Evidence map›Paper›PMID 35670217›Full record

ArticleCirculation. Heart failure2022

Diurnal Variations in Natriuretic Peptide Levels: Clinical Implications for the Diagnosis of Acute Heart Failure.

Tobias Breidthardt, William P T M van Doorn, Noreen van der Linden, Matthias Diebold, Desiree Wussler, Isabelle Danier, Tobias Zimmermann, Samyut Shrestha, Nikola Kozhuharov, Maria Belkin and 7 more

3 registry-linked trialsAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Heart failure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01831115 active not recruitingnot on this map

Basics in Acute Shortness of Breath EvaLuation (BASEL V) Study

TypeobservationalSponsorUniversity Hospital, Basel, SwitzerlandRan2006 to 2025Enrolled5,452ConditionsDyspnea
NCT02091427 completednot on this map

Circadian Variation of Cardiac Troponin

TypeobservationalSponsorMaastricht University Medical CenterRan2013 to 2014Enrolled24ConditionsHealthy Individuals
NCT02210897 completednot on this map

Influence of Renal Function on the Circadian Variation of Cardiac Troponin

TypeobservationalSponsorMaastricht University Medical CenterRan2014 to 2016Enrolled20ConditionsChronic Kidney Diseases
3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Role of Peptides in Skeletal Muscle Wasting: A Scoping Review.Journal of cachexia, sarcopenia and muscle · 2025
    Article
  2. Circadian rhythms in cardiovascular disease.European heart journal · 2025
    Review
  3. Review
  4. Review
  5. Observational
  6. Article
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Tobias Breidthardt *Divison of Internal Medicine (T.B., D.W., T.Z., S.S., M.B.), University Hospital Basel, Basel University, Switzerland.ORCID 0000-0003-2671-6456
William P T M van Doorn *General Clinical Chemistry and Hematology, Central Diagnostic Laboratory Maastricht University Medical Center, the Netherlands (W.P.T.M.v.D., N.v.d.L., S.J.R.M.).
Noreen van der LindenGeneral Clinical Chemistry and Hematology, Central Diagnostic Laboratory Maastricht University Medical Center, the Netherlands (W.P.T.M.v.D., N.v.d.L., S.J.R.M.).
Matthias DieboldCardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.ORCID 0000-0002-6914-9132
Desiree WusslerDivison of Internal Medicine (T.B., D.W., T.Z., S.S., M.B.), University Hospital Basel, Basel University, Switzerland.ORCID 0000-0002-1793-5297
Isabelle DanierCardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.
Tobias ZimmermannDivison of Internal Medicine (T.B., D.W., T.Z., S.S., M.B.), University Hospital Basel, Basel University, Switzerland.ORCID 0000-0002-6862-5205
Samyut ShresthaDivison of Internal Medicine (T.B., D.W., T.Z., S.S., M.B.), University Hospital Basel, Basel University, Switzerland.
Nikola KozhuharovCardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.ORCID 0000-0003-2086-3690
Maria BelkinDivison of Internal Medicine (T.B., D.W., T.Z., S.S., M.B.), University Hospital Basel, Basel University, Switzerland.ORCID 0000-0003-4643-8473
Caroline PortaCardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.
Ivo StrebelCardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.ORCID 0000-0001-9976-4112
Eleni MichouCardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.
Danielle M GualandroCardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.
Albina NowakDivision of Endocrinology, University Hospital Zurich, University of Zurich, Switzerland (A.N.).
S J R MeexGeneral Clinical Chemistry and Hematology, Central Diagnostic Laboratory Maastricht University Medical Center, the Netherlands (W.P.T.M.v.D., N.v.d.L., S.J.R.M.).
Christian MuellerCardiovascular Research Institute Basel (T.B., M.D., D.W., I.D., T.Z., S.S., N.K., M.B., C.P.' I.S., E.M., D.M.G., C.M.), University Hospital Basel, Basel University, Switzerland.ORCID 0000-0002-1120-6405

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent guidelines recommend interpreting concentrations of NPs (natriuretic peptides) irrespective of the time of presentation to the emergency department. We hypothesized that diurnal variations in NP concentration may affect their diagnostic accuracy for acute heart failure.

methodsIn a secondary analysis of a multicenter diagnostic study enrolling patients presenting with acute dyspnea to the emergency department and using central adjudication of the final diagnosis by 2 independent cardiologists, the diagnostic accuracy for acute heart failure of BNP (B-type NP), NT-proBNP (N-terminal pro-B-type NP), and MR-proANP (midregional pro-atrial NP) was compared among 1577 daytime presenters versus 908 evening/nighttime presenters. In a validation study, the presence of a diurnal rhythm in BNP and NT-proBNP concentrations was examined by hourly measurements in 44 stable individuals.

resultsAmong patients adjudicated to have acute heart failure, BNP, NT-proBNP, and MR-proANP concentrations were comparable among daytime versus evening/nighttime presenters (all

conclusionsBNP and NT-proBNP, but not MR-proANP, exhibit a diurnal rhythm that results in even higher diagnostic accuracy among evening/nighttime presenters versus daytime presenters. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifiers: NCT01831115, NCT02091427, and NCT02210897.

Indexed as

Heart FailureAtrial Natriuretic FactorBiomarkersCircadian RhythmDyspneaHumansNatriuretic Peptide, BrainNatriuretic PeptidesPeptide FragmentsVasodilator AgentsAtrial Natriuretic FactorBiomarkersNatriuretic Peptide, BrainNatriuretic PeptidesPeptide FragmentsVasodilator Agentscircadian rhythmdiagnostic techniques, cardiovasculardyspneaheart failurenatriuretic peptides

Identifiers

PMID35670217
PMCPMC10004748

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.