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Plasma Natriuretic Peptides for Community Screening for Left Ventricular Hypertrophy and Systolic Dysfunction: The Framingham Heart Study
Abstract
CONTEXT: Several reports have suggested the usefulness of plasma brain natriuretic peptide (BNP) as a screening test for left ventricular hypertrophy (LVH) and systolic dysfunction (LVSD). Prior studies were limited by small sample sizes and selection bias and none compared the diagnostic performance of these peptides in men and women. OBJECTIVES: To examine the usefulness of natriuretic peptides for screening for elevated LV mass and LVSD in the community. DESIGN, SETTING, AND PARTICIPANTS: Community-based prospective cohort study of 3177 participants (1707 women) from the Framingham Study who attended a routine examination in 1995-1998. MAIN OUTCOME MEASURES: Receiver operating characteristic (ROC) curves, test sensitivity, specificity, positive and negative predictive values, and likelihood ratios for identifying elevated LV mass (sex-specific 90th percentile or higher of LV mass/[height](2)), LVSD (ejection fraction < or = 50% and/or fractional shortening <29%), and moderate to severe LVSD (ejection fraction < or = 40% and/or fractional shortening <22%) at different discrimination limits of plasma BNP and N-terminal proatrial natriuretic peptide (NT-ANP), with echocardiography as the criterion standard. RESULTS: The areas under the ROC curves for elevated LV mass or LVSD were at or below 0.75 for both peptides, were higher for men compared with women, and were similar for BNP and NT-ANP. The diagnostic performance of natriuretic peptides for LVSD improved in women but not…
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“but LVSD is frequently diagnosed only after patients develop symptomatic disease due to the lack of effective screening strategies5–7.”
From Detection of left ventricular systolic dysfunction from single-lead electrocardiography adapted for portable and wearable devices (2023) · cites this paper as [6]
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Self-citation
Metadata
- Authors
- Vasan, R. S., Benjamin, E. J., Larson, M. G., Leip, E. P., Wang, T. J., Wilson, P. W. F., & Levy, D.
- Affiliations
- Framingham Heart Study (US)
- Boston University (US)
- National Institutes of Health (US)
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2002-09-11
- Volume
- 288
- Issue
- 10
- Pages
- 1252
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2059920038
- Cited by
- 493
- References
- 42
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 10 · 2023: 14 · 2022: 6 · 2021: 12 · 2020: 12 · 2019: 9 · 2018: 9 · 2017: 13 · 2016: 9 · 2015: 16 · 2014: 14 · 2013: 20 · 2012: 29
- FWCI
- 27.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc25195-41-0-1)
- National Heart, Lung, and Blood Institute (K24-HL-04334-01A1, N01‐HC25195, R01HL067288, K24HL004334, 1R01HL67288-01)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- natriuretic peptides, brain natriuretic peptide, N-terminal proatrial natriuretic peptide, left ventricular hypertrophy, left ventricular systolic dysfunction, left ventricular mass, cardiovascular screening, diagnostic performance, sex differences, Framingham Heart Study, echocardiography
- MeSH terms
- Echocardiography, Female, Humans, Male, Mass Screening, Middle Aged, Atrial Natriuretic Factor, Phenotype, Predictive Value of Tests, Prospective Studies, Protein Precursors, ROC Curve, Sensitivity and Specificity, Systole, Biomarkers, Likelihood Functions, Hypertrophy, Left Ventricular, Ventricular Dysfunction, Left, Natriuretic Peptide, Brain
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