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The role of NT-proBNP in the diagnostics and differentiation of cardiac and reflex syncope in adults: relative importance to clinical presentation and medical examinations

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to assess the clinical significance of N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations in the differentiation of patients with cardiac and reflex syncope.

Methods

The study included a group of 100 patients (56 women, 44 men), aged 18–77 years (mean 52.6 ± 16.7), with a history of reflex (group I) or cardiac syncope (group II). Diagnosis of syncope was performed according to the European Society of Cardiology (ESC) guidelines. In all patients, the concentration of NT-proBNP was measured.

Results

The assessment of NT-proBNP concentrations showed significantly higher concentrations in group II than in group I (448.7 ± 212.2 vs. 68.2 ± 64.1 pg/ml, P < 0.0001). The receiver operating characteristic (ROC) curve analysis revealed that the concentration of NT-proBNP at 210.5 pg/ml may be a useful cut-off point which allows the prediction of cardiac syncope with 98 % specificity, 94 % sensitivity, and 94 % negative predictive value. In patients with cardiac arrhythmias and conduction abnormalities, the concentrations of NT-proBNP were higher in comparison to those without such disorders.

Conclusions

The concentration of NT-proBNP is useful in the diagnosis of syncope and may initially guide the diagnostic process. The NT-proBNP value exceeding 200 pg/ml seems to be the most rational in determining cardiac syncope.

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Authors and Affiliations

  1. Cardiology Department, Chrzanow City Hospital, 16 Topolowa St., 32-500, Chrzanow, Poland

    Piotr J. Stryjewski, Wojciech Gilowski & Jacek Nowak

  2. Coronary Disease Department, Institute of Cardiology, Medical School of Jagiellonian University, John Paul II Hospital, Cracow, Poland

    Bohdan Nessler & Jadwiga Nessler

  3. 2nd Department of Cardiology, Zabrze, Medical University of Silesia, Katowice, Poland

    Agnieszka Kuczaj & Ewa Nowalany-Kozielska

  4. Electrocardiology Department, Institute of Cardiology, Medical School of Jagiellonian University, John Paul II Hospital, Cracow, Poland

    Paweł Matusik

Authors
  1. Piotr J. Stryjewski
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  2. Bohdan Nessler
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  3. Agnieszka Kuczaj
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  4. Paweł Matusik
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  5. Wojciech Gilowski
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  8. Jadwiga Nessler
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Correspondence to Piotr J. Stryjewski.

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Stryjewski, P.J., Nessler, B., Kuczaj, A. et al. The role of NT-proBNP in the diagnostics and differentiation of cardiac and reflex syncope in adults: relative importance to clinical presentation and medical examinations. J Interv Card Electrophysiol 41, 1–8 (2014). https://doi.org/10.1007/s10840-014-9923-x

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  • DOI: https://doi.org/10.1007/s10840-014-9923-x

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