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Natriuretic peptides to differentiate constrictive pericarditis and restrictive cardiomyopathy: A systematic review

Carlos Diaz-Arocutipa1,2,3, Jose Saucedo-Chinchay4, Massimo Imazio5

  • 1Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.

Clinical Cardiology
|December 30, 2021
PubMed

Insights

B-type natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels are significantly lower in constrictive pericarditis (CP) compared to restrictive cardiomyopathy (RCM). BNP shows good diagnostic accuracy in differentiating these conditions.

Area of Science:

  • Cardiology
  • Biomarkers
  • Diagnostic Medicine

Background:

  • Restrictive cardiomyopathy (RCM) and constrictive pericarditis (CP) present similar symptoms but have different management strategies.
  • Natriuretic peptides, including B-type natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP), are established biomarkers for heart failure.
  • Previous studies suggest differing natriuretic peptide levels in RCM versus CP, but a comprehensive evaluation is needed.

Purpose of the Study:

  • To systematically review and meta-analyze the diagnostic utility of BNP and NT-proBNP in differentiating CP from RCM.
  • To assess the accuracy of these biomarkers in distinguishing between these two distinct cardiac conditions.

Main Methods:

  • Systematic review and meta-analysis of studies published up to January 7, 2021.
  • Inclusion of studies assessing natriuretic peptides for CP vs. RCM differentiation in adult patients.
  • Random-effects model used for all meta-analyses.

Main Results:

  • Seven studies with 204 patients were included.
  • Both BNP and NT-proBNP levels were significantly lower in patients with CP compared to RCM.
  • The pooled area under the curve (AUC) for BNP demonstrated good diagnostic accuracy (0.81).

Conclusions:

  • BNP and NT-proBNP levels are significantly lower in constrictive pericarditis compared to restrictive cardiomyopathy.
  • BNP, with its good diagnostic accuracy, can aid in differentiating between CP and RCM.
  • These findings support the use of natriuretic peptides as valuable tools in the diagnostic workup of patients with suspected RCM or CP.

Keywords:
constrictive pericarditisnatriuretic peptidesrestrictive cardiomyopathysystematic review

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