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[Urinary levels of B-type natriuretic peptide (BNP) and ventricular systolic dysfunction in heart failure patients]
R Cortés1, M Rivera, L Martínez Dolz
1Unidad de Cardiocirculación. Centro de Investigación. Hospital Universitario La Fe. Valencia. España.
Background:
It was aimed to compare urine B-type natriuretic peptide (BNP) according to left ventricular systolic dysfunction and to investigate its diagnostic value in heart failure (HF) patients.
Material And Methods:
A total of 90 HF outpatients (61 men, age 66 +/- 12) and 30 age- and gender-matched controls were studied.
Results:
An increase in urine BNP was observed in patients with EF= 40% compared to EF> 40% (p < 0.0001), and controls (p < 0.0001). Significant correlations between urinary BNP and left ventricular functional parameters were obtained. A multivariate regression analysis was performed and the best model associated with urine BNP included plasma BNP (p < 0.0001), EF (p = 0.02) and LV volume indexes (p < 0.0001). The ROC for detection of EF = 40% using urine BNP levels showed an area under the curve of 0.74 +/- 0.05, (p < 0.0001). From the ROC curve, the optimal cut-off value (2.30 ng/l) had a 60% sensitivity and 90% specificity. Finally, we performed a binary logistic regression for detection of EF = 40%, and urine BNP was shown to be a strong predictor with an odds-ratio of 21.
Discussion:
Urine BNP levels correlated with left ventricular functional parameters. This biomarker is a useful tool for detecting and diagnosing left ventricular systolic dysfunction in heart failure.
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