Brain natriuretic peptide and left ventricular dysfunction in chagasic cardiomyopathy
Mem. Inst. Oswaldo Cruz
;
99(6): 645-649, Oct. 2004. tab, graf
Article
in English
| LILACS
| ID: lil-387917
RESUMO
Global left ventricular (LV) systolic dysfunction is the strongest predictor of morbidity and mortality in Chagas disease. Echocardiography is considered the gold standard for the detection of LV dysfunction, but not always available in endemic areas where chagasic cardiomyopathy is most common. Brain natriuretic peptide (BNP) is a neurohormone that has been recently described as a simple and inexpensive diagnostic and prognostic marker for patients with congestive heart failure. Chagasic patients (n = 63) and non-infected healthy individuals (n = 18) were recruited prospectively and underwent complete clinical examination, echocardiography and 24-h Holter monitoring. BNP was measured from thawed plasma samples using the Triage BNP test. We observed high levels of BNP in association with depression of LV ejection fraction, with increase of LV end-diastolic diameter and with LV premature complexes. An elevated concentration of BNP, defined as a concentration of 60 pg/ml or more, had a sensitivity of 91.7 percent, specificity of 82.8 percent, positive predictive value of 52.4 percent, and negative predictive value of 98 percent for detecting LV dysfunction (LV ejection fraction < 40 percent).BNP measurement using a simple, relatively inexpensive and rapid test has a promising role in identifying LV dysfunction associated with chagasic cardiomyopathy. Equally important, patients with Trypanosoma cruzi infection who have low levels of BNP level in plasma have a very low likelihood of severe cardiac involvement, and echocardiography is probably not necessary.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Chagas Cardiomyopathy
/
Ventricular Dysfunction, Left
/
Natriuretic Peptide, Brain
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Mem. Inst. Oswaldo Cruz
Journal subject:
Tropical Medicine
/
Parasitology
Year:
2004
Type:
Article
/
Project document
Affiliation country:
Brazil
/
United States
Institution/Affiliation country:
Universidade Federal de Minas Gerais/BR
/
Universtiy of Texas Southwestern Medical Center/US
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