Acute changes in N-terminal pro-brain natriuretic peptide induced by dobutamine stress echocardiography
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Karabinos, I.
Karvouni, E.
Chiotinis, N.
Papadopoulos, A.
Simeonidis, P.
Tsolas, O.
Katritsis, D.
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peer-reviewed
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Eur J Echocardiogr
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Description
AIMS: Aim of the study was to determine the effect of dobutamine stress echocardiography (DSE)-induced ischemia on circulating levels of N-terminal fragment of B-type natriuretic peptide (NT-pro-BNP). METHODS AND RESULTS: One hundred and twenty-eight patients underwent DSE for the evaluation of known or suspected coronary artery disease. NT-pro-BNP levels were measured before and 1h after completion of DSE. NT-pro-BNP levels were similar before and after DSE regardless of whether patients had (123+/-101.8 vs. 124.2+/-108.3, p=NS) or did not have inducible ischemia (96.5+/-70.5 vs. 100.5+/-71.1, p=NS). Patients with inducible myocardial ischemia had no different NT-pro-BNP levels compared to patients without inducible ischemia both before (123+/-101.8 vs. 96.5+/-70pg/ml, p=0.37) and after DSE (124.2+/-108.3 vs. 100.5+/-71.1pg/ml, p=0.55). Patients with severe inducible ischemia had significantly higher NT-pro-BNP levels compared to patients with mild or moderate inducible ischemia and patients without inducible ischemia, both before (208.5+/-125.5 vs. 96+/-78.9 vs. 96.5+/-70pg/ml, p=0.017 and p=0.025, respectively) and after DSE (212.5+/-138.1 vs. 94.8+/-81.1 vs. 100.5+/-71.1pg/ml, p=0.015 and p=0.023, respectively). NT-pro-BNP levels before DSE could be independently predicted by age (p<0.0001), presence of diabetes mellitus (p=0.002), and ejection fraction (p=0.005), but not DSE inducible ischemia. CONCLUSION: NT-pro-BNP is not affected by DSE-induced ischemia and cannot be used in clinical practice to improve diagnostic accuracy of DSE.
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Keywords
Acute Disease, Adult, Aged, Biological Markers, Coronary Artery Disease/diagnosis/*ultrasonography, *Echocardiography, Stress, Exercise Test, Female, Humans, Male, Middle Aged, Myocardial Ischemia/etiology/*physiopathology, Natriuretic Peptide, Brain/analysis/*physiology, Peptide Fragments/analysis/*physiology, Prospective Studies, Stroke Volume, Ventricular Function, Left
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http://www.ncbi.nlm.nih.gov/pubmed/16849043
http://ehjcimaging.oxfordjournals.org/content/8/4/265.full.pdf
http://ehjcimaging.oxfordjournals.org/content/8/4/265.full.pdf
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en
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Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής