| 유병수¹, 이경훈¹, 윤영진¹ , 김성윤¹ , 신명상¹ , 안민수¹ , 김장영¹ , 이승환¹ , 윤정한¹ , 최경훈¹ , 고상백² , 박종구² |
Background: BNP or NT-proBNP levels may serve as a useful marker of cardiovascular risk in a screening setting of the general population. We evaluated factors influencing NT-proBNP in normal patients and the ability of NT-proBNP to detect LV dysfunction in a large community sample.
Method: We included 3451 adult subjects (age; 40-69) of a community-based prospective cohort from Korea Rural Genomic Cohort (KRGC) Study in 2005-2007. The samples for NT-proBNP (Roche-Elecsys) of all participants were assessed
Results: The characteristics of cohort are described as below; males: 41.6%, mean age: 55.2±8.3 years. The distribution of risk factors for CHF are hypertension (24.1%), hypercholestolemia (5.2%), smoking (20.1%), DM (10.4 %), history of coronary heart disease (3.5 %), history of CHF (1.0), elevated serum Cr (≥1.5, 2.0%), obesity (42.5 %), respectively. The value of NT-proBNP of all subjects showed as below; mean 75.5± 112.2 pg/mL. In patients with history of CHF (73.2±143.4 vs. 164.8±221.4), old age (>60, 57.5±65.6 vs.107.9±198.3 pg/mL), NT-proBNP was higher (p<0.05). As a pilot sub-study, of 508 participants underwent echocardiography with assessment of left ventricular function, 4.7% had LVSD (systolic dysfunction) defined as an LVEF < 50%, whereas only 0.9% displayed LVEF < 40% and 12.4% had significant LVDD (diastolic dysfunction; ≥ grade II DD) in patients with normal systolic function (> LVEF 50%). The mean NT-proBNP level was higher in subjects with LVSD than without LVSD (54.3±86.7 vs. 15.9±251.6 pg/mL, p= 0.015). The mean NT-proBNP level in patients with LVDD was not different with patients without LVDD (52.5±68.5 vs. 61.35±138.7 pg/mL, p= 0.357). The diagnostic performance of NT-proBNP in detecting LVEF<50% was 0.63 (95% CI 0.45–0.81) and detecting diastolic dysfunction was 0.50 (95% CI 0.44–0.56).
Conclusion; The results of this study indicate that individuals with high NT-proBNP levels in the community have accumulating risk factors for CHF and related to the several risk factors. Also, in a large community-based cohort, the diagnostic performance for NT-proBNP measurement in screening for LVSD was useful.
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