Jungbauer, Carsten G. and Buchner, Stefan and Birner, Christoph and Resch, Markus and Heinicke, Norbert and Debl, Kurt and Buesing, Monika and Biermeier, Daniela and Schmitz, Gerd and Riegger, Guenter and Luchner, Andreas (2010) N-terminal pro-brain natriuretic peptide from fresh urine for the biochemical detection of heart failure and left ventricular dysfunction. EUROPEAN JOURNAL OF HEART FAILURE, 12 (4). pp. 331-337. ISSN 1388-9842,
Full text not available from this repository. (Request a copy)Abstract
Aims Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) is a strong biochemical marker of heart failure and left ventricular dysfunction (LVD). Due to renal arterio-venous clearance of NT-proBNP and the correlation of plasma concentrations with renal function, we hypothesized that NT-proBNP may have potential as a urinary marker. The objective of this study was to assess urinary concentrations of NT-proBNP and to identify the predictive value of urinary NT-proBNP for detecting LVD and heart failure. Methods and results N-terminal pro-brain natriuretic peptide (Elecsys proBNP (R), Roche) was assessed simultaneously in fresh spot urine and plasma from 191 individuals. In patients with heart failure (n = 149), urinary and plasma NT-proBNP concentrations were positively correlated (r = 0.79, P<0.001), but urinary NT-proBNP was significantly lower than plasma NT-proBNP (42 +/- 25 vs. 1389 +/- 325 pg/mL, P<0.001). Upon receiver operating curve analysis, urinary NT-proBNP detected LV dysfunction (ejection fraction <40%) with a sensitivity of 91% and a specificity of 98% at a cutpoint of 22 pg/mL [area under the curves (AUC) 0.98]. At the same cutpoint, symptomatic heart failure (NYHA-class > 2) was detected with a sensitivity of 97% and specificity of 98% (AUC 0.99) and clinical signs of fluid retention were detected with a sensitivity and specificity of 98% each (AUC 0.99). Conclusion N-terminal pro-brain natriuretic peptide concentrations were markedly lower in the urine than in the plasma. However, urinary NT-proBNP levels increased stepwise with the severity of heart failure and LVD, and therefore yielded satisfactory predictive values for the detection of significant LVD and symptomatic heart failure. Measurement of urinary NT-proBNP is a novel, promising, and simple method for the biochemical detection of heart failure.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MYOCARDIAL-INFARCTION; SYSTOLIC DYSFUNCTION; PLASMA; RECEPTORS; DYSPNEA; MARKERS; BNP; Urinary NT-proBNP; Heart failure; Cardiac markers; Natriuretic peptides |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II Medicine > Lehrstuhl für Klinische Chemie und Laboratoriumsmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 03 Aug 2020 08:33 |
| Last Modified: | 03 Aug 2020 08:33 |
| URI: | https://pred.uni-regensburg.de/id/eprint/24868 |
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