OBJECTIVE: To investigate the usefulness of measuring plasma concentrations of B type natriuretic peptide in the diagnosis of left ventricular systolic dysfunction in an unselected group of elderly people. DESIGN: Observational study. SETTING: General practice with four centres in Poole, Dorset. PARTICIPANTS: 155 elderly patients aged 70 to 84 years. MAIN OUTCOME MEASURES: Diagnostic characteristics of plasma B type natriuretic peptide measured by radioimmunoassay as a test for left ventricular systolic dysfunction assessed by echocardiography. RESULTS: The median plasma concentration of B type natriuretic peptide was 39.3 pmol/l in patients with left ventricular systolic dysfunction and 15.8 pmol/l in those with normal function. The proportional area under the receiver operator curve was 0.85. At a cut-off point of 18.7 pmol/l the test sensitivity was 92% and the predictive value 18%. CONCLUSIONS: Plasma concentration of B type natriuretic peptide could be used effectively as an initial test in a community screening programme and, possibly, using a low cut-off point, as a means of ruling out left ventricular systolic dysfunction. It is, however, not a good test to "rule in" the diagnosis, and access to echocardiography remains essential for general practitioners to diagnose heart failure early.
OBJECTIVE: To investigate the usefulness of measuring plasma concentrations of B type natriuretic peptide in the diagnosis of left ventricular systolic dysfunction in an unselected group of elderly people. DESIGN: Observational study. SETTING: General practice with four centres in Poole, Dorset. PARTICIPANTS: 155 elderly patients aged 70 to 84 years. MAIN OUTCOME MEASURES: Diagnostic characteristics of plasma B type natriuretic peptide measured by radioimmunoassay as a test for left ventricular systolic dysfunction assessed by echocardiography. RESULTS: The median plasma concentration of B type natriuretic peptide was 39.3 pmol/l in patients with left ventricular systolic dysfunction and 15.8 pmol/l in those with normal function. The proportional area under the receiver operator curve was 0.85. At a cut-off point of 18.7 pmol/l the test sensitivity was 92% and the predictive value 18%. CONCLUSIONS: Plasma concentration of B type natriuretic peptide could be used effectively as an initial test in a community screening programme and, possibly, using a low cut-off point, as a means of ruling out left ventricular systolic dysfunction. It is, however, not a good test to "rule in" the diagnosis, and access to echocardiography remains essential for general practitioners to diagnose heart failure early.
Authors: T A McDonagh; S D Robb; D R Murdoch; J J Morton; I Ford; C E Morrison; H Tunstall-Pedoe; J J McMurray; H J Dargie Journal: Lancet Date: 1998-01-03 Impact factor: 79.321
Authors: M R Cowie; A D Struthers; D A Wood; A J Coats; S G Thompson; P A Poole-Wilson; G C Sutton Journal: Lancet Date: 1997-11-08 Impact factor: 79.321
Authors: Ahmet Fuat; Jeremy J Murphy; A Pali S Hungin; Jane Curry; Ali A Mehrzad; Andrew Hetherington; Jennifer I Johnston; W Stuart A Smellie; Victoria Duffy; Patricia Cawley Journal: Br J Gen Pract Date: 2006-05 Impact factor: 5.386
Authors: Frans H Rutten; Karel G M Moons; Maarten-Jan M Cramer; Diederick E Grobbee; Nicolaas P A Zuithoff; Jan-Willem J Lammers; Arno W Hoes Journal: BMJ Date: 2005-12-01