title: Value of serum N-terminal B-type natriuretic peptide in asymptomatic structural heart disease in Taiwanese population: Comparisons with current ESC Guidelines.
abstract: BACKGROUND
  The relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac structural or functional anomalies in pre-clinical, asymptomatic Asian populations has not been well identified.
  
  
  METHODS
  From October 2005 to March 2008, we enrolled consecutive asymptomatic adults with preserved global left ventricular (LV) function (ejection fraction>50%) who underwent annual cardiovascular health survey. Circulating NT-proBNP was used to identify echo-defined cardiac structural/functional anomalies and compared to current recommended cut-off from the European Society of Heart Failure.
  
  
  RESULTS
  Among 976 eligible subjects, 371 (38%) had structural heart diseases. Echocardiography-based left atrial diameter (Coef: 71.2), diastolic dysfunction (Coef: 35.4), and presence of pulmonary hypertension (Coef: 83.1) or valvular heart disease (Coef: 56.1, all p<0.05) of any form independently predicted circulating NT-ProBNP. NT-ProBNP cut-off values of 32.8 and 115.4pg/ml for subjects aged ≤ and >75years, respectively, demonstrated areas under the receiver operating characteristic curve of 0.76 (95% CI: 0.73-0.80) and 0.70 (95% CI: 0.52-0.88) for predicting structural or functional anomaly.
  
  
  CONCLUSIONS
  We examined the feasibility of NT-ProBNP for identifying cardiac structural and functional anomaly in an asymptomatic ethnic Taiwanese population with a relatively lower cut-off value, indicating its potential role for pre-clinical screening of Asian patients.
authors.affiliation: Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan; Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei City 10449, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan.
authors.forename: Ta-Chuan
authors.initials: TC
authors.lastname: Hung
authors.affiliation: Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan; Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taitung Branch, Taitung 95054, Taiwan.
authors.forename: Kuang-Te
authors.initials: KT
authors.lastname: Wang
authors.affiliation: MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan; Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taitung Branch, Taitung 95054, Taiwan; Department of Radiology, MacKay Memorial Hospital, Taipei City 10449, Taiwan.
authors.forename: Chun-Ho
authors.initials: CH
authors.lastname: Yun
authors.affiliation: Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan; Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei City 10449, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan.
authors.forename: Jen-Yuan
authors.initials: JY
authors.lastname: Kuo
authors.affiliation: Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan; Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei City 10449, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan; Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taitung Branch, Taitung 95054, Taiwan; Department of Radiology, MacKay Memorial Hospital, Taipei City 10449, Taiwan.
authors.forename: Charles Jia-Yin
authors.initials: CJ
authors.lastname: Hou
authors.affiliation: Department of Gastroenterology, MacKay Memorial Hospital, 10449 Taipei, Taiwan.
authors.forename: Chia-Yuan
authors.initials: CY
authors.lastname: Liu
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, 11221 Taipei, Taiwan.
authors.forename: Tung-Hsin
authors.initials: TH
authors.lastname: Wu
authors.affiliation: Cardiovascular Department, University Hospitals Case Medical Center, Cleveland, OH, United States.
authors.forename: Hiram G
authors.initials: HG
authors.lastname: Bezerra
authors.affiliation: Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan; Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taitung Branch, Taitung 95054, Taiwan.
authors.forename: Hsiao-Yang
authors.initials: HY
authors.lastname: Cheng
authors.affiliation: Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan; Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei City 10449, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan. Electronic address: jotaro3791@gmail.com.
authors.forename: Chung-Lieh
authors.initials: CL
authors.lastname: Hung
authors.affiliation: Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan; Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei City 10449, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei City 11260, Taiwan.
authors.forename: Hung-I
authors.initials: HI
authors.lastname: Yeh
mesh_terms: D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D002309:Cardiology; D015150:Echocardiography, Doppler; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006331:Heart Diseases / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012372:ROC Curve; D012189:Retrospective Studies; D012955:Societies, Medical; D013599:Systole; D013624:Taiwan / Q000453:epidemiology; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Asian population; Echocardiography; Natriuretic peptide; Structural heart disease