Abstract 18079: B-Type Natriuretic Peptide is a Screening Tool to Rule Out Subclinical Left Ventricular Geometry and Diastolic Dysfunction in a Community-Based Population
Background: LV hypertrophy and LV diastolic dysfunction are common and associated with the incidence of cardiac events in the general population. LV systolic and/or diastolic dysfunction and LV hypertrophy are associated with high B-type natriuretic peptide (BNP) levels. Plasma BNP levels have been reported to be a useful biomarker to detect various heart diseases in the general population. However, it has not been investigated whether plasma BNP levels are useful to detect LV hypertrophy and/or diastolic dysfunction in the general population.
Methods: We studied 1162 community-dwelling subjects without obvious heart diseases (mean age, 63 +/- 11 years; 448 men, 714 women) who participated in annual health checkup in a rural Japanese community, Arita-cho. The population was divided into 5 groups referring to plasma BNP levels. LV diastolic dysfunction was determined with the waves of transmitral flow and mitral annular velocity. LV hypertrophy was defined as the top quintile of LV mass index.
Results: The prevalence of LV hypertrophy and/or diastolic dysfunction increased along with increases in BNP levels(Table). The area under the receiver operating characteristic curve showed the modest ability of plasma BNP levels for detecting those subjects (0.640 95%CI 0.590-0.690 p<0.001). An optimal threshold for the identification of the subjects with both LV hypertrophy and diastolic dysfunction was a BNP of 22.0 pg/ml with the sensitivity of 61%, the specificity of 58%, positive predictive value of 17%, and negative predictive value of 92%.
Conclusion: BNP levels seem the useful screening tool to rule out, rather than detect, subclinical LV impairment in the community-based population.
- © 2013 by American Heart Association, Inc.