© 2001 European Society of Cardiology
Relations between medical history, clinical findings and plasma N-terminal proatrial natriuretic peptide in patients in primary health care
a Institute for Surgical Research University of Oslo Oslo, Norway
b Institute of General Practice and Community Medicine, University of Oslo Oslo, Norway
c Medinnova SF, Norway
* Corresponding author. Research Institute for Internal Medicine, The National Hospital, Oslo 0027, Norway. Tel.: +47-23072786; fax: +47-23073630
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Abstract |
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Background: recent studies indicate that measurement of natriuretic peptides may be a valuable tool to improve the quality of the diagnosis of heart failure in general practice.
Aim: the aim of the present study was to examine the relationship between the plasma level of the natriuretic peptide N-terminal proANP and symptoms and signs of heart failure in patients from general practice in the Oslo area.
Methods and Results: we undertook a survey of 499 patients consecutively enrolled from the practice of 27 practitioners. One hundred and twenty-nine patients were classified as having possible or some degree of heart failure. The plasma concentration of N-terminal proANP increased with severity of heart failure as judged from clinical examination. In multivariate analysis age, history of heart disease, plasma creatinine, use of beta-blockers and digitalis, oedemas and atrial fibrillation were the main determinants of plasma N-terminal proANP.
Conclusion: while there was an overall increase in N-terminal proANP values with increasing symptoms and degree of heart failure, no single finding was closely related to N-terminal proANP. Treatment effects and diagnostic errors may both influence the relationship between N-terminal proANP and clinical findings. The current study has demonstrated the feasibility of using N-terminal proANP by general practitioners for the potentially improved diagnosis of heart failure. Further research is required to determine the precise role of this assay in clinical practice.
Key Words: Heart failure • General practice • Natriuretic peptides
Received April 13, 2000; Revised September 20, 2000; Accepted December 28, 2000
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