American Heart Journal
Volume 151, Issue 5 , Pages 999-1005 , May 2006

How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure: Results from the Breathing Not Properly Multinational Study

  • Lori B. Daniels, MD

      Affiliations

    • University of California at San Diego, San Diego, CA
    • Veterans Affairs Medical Center, San Diego, CA
    • ,
  • Paul Clopton, MS

      Affiliations

    • University of California at San Diego, San Diego, CA
    • Veterans Affairs Medical Center, San Diego, CA
    • ,
  • Vikas Bhalla, MD

      Affiliations

    • University of California at San Diego, San Diego, CA
    • Veterans Affairs Medical Center, San Diego, CA
    • ,
  • Padma Krishnaswamy, MD

      Affiliations

    • University of California at San Diego, San Diego, CA
    • Veterans Affairs Medical Center, San Diego, CA
    • ,
  • Richard M. Nowak, MD, MBA

      Affiliations

    • Henry Ford Hospital, Detroit, MI
    • ,
  • James McCord, MD

      Affiliations

    • Henry Ford Hospital, Detroit, MI
    • ,
  • Judd E. Hollander, MD

      Affiliations

    • University of Pennsylvania, Pennsylvania, PA
    • ,
  • Philippe Duc, MD

      Affiliations

    • Hôpital Bichat, Paris, France
    • ,
  • Torbjørn Omland, MD, PhD

      Affiliations

    • Akershus University Hospital, University of Oslo, Norway
    • ,
  • Alan B. Storrow, MD

      Affiliations

    • University of Cincinnati College of Medicine, Cincinnati, OH
    • ,
  • William T. Abraham, MD

      Affiliations

    • Ohio State University Hospital, Columbus, OH
    • ,
  • Alan H.B. Wu, PhD

      Affiliations

    • Hartford Hospital, Hartford, CT
    • ,
  • Philippe G. Steg, MD

      Affiliations

    • Hôpital Bichat, Paris, France
    • ,
  • Arne Westheim, MD, PhD, MPH

      Affiliations

    • Akershus University Hospital, University of Oslo, Norway
    • ,
  • Cathrine Wold Knudsen, MD

      Affiliations

    • Akershus University Hospital, University of Oslo, Norway
    • ,
  • Alberto Perez, MD

      Affiliations

    • Hartford Hospital, Hartford, CT
    • ,
  • Radmila Kazanegra, MD

      Affiliations

    • University of California at San Diego, San Diego, CA
    • Veterans Affairs Medical Center, San Diego, CA
    • ,
  • Howard C. Herrmann, MD

      Affiliations

    • University of Pennsylvania, Pennsylvania, PA
    • ,
  • Peter A. McCullough, MD, MPH

      Affiliations

    • University of Missouri–Kansas City School of Medicine, Truman Medical Center, Kansas City, KS
    • ,
  • Alan S. Maisel, MD

      Affiliations

    • University of California at San Diego, San Diego, CA
    • Veterans Affairs Medical Center, San Diego, CA
    • Corresponding Author InformationReprint requests: Alan Maisel, MD, VAMC Cardiology 111-A, 3350 La Jolla Village Drive, San Diego, CA 92161.

Received 19 April 2005 ,Accepted 20 October 2005.

References 

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  18. Dessi-Fulgheri P, Sarzani R, Tamburrini P, et al. Plasma atrial natriuretic peptide and natriuretic peptide receptor gene expression in adipose tissue of normotensive and hypertensive obese patients. J Hypertens. 1997;15:1695–1699
  19. James SK, Lindahl B, Siegbahn A, et al. N-terminal pro-brain natriuretic peptide and other risk markers for the separate prediction of mortality and subsequent myocardial infarction in patients with unstable coronary artery disease: a Global Utilization of Strategies To Open occluded arteries (GUSTO)–IV substudy. Circulation. 2003;108:275–281
  20. Mehra MR, Uber PA, Park MH, et al. Obesity and suppressed B-type natriuretic peptide levels in heart failure. J Am Coll Cardiol. 2004;43:1590–1595
  21. McCord J, Mundy BJ, Hudson MP, et al. Relationship between obesity and B-type natriuretic peptide levels. Arch Intern Med. 2004;164:2247–2252
  22. Morrison LK, Harrison A, Krishnaswamy P, et al. Utility of a rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea. J Am Coll Cardiol. 2002;39:202–209
  23. Mair J, Hammerer-Lercher A, Puschendorf B. The impact of cardiac natriuretic peptide determination on the diagnosis and management of heart failure. Clin Chem Lab Med. 2001;39:571–588
  24. Maisel A, Hollander JE, Guss D, et al. Primary results of the Rapid Emergency Department Heart Failure Outpatient Trial (REDHOT). A multicenter study of B-type natriuretic peptide levels, emergency department decision making, and outcomes in patients presenting with shortness of breath. J Am Coll Cardiol. 2004;44:1328–1333
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☆ Triage devices and meters and some financial support were provided by Biosite, San Diego, CA. Drs Nowak, Hollander, McCullough, and Maisel, and P Clopton have served as consultants and received research support from Biosite.

PII: S0002-8703(05)00948-8

doi: 10.1016/j.ahj.2005.10.011

American Heart Journal
Volume 151, Issue 5 , Pages 999-1005 , May 2006

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