A rapid B-type natriuretic peptide assay accurately diagnoses left ventricular dysfunction and heart failure: A multicenter evaluation

被引:158
作者
Wieczorek, SJ [1 ]
Wu, AHB
Christenson, R
Krishnaswamy, P
Gottlieb, S
Rosano, T
Hager, D
Gardetto, N
Chiu, A
Bailly, KR
Maisel, A
机构
[1] Hartford Hosp, Dept Pathol & Lab Med, Hartford, CT 06115 USA
[2] Univ Maryland, Baltimore, MD 21201 USA
[3] Albany Med Ctr, Div Lab Med, Albany, NY USA
[4] Univ Connecticut, Ctr Hlth, Div Cardiol, Farmington, CT USA
[5] San Diego VA Med Ctr, San Diego, CA USA
关键词
D O I
10.1067/mhj.2002.125623
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background B-Type. natriuretic peptide (BNP), a protein released from the left ventricle in response to volume expansion and pressure overload, has emerged as the first whole blood marker for the, identification of individuals with congestive heart failure (CHF). Objective The purpose of,this study was to assess the performance of a point-of-care assay to diagnose and evaluate the severity of CHF on the basis of the New York Heart Association (NYHA) classification system. Methods Through a prospective, multicenter trial, whole blood samples were collected from a total of 1050 inpatients, outpatients, and healthy control patients. Participants were divided into subgroups for BNP. analysis: patients without cardiovascular CHF (n=473), patients with hypertension and no cardiovascular disease (n=168), NYHA class I CHF (n=73), class II CHF (n=135), class III CHF (n=141), and class IV CHF (n=60). Results Circulating BNP concentrations determined from the bedside assay increased with CHF severity, as determined by the,NYHA classification system, but were only statistically significant (P<.001) between individuals with and without CHF. Individuals without CHF had a median BNP concentration of 9.29 pg/mL. Median BNP values, with their corresponding interquartile ranges, for NYHA classification I through IV were 83.1 pg/mL (49.4-137 pg/mL), 235 pg/mL (137-391 pg/mL), 459 pg/mL (200-871 pg/mL), and 1119 pg/mL (728->1300 pg/mL), respectively. With the use of a decision threshold of 100 pg/mL, the assay demonstrated 82% sensitivity-and 99% specificity for distinguishing control patients and patients with CHF. Conclusions BNP concentrations obtained from whole blood samples are useful in the diagnosis of CHF and staging the severity of the disease.
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页码:834 / 839
页数:6
相关论文
共 29 条
[1]   Post hoc subgroup analysis and the truth of a clinical trial [J].
Adams, KF .
AMERICAN HEART JOURNAL, 1998, 136 (05) :753-758
[2]  
*BIOS DIAGN, 2000, BNP TEST RAP QUANT B
[3]   A rapid bedside test for B-type peptide predicts treatment outcomes in patients admitted for decompensated heart failure: A pilot study [J].
Cheng, V ;
Kazanagra, R ;
Garcia, A ;
Lenert, L ;
Krishnaswamy, P ;
Gardetto, N ;
Clopton, P ;
Maisel, A .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2001, 37 (02) :386-391
[4]   Circulating levels of cardiac natriuretic peptides (ANP and BNP) measured by highly sensitive and specific immunoradiometric assays in normal subjects and in patients with different degrees of heart failure [J].
Clerico, A ;
Iervasi, G ;
Del Chicca, MG ;
Emdin, M ;
Maffei, S ;
Nannipieri, M ;
Sabatino, L ;
Forini, F ;
Manfredi, C ;
Donato, L .
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION, 1998, 21 (03) :170-179
[5]   Utility of B-type natriuretic peptide in the diagnosis of congestive heart failure in an urgent-care setting [J].
Dao, Q ;
Krishnaswamy, P ;
Kazanegra, R ;
Harrison, A ;
Amirnovin, R ;
Lenert, L ;
Clopton, P ;
Alberto, J ;
Hlavin, P ;
Maisel, AS .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2001, 37 (02) :379-385
[6]  
Del Ry S, 2001, CLIN CHEM LAB MED, V39, P446
[7]  
DRUMHOLTZ HM, 2000, AM HEART J, V139, P72
[8]  
Grantham JA, 1997, CIRCULATION, V96, P388
[9]  
HAUG C, 1994, CLIN INVESTIGATOR, V72, P430
[10]   A rapid test for B-type natriuretic peptide correlates with falling wedge pressures in patients treated for decompensated heart failure: A pilot study [J].
Kazanegra, R ;
Cheng, V ;
Garcia, A ;
Krishnaswamy, P ;
Gardetto, N ;
Clopton, P ;
Maisel, A .
JOURNAL OF CARDIAC FAILURE, 2001, 7 (01) :21-29