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Clinical Research in Cardiology

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01-10-2011 | Original Paper

Diagnostic accuracy of NT-proBNP ratio (BNP-R) for early diagnosis of tachycardia-mediated cardiomyopathy: a pilot study

Authors: Amir M. Nia, Natig Gassanov, Kristina M. Dahlem, Evren Caglayan, Martin Hellmich, Erland Erdmann, Fikret Er

Published in: Clinical Research in Cardiology | Issue 10/2011

Abstract

Background

When heart failure and tachycardia occur simultaneously, a useful diagnostic tool for early discrimination of patients with benign tachycardia-mediated cardiomyopathy (TMC) versus major structural heart disease (MSHD) is not available. Such a tool is required to prevent unnecessary and wearing diagnostics in patients with reversible TMC. Moreover, it could lead to early additional diagnostics and therapeutic approaches in patients with MSHD.

Methods

A total of 387 consecutive patients with supraventricular arrhythmia underwent assessment at a single center. Of these patients, 40 fulfilled the inclusion criteria with a resting heart rate ≥100 bpm and an impaired left ventricular ejection fraction <40%. In all patients, successful electrical cardioversion was performed. At baseline, day 1 and weekly for 4 weeks, levels of NT-proBNP and echocardiographic parameters were evaluated. An NT-proBNP ratio (BNP-R) was calculated as a quotient of baseline NT-proBNP/follow-up NT-proBNP. After 4 weeks, cardiac catheterization was performed to identify patients with a final diagnosis of TMC versus MSHD.

Results

Initial NT-proBNP concentrations were elevated and consecutively decreased after cardioversion in all patients. Multivariate regression and ROC analysis revealed that BNP-R discriminated between patients with TMC versus MSHD independent and superior to all other variables. The area under the ROC curve for BNP-R to detect TMC was 0.90 (95% CI 0.79–1.00; p < 0.001) after 1 week and 0.995 (95% CI 0.99–1.00; p < 0.0001) after 4 weeks. One week after cardioversion already, a BNP-R cutoff ≥2.3 was useful for TMC diagnosis indicated by an accuracy of 90%, sensitivity of 84% and specificity of 95%.

Conclusion

BNP-R was found to be highly accurate for the early diagnosis of TMC.

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Title: Diagnostic accuracy of NT-proBNP ratio (BNP-R) for early diagnosis of tachycardia-mediated cardiomyopathy: a pilot study
Authors: Amir M. Nia
Natig Gassanov
Kristina M. Dahlem
Evren Caglayan
Martin Hellmich
Erland Erdmann
Fikret Er
Publication date: 01-10-2011
Publisher: Springer-Verlag
Published in: Clinical Research in Cardiology / Issue 10/2011
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-011-0319-y

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Diagnostic accuracy of NT-proBNP ratio (BNP-R) for early diagnosis of tachycardia-mediated cardiomyopathy: a pilot study

Abstract

Background

Methods

Results

Conclusion

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