Comparison of Positive Cases for B-type Natriuretic Peptide and ECG Testing for Identification of Precursor Forms of Heart Failure in an Elderly Population
スポンサーリンク
概要
- 論文の詳細を見る
Plasma B-type natriuretic peptide (BNP) levels have been reported to be elevated in various types of cardiac disorders and in precursors of CHF. To elucidate the potential ability of BNP testing to identify individuals with structural cardiac disease (ie, hypertensive heart disease, coronary heart disease, valvular heart disease) among community-dwelling elderly persons, cases which were positive on BNP testing were compared to those positive on ECG testing. In the initial phase, we performed plasma BNP measurements and ECG in 856 participants (age ≥ 65 years) selected from a general population. From within this group, subjects with an abnormal ECG (n = 125) were selected according to the Minnesota code. Subjects with elevated BNP were selected independently on the basis of plasma levels (n = 112). In the next phase, subjects in both groups were invited to complete Roses angina questionnaire and to undergo physical examination and transthoracic echocardiography. In this subject group (positive in ECG testing and/or BNP testing), the two tests had comparable sensitivity (65% versus 59%: NS) and specificity (40% versus 41%: NS) for identifying hypertensive heart disease (n = 17). For coronary heart disease (n = 12), the two tests had also comparable sensitivity (58% versus 42%: NS) and specificity (39% versus 41%: NS). However, for selection of valvular heart disease (n = 7), BNP testing had higher sensitivity than ECG testing (100% versus 14%; P < 0.01) with comparable specificity (43% versus 40%: NS). Several types of structural heart disease, in particular valvular heart disease, could be identified exclusively by BNP testing, suggesting that BNP measurement can make a significant contribution to screening for CHF precursors when used in combination with ECG in elderly populations.
- インターナショナル・ハート・ジャーナル刊行会の論文
著者
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NAKAMURA Motoyuki
Second Department of Internal Medicine, School of Medicine, Iwate Medical University
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OKAYAMA Akira
Department of Preventive Cardiology, National Cardiovascular Center
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Hiramori Katsuhiko
岩手医科大学医学部附属循環器医療センター
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Hiramori Katsuhiko
Second Department Of Internal Medicine Iwate Medical University
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Sakai Toshiaki
Second Department of Internal Medicine, Iwate Medical University School of Medicine
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Osawa Masaki
Second Department of Internal Medicine, Iwate Medical University School of Medicine
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Onoda Toshiyuki
Second Department of Internal Medicine, Iwate Medical University School of Medicine
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Yonezawa Shinetsu
Iwate Health Service Association
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Okayama Akira
Department Of Hygiene And Preventive Medicine Osaka University School Of Medicine Nakanoshima
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Nakamura Motoyuki
Secon Department Of Internal Medicine Memorial Heart Center
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HIRAMORI Katsuhiko
Second Department of Internal Medicine, Iwate Medical University School of Medicine
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NAKAMURA Motoyuki
Second Department of Internal Medicine, Iwate Medical University School of Medicine
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Sakai Toshiaki
Second Department of Internal Medicine, Iwate Medical University
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Hiramori Katsuhiko
Second Department of Internal Medicine and Department of Hygiene, School of Medicine, Iwate Medical University
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