Screening for Asymptomatic Left Ventricular Dysfunction Using B‐Type Natriuretic Peptide
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Asymptomatic left ventricular dysfunction (ASLVD), a known precursor phase of heart failure, fulfills the essential criteria that should be met before screening for a disease. It is common and associated with reduced longevity and quality of life. Left untreated, it progresses to heart failure, which incurs a mortality greater than most cancers as well as significant morbidity rates. In addition, we now have several population-based studies that demonstrate that both B-type natriuretic peptide (BNP) and N-terminal prohormone brain natriuretic peptide (NTproBNP) can accurately exclude left ventricular systolic dysfunction. More recent work shows that this can be done cost-effectively. There is also a wealth of evidence from randomized controlled trials indicating that the treatment of ASLVD can reduce both morbidity and mortality and slow progression to the heart failure state. The main stumbling block to implementation of screening, in addition to the perceived cost, may well be the lack of a randomized study showing that screening the population for ASLVD really does alter the natural history of the condition, something that other screening strategies have so far failed to do.
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LVSD is frequently diagnosed only after patients develop symptomatic disease due to the lack of effective screening strategies.
“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 [7]
The Conclusions say that screening for asymptomatic left ventricular dysfunction is not yet routine and that health systems focus on treating manifest heart failure. They do not establish that LVSD is frequently diagnosed only after symptoms develop. They also describe BNP screening as acceptably accurate, so the barrier is not simply a lack of effective screening tests. (LLM, conf=0.84)
Experimental — accuracy not yet measured
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- Authors
- McDonagh, T. A., McDonald, K., & Maisel, A. S.
- Affiliations
- University of California San Diego (US)
- Corresponding author
- McDonagh, Theresa A.
- Venue
- Congestive Heart Failure
- Publisher
- Wiley
- Published
- 2008-07-08
- Volume
- 14
- Issue
- s1
- Pages
- 5-8
- ISSN
- 1527-5299 (ISSN-L)
- 1751-7133
- OpenAlex
- W2047549866
- Cited by
- 35
- References
- 27
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 6 · 2023: 3 · 2022: 2 · 2021: 8 · 2020: 2 · 2019: 1 · 2018: 1 · 2012: 1
- FWCI
- 1.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Congestive Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- 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 › Cardiac Fibrosis and Remodeling
- Keywords
- asymptomatic left ventricular dysfunction, brain natriuretic peptide, NT-proBNP, heart failure screening, left ventricular systolic dysfunction, heart failure prevention, cost-effectiveness, natural history of disease, barriers to screening
- MeSH terms
- Heart, Humans, Mass Screening, Ventricular Dysfunction, Left, Natriuretic Peptide, Brain
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