Assessment of brain natriuretic peptide in patients with suspected heart failure: comparison with radionuclide ventriculography data

Background: The aim of the study was to prospectively evaluate patients with suspected or known heart disease using plasma brain natriuretic peptide (BNP) measurement and radionuclide ventriculography to examine whether left ventricular dysfunction is associated with an abnormal rise of BNP concentration. Methods: Patients (n = 153) and controls (n = 14) underwent radionuclide ventriculography to determine Left ventricular Ejection Fraction (LVEF) and measurement of plasma BNP concentration using a commercial kit. Results: Plasma BNP concentration in controls was significantly lower than that in patients whatever the stage of the disease, significantly lower than that of patients with normal LVEF (LVEF > 55%); than that of patients with altered LVEF (LVEF less than or equal to 40%); and than that of patients with moderately reduced LVEF (40% < LVEF <less than or equal to> 5%). Comparisons between groups of patients showed that the more severe the disease, the higher the BNP level. From the ROC curve, a plasma BNP concentration of 52 pg/ml was attached to a 85% sensitivity and 82% specificity in identifying patients with LVEF less than or equal to 40%. Conclusions: Plasma BNP concentration provides a reliable and sensitive marker of LV systolic dysfunction evaluated by a nuclear medicine technique, and could be a potential screening test to identify patients for additional investigations. (C) 2001 Elsevier Science B.V. All rights reserved.