Skip to main content
SpringerLink
Log in

The Role of Brain Natriuretic Peptide in Population Screening

  • Published:
Heart Failure Reviews Aims and scope Submit manuscript

Abstract

While measurement of plasma BNP concentration has been shown to be useful in the diagnosis of heart failure, its role as a screening test for detection of pre-clinical ventricular remodeling or dysfunction in the general population has not been established. Here we review available population-based studies assessing the predictive characteristics of BNP for the detection of pre-clinical structural heart disease (Stage B Heart Failure).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hunt HA, BakerDW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS, Ganiats TG, Goldstein S, Gregoratos G, Jessup ML, Noble RJ, Packer M, Silver MA, Stevenson LW. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). American College of Cardiology Web site 2001:http://www.acc.org/clinical/guidelines/ failure/hf index.htm.

  2. Arnett DK, McGovern PG, Jacobs DR, Jr, Shahar E, Duval S, Blackburn H, Luepker RV. Fifteen-year trends in cardiovascular risk factors (1980–1982 through 1995–1997): The Minnesota Heart Survey. American Journal of Epidemiology 2002;156(10):929–935.

    Google Scholar 

  3. Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. New Englad Journal of Medicine 2000;342(3):145–153.

    Google Scholar 

  4. Anonymous. The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure [published erratum appears in Archives of Internal Medicine 158(6):573, March 23, 1998. Archives of Internal Medicine 1997;157(21):2413–2446.

    Google Scholar 

  5. Braunwald E. Shattuck lecture—Cardiovascular medicine at the turn of the millennium: Triumphs, concerns, and opportunities. New England Journal of Medicine 1997;337(19):1360–1369.

    Google Scholar 

  6. McCullough PA, Philbin EF, Spertus JA, Kaatz S, Sandberg KR, Weaver WD. Confirmation of a heart failure epidemic: Findings from the Resource Utilization Among Congestive Heart Failure (REACH) study. J Am Coll Cardiol 2002;39(1):60–69.

    Google Scholar 

  7. Levy D, Kenchaiah S, Larson MG, Benjamin EJ, Kupka MJ, Ho KKL, Murabito JM, Vasan RS. Long-term trends in the incidence of and survival with heart failure. New England Journal of Medicine 2002;347(18):1397–1402.

    Google Scholar 

  8. Redfield MM. Heart failure—An epidemic of uncertain proportions. N Engl J Med 2002;347(18):1442–1444.

    Google Scholar 

  9. Pfeffer MA, Braunwald E, Moye LA, Basta L, Brown EJ, Cuddy TE, Davis BR, Geltman EM, Goldman S, Flaker GC. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. The SAVE Investigators. New England Journal of Medicine 1992;327(10):669–677.

    Google Scholar 

  10. SOLVD-Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejections. New England Journal of Medicine 1992;327:685–691.

    Google Scholar 

  11. Senni M, Tribouilloy CM, Rodeheffer RJ, Jacobsen SJ, Evans JM, Bailey KR, Redfield MM. Congestive heart failure in the community: A study of all incident cases in Olmsted County, Minnesota, in 1991. Circulation 1998;98(21):2282–2289.

    Google Scholar 

  12. Kitzman DW, Gardin JM, Arnold A, Gottdiener JS, Vivienne ML, Smith E, Enright P, Lima J, Soloman R, Polak J, Cushman M, Bryan N. Heart failure with preserved LV function in the elderly: Clinical and echocardiographic correlates from the cardiovascular health study. Circulation 1999;94(8):I–433.

    Google Scholar 

  13. Vasan RS, Larson MG, Benjamin EJ, Evans JC, Reiss CK, Levy D. Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction. Journal of American College of Cardiology 1999;33:1948–1955.

    Google Scholar 

  14. Devereux RB, Roman MJ, Liu JE, Welty TK, Lee ET, Rodeheffer R, Fabsitz RR, Howard BV. Congestive heart failure despite normal left ventricular systolic function in a population-based sample: The Strong Heart Study. American Journal of Cardiology 2000;86(10):1090–1096.

    Google Scholar 

  15. Zile MR, Gaasch WH, Carroll JD, Feldman MD, Aurigemma GP, Schaer GL, Ghali JK, Liebson PR. Heart failure with normal ejection fraction. Is measurement of diastolic function necessary to make the diagnosis of diastolic heart failure. Circulation 2001;104:779–782.

