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The effects of ejection fraction on N-terminal ProBNP and BNP levels in patients with acute CHF: analysis from the ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) study. J Card Fail 2005 Jun;11(5 Suppl):S9-14

Date

06/11/2005

Pubmed ID

15948094

DOI

10.1016/j.cardfail.2005.04.011

Scopus ID

2-s2.0-30744476790 (requires institutional sign-in at Scopus site)   98 Citations

Abstract

BACKGROUND: Limited data exist regarding the impact of left ventricular ejection fraction (LVEF) on N-terminal pro-brain natriuretic peptide (NT-proBNP) and B-type natriuretic peptide (BNP) levels in patients with acute congestive heart failure (CHF).

METHODS AND RESULTS: LVEF data were analyzed for 153 subjects with acute CHF. LVEF > or =50% was defined as non-systolic CHF (NS-CHF); LVEF >50% was defined as systolic CHF (S-CHF). 76 subjects (49.7%) had NS-CHF. Median NT-proBNP and BNP levels were significantly higher among patients with S-CHF (6196 pg/mL, 592 pg/mL, respectively) compared with those patients with NS-CHF (2849 pg/mL, 259 pg/mL, respectively). With optimal cut-points, a false-negative rate of 7% was observed for both assays among patients with S-CHF. Among patients with NS-CHF, BNP had a significantly higher false-negative rate (20%) than did NT-proBNP (9%; P < .001 for difference). NT-proBNP, but not BNP, significantly correlated with CHF symptom severity among patients with NS-CHF.

CONCLUSION: Levels of both NT-proBNP and BNP are significantly lower in patients with NS-CHF; however, in contrast to NT-proBNP, BNP may be falsely negative in up to 20% of patients with NS-CHF and does not correlate with symptom severity in NS-CHF. NT-proBNP appears superior to BNP for the evaluation of suspected acute CHF in patients with preserved LVEF.

Author List

O'Donoghue M, Chen A, Baggish AL, Anwaruddin S, Krauser DG, Tung R, Januzzi JL

Author

Saif Anwaruddin MD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Biomarkers
Cohort Studies
Dyspnea
Emergency Service, Hospital
Female
Follow-Up Studies
Heart Failure
Humans
Male
Natriuretic Peptide, Brain
Peptide Fragments
Predictive Value of Tests
Prognosis
Prospective Studies
ROC Curve
Stroke Volume