Niveles urinarios de péptido natriurético tipo B (BNP) y disfunción ventricular sistólica en pacientes con insuficiencia cardiaca

Abstract

BackgroundIt was aimed to compare urine B-type natriuretic peptide (BNP) according to left ventricular systolic dysfunction and to investigate its diagnostic value in heart failure (HF) patients. Material and methodsA total of 90 HF outpatients (61 men, age 66±12) and 30 age- and gender-matched controls were studied. ResultsAn increase in urine BNP was observed in patients with EF≤ 40% compared to EF> 40% (p<0.0001), and controls (p<0.0001). Significant correlations between urinary BNP and left ventricular functional parameters were obtained. A multivariate regression analysis was performed and the best model associated with urine BNP included plasma BNP (p<0.0001), EF (p=0.02) and LV volume indexes (p<0.0001). The ROC for detection of EF≤40% using urine BNP levels showed an area under the curve of 0.74±0.05, (p<0.0001). From the ROC curve, the optimal cut-off value (2.30 ng/l) had a 60% sensitivity and 90% specificity. Finally, we performed a binary logistic regression for detection of EF≤40%, and urine BNP was shown to be a strong predictor with an odds ratio of 21. DiscussionUrine BNP levels correlated with left ventricular functional parameters. This biomarker is a useful tool for detecting and diagnosing left ventricular systolic dysfunction in heart failure.