Author response: B-type natriuretic peptide for cardiovascular events independent of left ventricular end-diastolic pressure
Article Outline
Dear Dr Wiwanitkit:
Thank you for your interest in our study. We agree that the clinical application of B-type natriuretic peptide (BNP) as a prognostic marker is still evolving. We do believe that the body of evidence supports a relationship between BNP and left ventricular end-diastolic pressure in adults with left ventricular dysfunction.1, 2, 3, 4, 5, 6, 7, 8, 9, 10 The lack of such a relationship in the study by Oyamada et al11 may instead be related to their unique study population of infants with ventricular septal defects. The issue of false positives as a limitation to BNP testing is acknowledged but may be more germane to the use of BNP as a diagnostic, rather than a prognostic, marker and reinforces that the strength of BNP as a diagnostic test is its high negative predictive value. Nonetheless, implementation of BNP into clinical practice as a prognostic marker will be facilitated by better understanding and adjustment for clinical covariates that affect BNP levels.12, 13
References
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PII: S0002-8703(09)00959-4
doi:10.1016/j.ahj.2009.12.005
© 2010 Mosby, Inc. All rights reserved.
Refers to article:
- Brain natriuretic peptide for cardiovascular events independent of left ventricular end-diastolic pressure
