High intraindividual variation of B-type natriuretic peptide (BNP) and amino-terminal proBNP in patients with stable chronic heart failure
| Autor: | Jody M.W. van den Ouweland, Frits A. J. Muskiet, Jeroen W.P. Römer, Sanne Bruins, Fey P. L. van der Dijs, M. Rebecca Fokkema, Mike J. L. DeJongste |
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| Přispěvatelé: | Lifestyle Medicine (LM), Center for Liver, Digestive and Metabolic Diseases (CLDM) |
| Rok vydání: | 2004 |
| Předmět: |
BIOMARKER
Adult Male medicine.medical_specialty Time Factors Heart disease medicine.drug_class Amino terminal Clinical Biochemistry Nerve Tissue Proteins THERAPY ACTIVATION chemistry.chemical_compound Internal medicine Biological variation Natriuretic Peptide Brain medicine Natriuretic peptide MANAGEMENT Humans cardiovascular diseases BRAIN PLASMA-LEVELS Aged Aged 80 and over Heart Failure Immunoassay business.industry EMERGENCY DIAGNOSIS Biochemistry (medical) Middle Aged medicine.disease Brain natriuretic peptide SPIRONOLACTONE Peptide Fragments Endocrinology chemistry Heart failure BIOLOGICAL VARIATION Chronic Disease Spironolactone Cardiology Biomarker (medicine) Female business hormones hormone substitutes and hormone antagonists Biomarkers RESPONSES |
| Zdroj: | Clinical Chemistry, 50(11), 2052-2058. AMER ASSOC CLINICAL CHEMISTRY |
| ISSN: | 0009-9147 |
| Popis: | Background: Plasma B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are promising markers for heart failure diagnosis, prognosis, and treatment. Insufficient data on the intraindividual biological variation (CVi) of BNP and NT-proBNP hamper interpretation of changes in concentration on disease progression or treatment optimization. We therefore investigated CVi values in stable heart failure patients. Methods: We recruited 43 patients with stable chronic heart failure living in Curaçao (22 males, 21 females; median age, 63 years; range, 20–86 years; New York Heart Association classes I–III). Samples were collected for within-day CVi (n = 6; every 2 h starting at 0800), day-to-day CVi (n = 5; samples collected between 0800 and 1000 on 5 consecutive days), and week-to-week CVi (n = 6; samples collected between 0800 and 1000 on the same day of the week for 6 consecutive weeks). NT-proBNP (Roche) and BNP (Abbott) were measured by immunoassay. Results: Median (range) concentrations were 134 (0–1630) ng/L (BNP) and 570 (17–5048) ng/L (NT-proBNP). Analytical variation, week-to-week CVi, and reference change values were 8.4%, 40%, and 113% (BNP), and 3.0%, 35%, and 98% (NT-proBNP). Week-to week CVis were inversely related to median BNP concentrations. Week-to week CVis for BNP were 44% (BNP ≤350 ng/L) and 30% (BNP >350 ng/L). Both BNP and NT-proBNP increased between 0800 and 1000. Median NT-proBNP/BNP ratios were inversely related to median BNP concentrations. Conclusions: The high CVis hamper interpretation of changes in BNP and NT-proBNP concentrations and may partly explain their poor diagnostic values in chronic heart failure. Easily modifiable determinants to lower CVi have not been identified. The value of BNP and NT-proBNP for chronic heart failure diagnosis, and especially for follow-up and treatment optimization of individuals, remains largely to be established. |
| Databáze: | OpenAIRE |
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