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Screening for asymptomatic left ventricular dysfunction using B-type natriuretic Peptide

Theresa A McDonagh1, Kenneth McDonald, Alan S Maisel

  • 1Royal Brompton Hospital, London, UK. t.mcdonagh@ic.ac.uk

Congestive Heart Failure (Greenwich, Conn.)
|October 4, 2008
PubMed

Insights

Screening for asymptomatic left ventricular dysfunction (ASLVD) is feasible using natriuretic peptides. Early treatment of ASLVD can improve patient outcomes and reduce heart failure progression.

Area of Science:

  • Cardiology
  • Preventive Medicine
  • Biomarker Research

Background:

  • Asymptomatic left ventricular dysfunction (ASLVD) precedes heart failure and impacts longevity.
  • ASLVD is common and untreated, it leads to significant morbidity and mortality.
  • Current screening criteria are met by ASLVD, making it a viable target for early detection.

Purpose of the Study:

  • To evaluate the potential for population-based screening of ASLVD.
  • To assess the efficacy of natriuretic peptides in detecting left ventricular systolic dysfunction.
  • To review evidence supporting the treatment of ASLVD to prevent heart failure.

Main Methods:

  • Review of population-based studies on B-type natriuretic peptide (BNP) and N-terminal prohormone brain natriuretic peptide (NTproBNP) accuracy.
  • Analysis of randomized controlled trials on ASLVD treatment efficacy.
  • Cost-effectiveness evaluation of natriuretic peptide screening.

Main Results:

  • BNP and NTproBNP accurately exclude left ventricular systolic dysfunction cost-effectively.
  • Evidence supports that treating ASLVD reduces morbidity and mortality.
  • Treatment can slow the progression to symptomatic heart failure.

Conclusions:

  • Natriuretic peptide testing is a viable and cost-effective tool for ASLVD screening.
  • Treating ASLVD offers significant clinical benefits, reducing heart failure progression.
  • A large randomized trial is needed to demonstrate that ASLVD screening alters natural disease history.

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