PMID- 12422152
OWN - NLM
STAT- MEDLINE
DCOM- 20021230
LR  - 20190626
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 144
IP  - 5
DP  - 2002 Nov
TI  - A rapid B-type natriuretic peptide assay accurately diagnoses left ventricular 
      dysfunction and heart failure: a multicenter evaluation.
PG  - 834-9
AB  - BACKGROUND: B-Type natriuretic peptide (BNP), a protein released from the left 
      ventricle in response to volume expansion and pressure overload, has emerged as 
      the first whole blood marker for the identification of individuals with 
      congestive heart failure (CHF). OBJECTIVE: The purpose of this study was to 
      assess the performance of a point-of-care assay to diagnose and evaluate the 
      severity of CHF on the basis of the New York Heart Association (NYHA) 
      classification system. METHODS: Through a prospective, multicenter trial, whole 
      blood samples were collected from a total of 1050 inpatients, outpatients, and 
      healthy control patients. Participants were divided into subgroups for BNP 
      analysis: patients without cardiovascular CHF (n = 473), patients with 
      hypertension and no cardiovascular disease (n = 168), NYHA class I CHF (n = 73), 
      class II CHF (n = 135), class III CHF (n = 141), and class IV CHF (n = 60). 
      RESULTS: Circulating BNP concentrations determined from the bedside assay 
      increased with CHF severity, as determined by the NYHA classification system, but 
      were only statistically significant (P <.001) between individuals with and 
      without CHF. Individuals without CHF had a median BNP concentration of 9.29 
      pg/mL. Median BNP values, with their corresponding interquartile ranges, for NYHA 
      classification I through IV were 83.1 pg/mL (49.4-137 pg/mL), 235 pg/mL (137-391 
      pg/mL), 459 pg/mL (200-871 pg/mL), and 1119 pg/mL (728->1300 pg/mL), 
      respectively. With the use of a decision threshold of 100 pg/mL, the assay 
      demonstrated 82% sensitivity and 99% specificity for distinguishing control 
      patients and patients with CHF. CONCLUSIONS: BNP concentrations obtained from 
      whole blood samples are useful in the diagnosis of CHF and staging the severity 
      of the disease.
FAU - Wieczorek, Stacey J
AU  - Wieczorek SJ
AD  - Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, 
      Conn, USA.
FAU - Wu, Alan H B
AU  - Wu AH
FAU - Christenson, Robert
AU  - Christenson R
FAU - Krishnaswamy, Padma
AU  - Krishnaswamy P
FAU - Gottlieb, Stephen
AU  - Gottlieb S
FAU - Rosano, Thomas
AU  - Rosano T
FAU - Hager, David
AU  - Hager D
FAU - Gardetto, Nancy
AU  - Gardetto N
FAU - Chiu, Albert
AU  - Chiu A
FAU - Bailly, Kathryn R
AU  - Bailly KR
FAU - Maisel, Alan
AU  - Maisel A
LA  - eng
PT  - Clinical Trial
PT  - Controlled Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Biomarkers)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Atrial Natriuretic Factor/*blood
MH  - Biomarkers/blood
MH  - Female
MH  - Heart Failure/blood/*diagnosis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain
MH  - *Point-of-Care Systems
MH  - Prospective Studies
MH  - ROC Curve
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
MH  - Ventricular Dysfunction, Left/blood/*diagnosis
EDAT- 2002/11/08 04:00
MHDA- 2002/12/31 04:00
CRDT- 2002/11/08 04:00
PHST- 2002/11/08 04:00 [pubmed]
PHST- 2002/12/31 04:00 [medline]
PHST- 2002/11/08 04:00 [entrez]
AID - S0002870302001941 [pii]
AID - 10.1067/mhj.2002.125623 [doi]
PST - ppublish
SO  - Am Heart J. 2002 Nov;144(5):834-9. doi: 10.1067/mhj.2002.125623.