Clinical research studyUse of N-terminal pro-B-type natriuretic peptide to detect myocardial ischemia
Section snippets
Patient population
From May 2004 to August 2004, consecutive patients referred for coronary artery disease evaluation by rest/bicycle ergometry myocardial perfusion single-photon emission computed tomography at the University Hospital Basel were eligible for inclusion in this study. This cohort included patients with stable coronary artery disease as well as patients with unstable coronary artery disease after initial stabilization on medical therapy. Patients with baseline electrocardiogram (ECG) abnormalities
Patient characteristics
The baseline characteristics and details regarding exercise testing and myocardial perfusion single-photon emission computed tomography findings of the 260 patients referred to rest/bicycle ergometry myocardial perfusion single-photon emission computed tomography are listed in Table 1. At rest/ergometry stress myocardial perfusion single-photon emission computed tomography, an inducible ischemia on perfusion images was documented in 129 patients (49.6%).
Plasma NT-proBNP at rest and the response to exercise
The baseline NT-proBNP level (Table 2)
Discussion
This prospective study in unselected consecutive patients referred for rest/bicycle ergometry myocardial perfusion single-photon emission computed tomography examined the use of NT-proBNP measurements in the detection of myocardial ischemia defined as reversible defects on radionuclide imaging. We found that the baseline NT-proBNP, as well as ΔNT-proBNP and peak exercise NT-proBNP were associated with inducible myocardial ischemia. Overall, the accuracy of baseline NT-proBNP, ΔNT-proBNP, and
Acknowledgment
Diagnostic reagents were provided by Roche Diagnostics GmbH, Mannheim, Germany.
References (32)
- et al.
Plasma brain natriuretic peptide in assessment of acute dyspnea
Lancet
(1994) - et al.
Brain natriuretic peptide and N-terminal brain natriuretic peptide in the diagnosis of heart failure in patients with acute shortness of breath
J Am Coll Cardiol
(2003) - et al.
Plasma amino-terminal pro-brain natriuretic peptide and accuracy of heart-failure diagnosis in primary careA randomized, controlled trial
J Am Coll Cardiol
(2003) - et al.
The role of the circulation in processing pro-brain natriuretic peptide (proBNP) to amino-terminal BNP and BNP-32
Peptides
(1997) - et al.
Exercise release of cardiac natriuretic peptides is markedly enhanced when patients with coronary artery disease are treated medically by beta-blockers
J Am Coll Cardiol
(2004) - et al.
Usefulness of plasma brain natriuretic peptide levels in predicting dobutamine-induced myocardial ischemia
Am J Cardiol.
(2004) - et al.
N-terminal B-type natriuretic peptide predicts extent of coronary artery disease and ischemia in patients with stable angina pectoris
Am Heart J
(2004) - et al.
Detection of exercise-induced ischemia by changes in B-type natriuretic peptides
J Am Coll Cardiol
(2004) - et al.
Acute changes in circulating natriuretic peptide levels in relation to myocardial ischemia
J Am Coll Cardiol
(2004) - et al.
Separate acquisition rest thallium-201/stress technetium-99m sestamibi dual-isotope myocardial perfusion single-photon emission computed tomographya clinical validation study
J Am Coll Cardiol
(1993)
Response of B-type natriuretic peptide to exercise in hypertensive patients with suspected diastolic heart failurecorrelation with cardiac function, hemodynamics, and workload
Am Heart J
Comparison of the sensitivity and specificity of exercise electrocardiography in biased and unbiased populations of men and women
Am Heart J.
ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarctionexecutive summary and recommendations
A report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee on the management of patients with unstable angina). Circulation
Clinical practiceSelecting asymptomatic patients for coronary computed tomography or electrocardiographic exercise testing
N Engl J Med
Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure
N Engl J Med
N-terminal pro-brain natriuretic peptide for discriminating between cardiac and non-cardiac dyspnoea
Eur Heart J
Cited by (0)
This study was supported by research grants from the Swiss National Science Foundation, and the Swiss Heart Foundation