Related Experiment Videos
Plasma B-type natriuretic peptide measurement in a multiphasic health screening program
H Niinuma1, M Nakamura, K Hiramori
1Second Department of Internal Medicine, Iwate Medical University, Morioka, Japan.
Insights
Plasma B-type natriuretic peptide (BNP) effectively screens for heart disease in large populations, regardless of left ventricular function. A BNP level below 13 pg/ml indicates no heart disease with 100% accuracy.
Area of Science:
- Cardiology
- Biochemistry
- Preventive Medicine
Background:
- Early detection of heart disease is crucial for effective management.
- Multiphasic health screening programs offer opportunities for identifying asymptomatic individuals with cardiac conditions.
- Plasma levels of natriuretic peptides, such as atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP), are investigated as potential biomarkers for heart disease.
Purpose of the Study:
- To evaluate the efficacy of plasma ANP and BNP measurements in predicting heart disease in a multiphasic health screening setting.
- To determine if these biomarkers can identify patients with various forms of heart disease, independent of left ventricular function.
- To assess the diagnostic performance of ANP and BNP in a large, asymptomatic population.
Main Methods:
- Analysis of plasma ANP and BNP levels in 481 consecutive subjects undergoing multiphasic health screening.
- Identification of 13 subjects with diagnosed heart disease (myocardial infarction, cardiomyopathy, valvular disease, hypertensive heart disease, atrial fibrillation) through routine examinations.
- Calculation of sensitivity, specificity, and quintile analysis for ANP and BNP, with construction of Receiver Operating Characteristic (ROC) curves.
Main Results:
- A plasma BNP level of 40 pg/ml demonstrated 85% sensitivity and 92% specificity for heart disease detection.
- The area under the ROC curve for BNP (0.94) was significantly higher than for ANP (0.81), indicating superior diagnostic performance.
- A plasma BNP level of 13 pg/ml or less provided a 100% negative predictive value for heart disease.
Conclusions:
- Plasma BNP concentration serves as a valuable biochemical marker for screening asymptomatic individuals with diverse etiologies of heart disease.
- BNP is a more effective biomarker than ANP for detecting heart disease in large population samples during health screenings.
- The findings support the use of plasma BNP as a cost-effective tool for early identification of cardiac conditions in preventive medicine programs.
Abstract:
The aim of this study was to determine whether measurement of plasma levels of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) is an efficacious method to predict patients with heart disease irrespective of left ventricular function in a multiphasic health screening program. We have examined whether patients with various heart disease selected by physical examination, ECG, and chest X-rays can be identified by plasma levels of ANP and BNP. We examined 481 consecutive subjects who visited our checkup clinic for a multiphasic health screening test. By routine methods, among the 481 subjects, 13 were found to have some form of heart disease (old myocardial infarction, 2; cardiomyopathy, 2; valvular heart disease, 2; hypertensive heart disease, 5, and lone atrial fibrillation, 2). Sensitivity, specificity, and quintile analysis for identification of the patients with heart disease were determined by various cutoff levels of plasma ANP and BNP. Receiver operating characteristic (ROC) curves were constructed for the identification of these patients. A plasma BNP level of 40 pg/ml had a sensitivity of 85% and a specificity of 92% for heart disease detection. The area under the ROC curve for BNP was significantly greater than that for ANP (0.94 vs. 0.81; p < 0.001). A plasma BNP level of 13 pg/ml or less gave a 100% negative prediction value for heart disease. Plasma BNP concentration is a useful biochemical marker for the screening of asymptomatic patients with heart disease due to various etiologies from large population samples.