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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.
Cardiology
|October 21, 1998
Summary
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.