    Google Scholar 

  16. Redfield MM, Jacobsen SJ, Burnett JC, Jr, Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic ventricular dysfunction in the community: Appreciating the scope of the heart failure epidemic. Journal of the American Medical Association 2003;289(2):194–202.

    Google Scholar 

  17. Aurigemma GP, Gottdiener JS, Shemanski L, Gardin J, Kitzman D. Predictive value of systolic and diastolic function for incident congestive heart failure in the elderly: The cardiovascular health study. J Am Coll Cardiol 2001;37(4):1042–1048.

    Google Scholar 

  18. Bella JN, Palmieri V, Roman MJ, Liu JE, Welty TK, Lee ET, Fabsitz RR, Howard BV, Devereux RB. Mitral ratio of peak early to late diastolic filling velocity as a predictor of mortality in middle-aged and elderly adults: The Strong Heart Study. Circulation 2002;105(16):1928–1933.

    Google Scholar 

  19. Levy D, Larson MG, Vasan RS, Kannel WB, Ho KKL. The progression from hypertension to congestive heart failure. JAMA 1996;275(20):1557–1562.

    Google Scholar 

  20. Vasan RS, Larson MG, Benjamin EJ, Evans JC, Levy D. Left ventricular dilatation and the risk of congestive heart failure in people without myocardial infarction. New England Journal of Medicine 1997;336(19):1350–1355.

    Google Scholar 

  21. Francis GS, Benedict C, Johnstone DE, Kirlin PC, Nicklas J, Liang CS, Kubo SH, Rudin-Toretsky E, Yusuf S, SOLVDInvestigators. Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure. A substudy of the studies of left ventricular dysfunction (SOLVD). Circulation 1990;82:1724–1729.

    Google Scholar 

  22. Lerman A, Gibbons RJ, Rodeheffer RJ, Bailey KR, McKinley LJ, Heublein DM, Burnett JC, Jr. Circulating N-terminal atrial natriuretic peptide as a marker for symptomless left-ventricular dysfunction. Lancet 1993;341:1105–1109.

    Google Scholar 

  23. Maisel AS, Krishnaswamy P, Nowak RM, McCord J, Hollander JE, Duc P, Omland T, Storrow AB, Abraham WT, Wu AH, Clopton P, Steg PG, Westheim A, Knudsen CW, Perez A, Kazanegra R, Herrmann HC, McCullough PA. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 2002;347(3):161–167.

    Google Scholar 

  24. McCullough PA, Nowak RM, McCord J, Hollander JE, Herrmann HC, Steg PG, Duc P, Westheim A, Omland T, Knudsen CW, Storrow AB, Abraham WT, Lamba S, Wu AH, Perez A, Clopton P, Krishnaswamy P, Kazanegra R, Maisel AS. B-type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: Analysis from Breathing Not Properly (BNP) Multinational Study. Circulation 2002;106(4):416–422.

    Google Scholar 

  25. Yamamoto K, Burnett JC, Jr., Jougasaki M, Nishimura RA, Bailery KR, Saito Y, Nakao K, Redfield MM. Superiority of brain natriuretic peptide as a hormonal marker of ventricular systolic and diastolic dysfunction and ventriuclar hypertrophy. Hypertension 1996;28:988–994.

    Google Scholar 

  26. Sox HC, Jr. Preventive health services in adults. New England Journal of Medicine 1994;330(22):1589–1595.

    Google Scholar 

  27. Doukas DJ, Fetters M, Ruffin MTt, McCullough LB. Ethical considerations in the provision of controversial screening tests. Archives of Family Medicine 1997;6(5):486–490.

    Google Scholar 

  28. McDonagh TA, Morrison CE, Lawrence A, Ford I, Tunstall-Pedoe H, McMurray JJ, Dargie HJ. Symptomatic and asymptomatic left-ventricular systolic dysfunction in an urban population. Lancet 1997;350:829–833.

    Google Scholar 

  29. Mosterd A, Hoes AW, de Bruyne MC, Deckers JW, Linker DT, Hofman A, Grobbee DE. Prevalence of heart failure and left ventricular dysfunction in the general population; The Rotterdam Study. European Heart Journal 1999;20(6):447–455.

    Google Scholar 

  30. Devereux RB, Roman MJ, Paranicas M, Lee ET, Welty TK, Fabsitz RR, RobbinsD, Rhoades ER, Rodeheffer RJ, Cowan LD, Howard BV. A population-based assessment of left ventricular systolic dysfunction in middle-aged and older adults: The Strong Heart Study. American Heart Journal 2001;141(3):439–446.

