title: Pericardial fluid and serum biomarkers equally predict ventricular dysfunction.
abstract: BACKGROUND
  serum level of amino-terminal pro-B-type natriuretic peptide, a cardiac hormone produced by the heart, is elevated in patients with left ventricular dysfunction. The purpose of this study was to compare the abilities of serum and pericardial fluid levels of amino-terminal pro-B-type natriuretic peptide to detect the left ventricular systolic dysfunction determined by echocardiography.
  
  
  METHODS
  50 patients undergoing coronary artery bypass grafting were included in this study. Left ventricular systolic function was assessed using echocardiography before coronary artery bypass grafting. The samples of serum and pericardial fluid were collected during surgery, and amino-terminal pro-B-type natriuretic peptide levels were assessed by an electrochemiluminescence immunoassay. The log value of amino-terminal pro-B-type natriuretic peptide concentrations was calculated.
  
  
  RESULTS
  the pericardial fluid levels of log amino-terminal pro-B-type natriuretic peptide were significantly elevated compared to the serum levels in patients with impaired left ventricular systolic function. Both serum and pericardial fluid levels of log amino-terminal pro-B-type natriuretic peptide correlated significantly with left ventricular ejection fraction and end-diastolic and end-systolic volume indices. Furthermore, a paired comparison of receiver operating characteristic curves showed a similar performance of amino-terminal pro-B-type natriuretic peptide levels both in serum and pericardial fluid to discriminate left ventricular systolic dysfunction.
  
  
  CONCLUSIONS
  serum amino-terminal pro-B-type natriuretic peptide levels have comparable diagnostic value for left ventricular systolic dysfunction with its pericardial fluid levels in patients undergoing CABG.
authors.affiliation: Department of Physiology, Ziauddin University, Karachi, Pakistan.
authors.forename: Sofia
authors.initials: S
authors.lastname: Amjad
authors.forename: Shahid A
authors.initials: SA
authors.lastname: Sami
authors.forename: Muhammad Nageeb
authors.initials: MN
authors.lastname: Basir
authors.forename: Kamran
authors.initials: K
authors.lastname: Hameed
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Fujita
authors.forename: Hakeemuddin Razi
authors.initials: HR
authors.lastname: Ahmad
mesh_terms: D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D001026:Coronary Artery Bypass; D055664:Electrochemical Techniques; D005260:Female; D006801:Humans; D007118:Immunoassay; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood / Q000378:metabolism*; D010446:Peptide Fragments / Q000097:blood / Q000378:metabolism*; D010490:Pericardial Effusion / Q000378:metabolism*; D011237:Predictive Value of Tests; D012372:ROC Curve; D013599:Systole; D014463:Ultrasonography; D015854:Up-Regulation; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Amino terminal pro-B-type natriuretic; CABG; pericardial fluid; ventricular dysfunction