PMID- 14967727
OWN - NLM
STAT- MEDLINE
DCOM- 20040601
LR  - 20201216
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 109
IP  - 8
DP  - 2004 Mar 2
TI  - Usefulness of B-type natriuretic peptide assay in the assessment of symptomatic 
      state in hypertrophic cardiomyopathy.
PG  - 984-9
AB  - BACKGROUND: Hypertrophic cardiomyopathy (HCM) has a diverse clinical spectrum 
      that often includes progressive heart failure symptoms and disability. Assessment 
      of symptom severity may be highly subjective, encumbered by the heterogeneous 
      clinical presentation. Plasma B-type natriuretic peptide (BNP) has been used 
      widely as an objective marker for heart failure severity and outcome, 
      predominantly in coronary heart disease with ventricular dilatation and systolic 
      dysfunction. METHODS AND RESULTS: We prospectively assessed plasma BNP as a 
      quantitative clinical marker of heart failure severity in 107 consecutive HCM 
      patients. BNP showed a statistically significant relationship to magnitude of 
      functional limitation, assessed by New York Heart Association (NYHA) functional 
      class: I, 136+/-159 pg/mL; II, 338+/-439 pg/mL; and III/IV, 481+/-334 pg/mL 
      (P<0.001). Multivariable analysis showed that BNP was independently related to 
      NYHA class as well as age and left ventricular wall thickness (each with a value 
      of P=0.0001). BNP > or =200 pg/mL was the most reliable predictor of heart 
      failure symptoms, with positive and negative predictive values of 63% and 79%, 
      respectively. BNP power in distinguishing patients with or without heart failure 
      symptoms was less than that for differentiating between no (or only mild) and 
      severe symptoms (area under receiver operating characteristic curve=0.75 and 
      0.83, respectively). CONCLUSIONS: Plasma BNP is independently related to the 
      presence and magnitude of heart failure symptoms in patients with HCM. As a 
      clinical marker for heart failure, BNP is limited by considerable overlap in 
      values between categories of heart failure severity as well as confounding 
      variables of left ventricular wall thickness and age.
FAU - Maron, Barry J
AU  - Maron BJ
AD  - Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, and 
      University of Minnesota, Minneapolis, MN 55407, USA. hcm.maron@mhif.org
FAU - Tholakanahalli, Venkatakrishna N
AU  - Tholakanahalli VN
FAU - Zenovich, Andrey G
AU  - Zenovich AG
FAU - Casey, Susan A
AU  - Casey SA
FAU - Duprez, Daniel
AU  - Duprez D
FAU - Aeppli, Dorothee M
AU  - Aeppli DM
FAU - Cohn, Jay N
AU  - Cohn JN
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20040216
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 0 (Biomarkers)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
CIN - Circulation. 2004 Mar 2;109(8):e9013-4. PMID: 14993149
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Biomarkers
MH  - Cardiomyopathy, Hypertrophic/*blood/diagnostic imaging/pathology
MH  - Female
MH  - Heart Ventricles/diagnostic imaging/pathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - ROC Curve
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
MH  - Ultrasonography
EDAT- 2004/02/18 05:00
MHDA- 2004/06/02 05:00
CRDT- 2004/02/18 05:00
PHST- 2004/02/18 05:00 [pubmed]
PHST- 2004/06/02 05:00 [medline]
PHST- 2004/02/18 05:00 [entrez]
AID - 01.CIR.0000117098.75727.D8 [pii]
AID - 10.1161/01.CIR.0000117098.75727.D8 [doi]
PST - ppublish
SO  - Circulation. 2004 Mar 2;109(8):984-9. doi: 10.1161/01.CIR.0000117098.75727.D8. 
      Epub 2004 Feb 16.