ArticleESC heart failure2022
Assessment of the impact of different N terminal pro brain natriuretic peptide thresholds on echocardiography services.
Article in ESC heart failure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- The addition of alpha-ketoglutarate to NT-proBNP improves the prediction of long-term all-cause mortality in acute heart failure patients.Annals of medicine · 2025Article
- Correlation between 25-hydroxyvitamin D, N-terminal pro-brain natriuretic peptide, inflammatory factors and myocardial injury in children with mycoplasma pneumoniae pneumonia.BMC pediatrics · 2025Article
- Assessment of the impact of different N terminal pro brain natriuretic peptide thresholds on echocardiography services.ESC heart failure · 2022Article
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
aimsN terminal pro brain natriuretic peptide (NT-proBNP) is considered a rule-out test for patients with suspected heart failure. The NT-proBNP thresholds recommended for echocardiography by the European Society of Cardiology (ESC) and National Institute for Health and Care Excellence (NICE) are based on small studies of patients with heart failure and left ventricular (LV) systolic dysfunction (LVSD). The purpose of our study was to examine the relation between NT-proBNP and LVSD in a larger number of patients with symptoms suggestive of heart failure in a non-acute setting. METHODS AND
resultsOne thousand patients with suspected chronic heart failure underwent echocardiography within 6 months of NT-proBNP measurement. NT-proBNP was the strongest predictor of any form of LVSD in univariate (OR 2.52, 95% CI 2.19-2.91, P value < 0.001) and multivariate (OR 2.73, 95% CI 2.32-3.21, P value < 0.001) analyses. Negative predictive value (NPV) of NT-proBNP for impaired LV systolic function (ejection fraction 35-49%) was 98% at 125 pg/mL (the ESC threshold), 93% at 400 pg/mL (the NICE threshold), 91% at 1000 pg/mL and 90% at 2000 pg/mL. Corresponding values for severe LVSD (ejection fraction <35%) were 100%, 99%, 98% and 96%. The number of patients per 1000 with suspected chronic heart failure requiring echocardiography at each threshold was 851, 543, 324, and 182, respectively.
conclusionsN terminal pro brain natriuretic peptide thresholds recommended by ESC and NICE result in large numbers of patients with suspected chronic heart failure being referred for echocardiography. Raising the NT-proBNP threshold would improve access to echocardiography with minimal negative impact on the clinical performance of this cardiac biomarker.
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