© 2005 European Society of Cardiology
Diagnostic and prognostic value of urine NT-proBNP levels in heart failure patients
a Research Center La Fe Hospital Valencia, Spain
b La Fe Hospital Valencia, Spain
c San Juan Hospital Alicante, Spain
d Elche Hospital Alicante, Spain
e General Hospital Alicante, Spain
f General Hospital Valencia, Spain
* Corresponding author. Address: Jose Maria Haro, 59, puerta 59, 46022 Valencia, Spain. Tel.: +34 96 37 61 98; fax: +34 96 197 30 18. E-mail address: rivera_jmi{at}gva.es (M. Rivera).
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Abstract |
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Background: Plasma NT-proBNP levels are sensitive markers of ventricular dysfunction. However, studies of natriuretic peptides in urine are limited.
Aims: To compare urine and plasma NT-proBNP levels and to investigate the diagnostic and prognostic value of urine levels in heart failure (HF).
Methods: Urinary and plasma NT-proBNP levels were measured in 96 HF patients and 20 control subjects. The patients were functionally classified according to the NYHA criteria.
Results: Urine NT-proBNP was higher in HF patients than in control subjects (94 ± 31 pg/ml vs. 67 ± 6 pg/ml, p < 0.0001), correlating with plasma NT-proBNP levels (r = 0.78, p < 0.0001). Urinary levels were elevated in the more severe functional classes and diminished in obese patients. Urine NT-proBNP was a good tool for diagnosis of HF, the area under the curve (AUC) being 0.96 ± 0.02 (p < 0.0001), and for predicting 12-month cardiac events (p = 0.011). To determine the prognostic power of urinary NT-proBNP in detecting 12-month cardiac mortality, we obtained an AUC of 0.75 ± 0.10 (p = 0.015).
Conclusion: Urinary NT-proBNP, a relatively simple non-invasive test, is a new candidate marker for the diagnosis and evaluation of prognosis in HF and for the characterization of functional status in these patients.
Key Words: Natriuretic peptides • Urine • Heart failure
Received June 9, 2005; Revised September 26, 2005; Accepted November 21, 2005
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