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Utility of BNP in differentiating constrictive pericarditis from restrictive cardiomyopathy in patients with renal insufficiency.

Abstract：

BACKGROUND:Differentiating between constrictive pericarditis (CP) and restrictive cardiomyopathy (RCMP) is difficult because of similar clinical and hemodynamic presentation. Brain natriuretic peptide (BNP) has been reported a useful noninvasive biomarker to differentiate CP from RCMP; however, its utility in patients with renal insufficiency has not been evaluated. METHODS AND RESULTS:Consecutive patients with suspected CP or RCMP were enrolled. All but 7 patients underwent transseptal catheterization. BNP, renal function, and comorbid conditions were recorded at the time of the procedure. Renal function was estimated using the Cockcroft-Gault formula. Descriptive statistics, Student t-test, and Mann-Whitney U test were performed; P < .05 was significant. Twenty-two patients had hemodynamically or surgically proven CP or RC. In patients with CP, 9 had at least Stage II kidney disease (GFR <90 mL/min, mean 58) and 8 had normal or Stage I kidney disease (GFR >90 mL/min, mean 118). BNP was higher in patients with CP and renal insufficiency versus those with CP and normal renal function (433 versus 116 pg/mL; P = .016). BNP in patients with CP and normal renal function was lower than in patients with RC (116 versus 728 pg/mL; P = .005). CONCLUSION:BNP has reduced clinical utility in renal insufficiency to differentiate CP from RCMP.

journal_name

J Card Fail

journal_title

Journal of cardiac failure

authors

Reddy PR,Dieter RS,Das P,Steen LH,Lewis BE,Leya FS

doi

10.1016/j.cardfail.2007.05.001

subject

Has Abstract

pub_date

2007-10-01 00:00:00

pages

668-71

issue

8

eissn

1071-9164

issn

1532-8414

pii

S1071-9164(07)00163-7

journal_volume

13

pub_type

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