Author/Editor     Jug, Borut; Šebeštjen, Miran; Gajšek, Martina; Corel, Daša; Keber, Irena
Title     Diagnostic performance of NT-proBNP in patients referred for specialized evaluation of heart failure signs and symptoms
Translated title     Diagnostična uporabnost NT-proBNP pri bolnikih, ki so jih zaradi simptomov in znakov srčnega popuščanja napotili na specialistično obravnavo
Type     članek
Source     Slov Kardiol
Vol. and No.     Letnik 3, št. 2
Publication year     2006
Volume     str. 92-5
Language     eng
Abstract     Amino-terminal pro-B-type natriuretic peptide (NT-proBNP) is an important diagnostic and prognostic marker of heart failure, however its diagnostic performance is affected by specifics of the screened population. Therefore, we sought to establish the diagnostic performance of NT-proBNP in patients referred for specialist evaluation due to signs and symptoms of heart failure. Consecutive outpatients (n=306) referred for evaluation of suspected heart failure to a university hospital heart failure clinic underwent clinical and echocardiographic assessment, and had their NT-proBNP levels determined (using sandwich chemiluminescent immunoassay with two antibodies on an Elecsys analyser). Median NT-proBNP levels were significantly higher in patients with evidence of structural heart disease - 250 (interquartile range 7-282) pg/ml vs. 1671 (621-9120) pg/ml; a cut-off of 200 pg/ml discriminated them from individuals with no structural heart disease, with a 91% sensitivity and a 60% specificity. Apart from the severity of heart failure, the following other (statistically non-significant) determinants of NT-proBNP levels also emerged: age, gender and renal function. NT-proBNP is an accurate diagnostic marker in patients referred for specialized evaluation of heart failure signs and symptoms. However, when interpreting test results one should be aware that several factors apart from heart failure severity influence NT-proBNP levels.
Summary     Aminski konec predoblike natriuretičnega peptida B (NT-proBNP) je pomemben diagnostočni in prognostični označevalec srčnega popuščanja, vendar je njegova diagnostična uporabnost v veliki meri odvisna od preučevane populacije bolnikov. Zato smo poskušali opredeliti diagnostično uporabnost NT-proBNP pri bolnikih, ki so jih zaradi simptomov in znakov srčnega popuščanja napotili na specialistično obravnavo. Pri 306 zaporednih bolnikih, ki so jih zaradi suma na srčno popuščanje napotili v specializirano ambulanto, smo opravili klinični pregled in ultrazvočno preiskavo srca, hkrati pa izmerili vrednosti NT-proBNP (z metodo kemoluminescence z dvema protitelesoma na aparatu Elecsys). Mediane ravni NT-proBNP so bile višje pri bolnikih s strukturnim obolenjem srca - 250 (medkvartilni razpon 7-282) pg/ml proti 1671 (621-9120) pg/ml; razmejitvena vrednost 200 pg/ml (p<0,001) je z 91-odstotno občutljivostjo in 60-odstotno specifičnostjo razločila bolnike s strukturno boleznijo srca od posameznikov brez nje. Poleg napredovalosti srčnega popuščanja so starost, spol in ledvična funkcija neodvisno napovedovali vrednost NT-proBNP NT-proBNP je natančen diagnostični označevalec pri bolnilcih, ki so jih zaradi simptomov in znakov napotili na specialistično obravnavo. Pri interpretaciji izsledkov preiskave pa se moramo zavedati, da na njegove ravni - poleg napredovalosti srčnega popuščanja - vplivajo številni drugi dejavniki.
Descriptors     HEART FAILURE, CONGESTIVE
ECHOCARDIOGRAPHY
AMBULATORY CARE
NATRIURETIC HORMONE
PROGNOSIS