부산대학교 도서관

BACKGROUND.: METHODS AND RESULTS.: A total of 1012 patients with hypertension and/or diabetes and no symptoms or signs of HF were assessed by NT-pro-BNP assay and echocardiography. Diastolic dysfunction was present in 368 of 1012 patients (36.4%): 327 (32.4%) with mild diastolic dysfunction and 41 (4%) with a moderate to severe diastolic dysfunction. Systolic dysfunction was present in 11 of 1012 patients (1.1%). NT-pro-BNP levels were 170±206 and 859±661 pg/mL, respectively, in diastolic and systolic dysfunction and 92±169 in healthy patients (P<.0001). Pooling moderate to severe diastolic with systolic dysfunction, a total of 52 patients (5.1%) were obtained: the best cutoff of NT-pro-BNP was 125 pg/mL (men younger than 67 years: sensitivity, 87.5%; specificity, 92.7%; negative predictive value [NPV], 99.5%; positive predictive value [PPV], 33.3%; women younger than 67 years: sensitivity, 100%; specificity, 84.1%; NPV, 100%; PPV, 33.3%; men 67 years or older: sensitivity, 100%; specificity, 77.1%; NPV, 100%; PPV, 32.5%; women 67 years or older: sensitivity, 100%; specificity, 59.9%; NPV, 100%; PPV, 23%). CONCLUSIONS.: The prevalence of ALVD in patients at risk for HF is 5.1%. Because of its excellent NPV, NT-pro-BNP assessment can be used by general practitioners to rule out ALVD in hypertensive or diabetic patients.—Betti I, Castelli G, Barchielli A, et al. The role of N-terminal Pro-brain natriuretic peptide and echocardiography for screening asymptomatic left ventricular dysfunction in a population at high risk for heart failure. The PROBE-HF study. J Card Fail. 2009;15:377–384.