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Diagnostic ability of B-type natriuretic peptide and impedance cardiography: testing to identify left ventricular

Vikas Bhalla1, Susan Isakson, Meenakshi A Bhalla

  • 1Division of Cardiology and the Department of Medicine, Veterans Affairs Medical Center and University of California, San Diego, San Diego, California 92161, USA.

American Journal of Hypertension
|March 9, 2005
PubMed

Insights

Brain natriuretic peptide (BNP) and N-terminal BNP (NT-BNP) tests, along with impedance cardiography (ICG), can help detect left ventricular dysfunction (LVD) in hypertensive patients. Combining ICG with natriuretic peptide testing shows promise for improved LVD detection.

Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Hypertension poses a significant risk for left ventricular dysfunction (LVD).
  • Echocardiography, the gold standard for LVD diagnosis, is limited by cost and accessibility for frequent monitoring.
  • Biomarkers like Brain Natriuretic Peptide (BNP) and N-terminal BNP (NT-BNP), and noninvasive hemodynamic monitoring via Impedance Cardiography (ICG) offer potential alternatives.

Purpose of the Study:

  • To evaluate the efficacy of BNP, NT-BNP, and ICG in identifying LVD in hypertensive individuals.
  • To compare the diagnostic capabilities of these methods, individually and in combination.

Main Methods:

  • Retrospective analysis of 193 hypertensive subjects undergoing echocardiography.
  • Exclusion of patients with pre-existing LVD.
  • Diagnosis of LVD based on echocardiographic findings of systolic/diastolic dysfunction, abnormalities, or hypertrophy.

Main Results:

  • Multivariate analysis identified cardiac index, left cardiac work index, BNP, arrhythmia, angina, and systemic vascular resistance as significant LVD predictors.
  • Receiver operating characteristic (ROC) analysis showed areas under the curve (AUC) for BNP (0.60), NT-BNP (0.67), and ICG (0.66).
  • Combined testing demonstrated improved AUC: ICG with BNP (0.70) and ICG with NT-BNP (0.73).

Conclusions:

  • BNP, NT-BNP, and ICG are valuable tools for detecting LVD in high-risk hypertensive patients.
  • The combination of ICG with natriuretic peptide testing enhances the detection accuracy for LVD.
Abstract

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