    Google Scholar 

  31. Davies M, Hobbs F, Davis R, Kenkre J, Roalfe AK, Hare R, Wosornu D, Lancashire RJ. Prevalence of left-ventricular systolic dysfunction and heart failure in the Echocardiographic Heart of England Screening study: A population based study. Lancet 2001;358(9280):439–444.

    Google Scholar 

  32. Gottdiener JS, Arnold AM, Aurigemma GP, Polak JF, Tracy RP, Kitzman DW, Gardin JM, Rutledge JE, Boineau RC. Predictors of congestive heart failure in the elderly: The Cardiovascular Health Study. J Am Coll Cardiol 2000;35(6):1628–1637.

    Google Scholar 

  33. Vasan RS, Benjamin EJ, Larson MG, Leip EP, Wang TJ, Wilson PW, Levy D. Plasma natriuretic peptides for community screening for left ventricular hypertrophy and systolic dysfunction: The Framingham heart study. Journal of the American Medical Association 2002;288(10):1252–1259.

    Google Scholar 

  34. Cohn JN. The prevention of heart failure: A new agenda. New England Journal of Medicine 1992;327:725–727.

    Google Scholar 

  35. Redfield MM, Rodeheffer RJ, Jacobsen SJ, Mahoney DW, Bailey KR, Burnett JC, Jr. Plasma brain natriuretic peptide concentration: Impact of age and gender. Journal of the American College of Cardiology 2002;40(5):976–982.

    Google Scholar 

  36. Wang TJ, Larson MG, Levy D, Leip EP, Benjamin EJ, Wilson PW, Sutherland P, Omland T, Vasan RS. Impact of age and sex on plasma natriuretic peptide levels in healthy adults. American Journal of Cardiology 2002;90(3):254–258.

    Google Scholar 

  37. Luchner A, Burnett JC, Jr, Jougasaki M, Hense HW, Riegger GA, Schunkert H. Augmentation of the cardiac natriuretic peptides by beta-receptor antagonism: Evidence from a population-based study. Journal of American College of Cardiology 1998;32(7):1839–1844.

    Google Scholar 

  38. McDonagh TA, Robb SD, Murdoch DR, Morton JJ, Ford I, Morrison CE, Tunstall-Pedoe H, McMurray JJ, Dargie HJ. Biochemical detection of left-ventricular systolic dysfunction. Lancet 1998;351(9095):9–13.

    Google Scholar 

  39. Nielsen OW, McDonagh TA, Robb SD, Dargie HJ. Retrospective analysis of the cost-effectiveness of using plasma brain natriuretic peptide in screening for left ventricular systolic dysfunction in the general population. Journal of the American College of Cardiology 2003;41(1):113–120.

    Google Scholar 

  40. Boyko EJ. Ruling out or ruling in disease with the most sensitive or specific diagnostic test: Short cut or wrong turn? Medical Decision Making 1994;14(2):175–179.

    Google Scholar 

  41. Smith H, Pickering RM, Struthers A, Simpson I, Mant D. Biochemical diagnosis of ventricular dysfunction in elderly patients in general practice: Observational study. British Medical Journal 2000;320(7239):906–908.

    Google Scholar 

  42. McClure SJ, Caruana L, Davie AP, Goldthorp S, McMurray JJ. Cohort study of plasma natriuretic peptides for identifying left ventricular systolic dysfunction in primary care. British Medical Journal 1998;317(7157):516–519.

    Google Scholar 

  43. Luchner A, Burnett JC, Jr., Jougasaki M, Hense HW, Heid IM, Muders F, Riegger GA, Schunkert H. Evaluation of brain natriuretic peptide as marker of left ventricular dysfunction and hypertrophy in the population. Journal of Hypertension 2000;18(8):1121–1128.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Mayo Clinic and Foundation, Rochester, MN, USA

    Liselotte N. Dyrbye

  2. Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, MN, USA

    Margaret M. Redfield

Authors
  1. Liselotte N. Dyrbye
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Margaret M. Redfield
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Margaret M. Redfield.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dyrbye, L.N., Redfield, M.M. The Role of Brain Natriuretic Peptide in Population Screening. Heart Fail Rev 8, 349–354 (2003). https://doi.org/10.1023/A:1026143231117

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1026143231117

Search

Navigation