Abstract:
BACKGROUND:Preclinical systolic or diastolic dysfunction is associated with increased morbidity and mortality. We postulated that plasma brain natriuretic peptide (BNP) might serve as a biomarker for preclinical ventricular dysfunction (PCVD) but that the discriminatory values for BNP may vary with age and sex. METHODS AND RESULTS:We measured BNP, systolic and diastolic ventricular function, and clinical parameters in 2042 randomly selected residents of Olmsted County, Minn, aged 45 years or older. For preclinical systolic dysfunction, the areas under the receiver operating characteristics curve were higher for those with more severe (0.82 to 0.92) than any (0.51 to 0.74) systolic dysfunction and were similar in men and women and in younger and older persons. For preclinical diastolic dysfunction, the areas under the receiver operating characteristics curve were higher for those with moderate-to-severe (0.74 to 0.79) than any (0.52 to 0.68) diastolic dysfunction and were similar regardless of age or sex. Optimal discriminatory values of BNP varied with age and sex. Considering the prevalence of preclinical systolic or diastolic dysfunction and the predictive characteristics observed, using BNP to screen for PCVD would necessitate echo in 10% to 40% of those screened, with most confirmatory echocardiograms being negative, and would miss 10% to 60% of those affected. CONCLUSIONS:BNP is a suboptimal screening test for PCVD in the population.
journal_name
Circulationjournal_title
Circulationauthors
Redfield MM,Rodeheffer RJ,Jacobsen SJ,Mahoney DW,Bailey KR,Burnett JC Jrdoi
10.1161/01.CIR.0000130845.38133.8Fsubject
Has Abstractpub_date
2004-06-29 00:00:00pages
3176-81issue
25eissn
0009-7322issn
1524-4539pii
01.CIR.0000130845.38133.8Fjournal_volume
109pub_type
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