The Role of N-terminal PRO-Brain Natriuretic Peptide and Echocardiography for Screening Asymptomatic Left Ventricular Dysfunction in a Population at High Risk for Heart Failure. The PROBE-HF Study

Irene Betti*, Gabriele Castelli, Alessandro Barchielli, Cinzia Beligni, Vittorio Boscherini, Leonardo De Luca, Gianni Messeri, Mihai Gheorghiade, Alan Maisel, Alfredo Zuppiroli

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

72 Scopus citations

Abstract

Background: Screening for asymptomatic left ventricular dysfunction (ALVD) in subjects at risk for heart failure (HF) can affect clinical management. The aim of the present study is to examine the role of NT-pro BNP in the diagnosis of ALVD in subjects with hypertension and diabetes from primary care. Methods and Results: A total of 1012 subjects with hypertension and/or diabetes and no symptoms or signs of HF were assessed by B-type natriuretic peptide (NT-proBNP) assay and echocardiography. Diastolic dysfunction was present in 368/1012 subjects (36.4%): 327 (32.4%) with mild diastolic dysfunction and 41 (4%) with a moderate-to-severe diastolic dysfunction. Systolic dysfunction was present in 11/1012 (1.1%). NT-proBNP levels were 170 ± 206 and 859 ± 661 pg/mL, respectively, in diastolic and systolic dysfunction and 92 ± 169 in normal subjects (P < .0001). Pooling moderate-to-severe diastolic with systolic dysfunction, a total of 52 subjects (5.1 %) were obtained: best cutoff value of NT-proBNP was 125 pg/mL (males <67 years: sensitivity [Sens] 87.5%, specificity [Spec] 92.7%, negative predictive value [NPV] 99.5%, positive predictive value [PPV] 33.3%; females <67 years: Sens 100%, Spec 84.1%, NPV 100%, PPV 33.3%; males ≥67 years: Sens 100%, Spec 77.1%, NPV 100%, PPV 32.5%; females ≥67 years: Sens 100%, Spec 59.9%, NPV 100%, PPV 23%). Conclusions: The prevalence of ALVD in subjects at risk for HF is 5.1%. Because of its excellent NPV, NT-proBNP can be used by general practitioners to rule out ALVD in hypertensive or diabetic patients.

Original languageEnglish (US)
Pages (from-to)377-384
Number of pages8
JournalJournal of Cardiac Failure
Volume15
Issue number5
DOIs
StatePublished - Jun 1 2009

Keywords

  • Natriuretic peptides
  • diabetes
  • systemic hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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