertrophy.
abstract: The aim of this study was to compare the diagnostic performance of N-terminal pro-brain natriuretic peptide (NT-proBNP), electrocardiographic (ECG) criteria and transthoracic echocardiography (TTE) versus cardiac magnetic resonance imaging in detecting left ventricular hypertrophy (LVH). The study included 42 hypertensive subjects with mean±s.d. age 48.1±12.3 years, 57.1% men, 24-h ambulatory blood pressure 144/89 mm Hg, left ventricular ejection fraction >50%, without symptoms of heart failure, and not taking any drugs that interfere with hormonal regulation. The accuracies of the methods in detecting LVH were compared at two diagnostic LVH cutoffs: low, 83 g m(-2) in men and 67 g m(-2) in women; and high, 96 g m(-2) in men and 81 g m(-2) in women. With the low and high LVH cutoffs, the areas under the receiver-operating characteristic curves and the optimal values for NT-proBNP were 0.761, 0.849, 200 and 421 pg ml(-1), respectively. An NT-proBNP level under 30 pg ml(-1) ruled out LVH with 100% sensitivity. The optimal values and literature-based values of NT-proBNP allowed a correct classification of 73-81% of the subjects. In 80-90% of the cases, the diagnostic accuracy of NT-proBNP was close to that of ECG criteria but lower than that of TTE criteria. Interestingly, combining ECG criteria and NT-proBNP level improved the diagnostic performance to be at least comparable to that of TTE: the percentages of correctly classified subjects were 73-95% vs. 67-86%, respectively. Of note, the range considers both diagnostic LVH cutoffs. The simultaneous use of ECG criteria and NT-proBNP plasma levels seemed to be powerful enough to detect LVH in most hypertensive subjects.
authors.affiliation: 1] Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France [2] Génomique Fonctionnelle de l'Hypertension artérielle, Université Claude Bernard Lyon1, Villeurbanne, France [3] Hôpital Nord-Ouest, Villefranche sur Saône, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Courand
authors.affiliation: Cardiology Department, Hôpital Nord Ouest, Villefranche-sur-Saône, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Gaudebout
authors.affiliation: Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
authors.forename: Carine
authors.initials: C
authors.lastname: Mouly-Bertin
authors.affiliation: Radiology Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
authors.forename: Vivien
authors.initials: V
authors.lastname: Thomson
authors.affiliation: 1] Génomique Fonctionnelle de l'Hypertension artérielle, Université Claude Bernard Lyon1, Villeurbanne, France [2] Hôpital Nord-Ouest, Villefranche sur Saône, France [3] Nephrology and hypertension Department, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Fauvel
authors.affiliation: 1] Génomique Fonctionnelle de l'Hypertension artérielle, Université Claude Bernard Lyon1, Villeurbanne, France [2] Hôpital Nord-Ouest, Villefranche sur Saône, France.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Bricca
authors.affiliation: 1] Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France [2] Génomique Fonctionnelle de l'Hypertension artérielle, Université Claude Bernard Lyon1, Villeurbanne, France [3] Hôpital Nord-Ouest, Villefranche sur Saône, France [4] Cardiology Department, Hôpital Nord Ouest, Villefranche-sur-Saône, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Lantelme
mesh_terms: D000328:Adult; D018660:Blood Pressure Monitoring, Ambulatory; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000473:pathology / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D012680:Sensitivity and Specificity
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain