Natriuretic peptides in the detection of preclinical diastolic or systolic dysfunction
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Natriuretic peptides in the detection of preclinical diastolic or systolic dysfunction. / Luers, Claus; Wachter, Rolf; Kleta, Sibylle; Uhlir, Marc; Koschack, Janka; Scherer, Martin; Binder, Lutz; Herrmann-Lingen, Christoph; Zapf, Antonia; Kulle, Bettina; Kochen, Michael M; Pieske, Burkert.
in: CLIN RES CARDIOL, Jahrgang 99, Nr. 4, 04.2010, S. 217-26.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Natriuretic peptides in the detection of preclinical diastolic or systolic dysfunction
AU - Luers, Claus
AU - Wachter, Rolf
AU - Kleta, Sibylle
AU - Uhlir, Marc
AU - Koschack, Janka
AU - Scherer, Martin
AU - Binder, Lutz
AU - Herrmann-Lingen, Christoph
AU - Zapf, Antonia
AU - Kulle, Bettina
AU - Kochen, Michael M
AU - Pieske, Burkert
PY - 2010/4
Y1 - 2010/4
N2 - AIMS: The diagnostic value of natriuretic peptides in asymptomatic patients at risk for diastolic or systolic HF is controversial. We tested (1) the prevalence of preclinical LV dysfunction in an at-risk cohort; (2) the diagnostic accuracy of natriuretic peptides alone or in combination with clinical parameters for predicting asymptomatic left ventricular systolic or diastolic dysfunction.METHODS: 542 primary care patients (mean age 63 +/- 11 years, 42% female) without prediagnosed HF, but with risk factors for left ventricular dysfunction, underwent thorough cardiological workup, including echocardiography and analysis of natriuretic peptides.RESULTS: 23 patients (4%) showed reduced systolic function (EF < 50%), and 15 patients (3%) had severe diastolic dysfunction. All natriuretic peptides significantly increased with decreasing ejection fraction and with increasing degree of diastolic dysfunction. For natriuretic peptides, receiver operating characteristics analysis yielded good results for the detection of systolic dysfunction or severe diastolic dysfunction. Combining clinical parameters with natriuretic peptide data improved the diagnostic accuracy and largely reduced the number of needed screening echoes to identify patients with LV systolic or diastolic dysfunction.CONCLUSIONS: The prevalence of preclinical diastolic dysfunction is high in primary care patients at risk, but the relative prevalence of severe diastolic dysfunction and systolic dysfunction is only 7%. High-risk individuals may be screened most efficiently by using a score system incorporating clinical data and NT-proBNP.
AB - AIMS: The diagnostic value of natriuretic peptides in asymptomatic patients at risk for diastolic or systolic HF is controversial. We tested (1) the prevalence of preclinical LV dysfunction in an at-risk cohort; (2) the diagnostic accuracy of natriuretic peptides alone or in combination with clinical parameters for predicting asymptomatic left ventricular systolic or diastolic dysfunction.METHODS: 542 primary care patients (mean age 63 +/- 11 years, 42% female) without prediagnosed HF, but with risk factors for left ventricular dysfunction, underwent thorough cardiological workup, including echocardiography and analysis of natriuretic peptides.RESULTS: 23 patients (4%) showed reduced systolic function (EF < 50%), and 15 patients (3%) had severe diastolic dysfunction. All natriuretic peptides significantly increased with decreasing ejection fraction and with increasing degree of diastolic dysfunction. For natriuretic peptides, receiver operating characteristics analysis yielded good results for the detection of systolic dysfunction or severe diastolic dysfunction. Combining clinical parameters with natriuretic peptide data improved the diagnostic accuracy and largely reduced the number of needed screening echoes to identify patients with LV systolic or diastolic dysfunction.CONCLUSIONS: The prevalence of preclinical diastolic dysfunction is high in primary care patients at risk, but the relative prevalence of severe diastolic dysfunction and systolic dysfunction is only 7%. High-risk individuals may be screened most efficiently by using a score system incorporating clinical data and NT-proBNP.
KW - Aged
KW - Diastole
KW - Echocardiography
KW - Heart Failure, Diastolic
KW - Heart Failure, Systolic
KW - Humans
KW - In Vitro Techniques
KW - Mass Screening
KW - Middle Aged
KW - Natriuretic Peptides
KW - Prevalence
KW - Primary Health Care
KW - Prospective Studies
KW - Risk Factors
KW - Severity of Illness Index
KW - Systole
KW - Ventricular Dysfunction, Left
U2 - 10.1007/s00392-009-0108-z
DO - 10.1007/s00392-009-0108-z
M3 - SCORING: Journal article
C2 - 20052479
VL - 99
SP - 217
EP - 226
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
IS - 4
ER -