Universität zu Köln

Nia, Amir M., Gassanov, Natig, Dahlem, Kristina M., Caglayan, Evren, Hellmich, Martin ORCID: 0000-0001-5174-928X, Erdmann, Erland and Er, Fikret (2011). Diagnostic accuracy of NT-proBNP ratio (BNP-R) for early diagnosis of tachycardia-mediated cardiomyopathy: a pilot study. Clin. Res. Cardiol., 100 (10). S. 887 - 897. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Nia, Amir M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gassanov, Natig UNSPECIFIED UNSPECIFIED UNSPECIFIED Dahlem, Kristina M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Caglayan, Evren UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED orcid.org/0000-0001-5174-928X UNSPECIFIED Erdmann, Erland UNSPECIFIED UNSPECIFIED UNSPECIFIED Er, Fikret UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-487609
DOI:	10.1007/s00392-011-0319-y
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	100
Number:	10
Page Range:	S. 887 - 897
Date:	2011
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BRAIN NATRIURETIC PEPTIDE; VENTRICULAR SYSTOLIC FUNCTION; CONGESTIVE-HEART-FAILURE; ATRIAL-FIBRILLATION; RHYTHM CONTROL; SUPRAVENTRICULAR TACHYCARDIA; DILATED CARDIOMYOPATHY; STANDARDS COMMITTEE; OF-ECHOCARDIOGRAPHY; CATHETER ABLATION Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48760