Use of N-terminal pro-B-type natriuretic peptide to detect myocardial ischemia

被引：68

作者：

Staub, Daniel ^{[1
]}

Jonas, Nils ^{[1
]}

Zellweger, Michael J. ^{[2
]}

Nusbaumer, Charly ^{[3
]}

Wild, Damian ^{[4
]}

Pfisterer, Matthias E. ^{[2
]}

Mueller-Brand, Jan ^{[4
]}

Perruchoud, Andre P. ^{[1
]}

Mueller, Christian ^{[1
]}

机构：

[1] Univ Basel Hosp, Dept Internal Med, CH-4031 Basel, Switzerland

[2] Univ Basel Hosp, Div Cardiol, CH-4031 Basel, Switzerland

[3] Univ Basel Hosp, Dept Lab Med, CH-4031 Basel, Switzerland

[4] Univ Basel Hosp, Dept Nucl Med, CH-4031 Basel, Switzerland

来源：

AMERICAN JOURNAL OF MEDICINE | 2005年 / 118卷 / 11期

基金：

瑞士国家科学基金会;

关键词：

Natriuretic peptides; Ischemia; Exercise; Electrocardiography;

D O I：

10.1016/j.amjmed.2005.05.020

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

PURPOSE: To evaluate the utility of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels to detect myocardial ischemia. METHODS: We conducted a prospective observational study in 260 consecutive patients with suspected myocardial ischemia referred for rest/ergometry myocardial perfusion single-photon emission computed tomography. Levels of NT-proBNP were determined before and immediately after symptom-limited bicycle ergometry. RESULTS: Inducible myocardial ischemia on perfusion images was detected in 129 patients (49.6%). Baseline NT-proBNP and exercise induced increase in NT-proBNP ( Delta NT-proBNP) were significantly higher in patients with myocardial ischemia (median baseline NT-proBNP 155 pg/mL vs 91 pg/mL, P <.001; Delta NT-proBNP 15 pg/mL vs 7 pg/mL, P < .002). Compared with patients in the lowest Delta NT-proBNP quartile, those in the highest quartile of Delta NT-proBNP had three times the risk of inducible ischemia (relative risk, 2.9; 95% confidence interval, 1.4 to 6.0; P < .003). Overall, the accuracy of baseline NT-proBNP and Delta NT-proBNP in the detection of myocardial ischemia were similar to that of the exercise electrocardiogram (ECG). Combining exercise ECG and baseline NT-proBNP or Delta NT-proBNP slightly increased the accuracy of exercise ECG only. CONCLUSION: The NT-proBNP level at rest as well as Delta NT-proBNP during exercise stress testing is associated with inducible myocardial ischemia. NT-proBNP levels may have incremental value in the diagnosis of myocardial ischemia. (C) 2005 Elsevier Inc. All rights reserved.

引用

页码：1287.e9 / 1287.e16

页数：8

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