Authors: M Feola L Valeri E Menditto E Nervo F Bianco N Aspromonte R Valle G Visconti
Publish Date: 2010/02/15
Volume: 33, Issue: 8, Pages: 554-558
Abstract
This study compared two different methods namely the immunoradiometric IRMA and fluorimetric FIA in order to determine plasma brain natriuretic peptide BNP in congestive heart failure CHF patients Methods CHF inpatients underwent echocardiography and plasma BNP determination using both two methods The echocardiograms analysed left ventricular endsystolic LVESV and enddiastolic LVEDV volumes and systolic dysfunction left ventricular ejection fraction LVEF 50 Results Seventythree 71 males age 67±96 yr patients were enrolled 315 affected by valvular heart disease The mean LVEF was 398±141 in 26 35 a hypertensive etiology emerged The immunoradiometric assay IRMA BNP was found to be significantly lower than the FIA determination 1165±149 pg/ml vs 2673±2856 pg/ml p=00001 and the two methods were closely correlated r=089 p=000001 Logistic regression demonstrated a significant correlation between BNP LVEF and LVESV/LVEDV r=−045 p=00003 r=−048 p=000001 r=022 p=0003 r=034 p=00001 r=013 p=002 r=028 p=0001 IRMA and FIA respectively IRMA BNP and FIA BNP significantly increased according to the worsening functional class from 343±602 pg/ml in NYHA New York Heart Association I to 5555±2731 pg/ml in NYHA IV from 861 ±1621 pg/ml in NYHA I to 1070±422 pg/ml in NYHA IV respectively In severe systolic dysfunction LVEF30 receiver operating characteristic analysis revealed a satisfactorily sensitivity and specificity using a cutoff point of 506 pg/ml with IRMA and 243 pg/ml with FIA In mild systolic dysfunction LVEF50 a good sensitivity and specificity using a cutoff point of 42 pg/ml with IRMA and 182 pg/ml with FIA emerged Conclusions In CHF patients both BNP methods correlated with NYHA class LVEF and ventricular volumes
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