TY - JOUR

T1 - BNP cannot replace gated equilibrium radionuclide ventriculography in monitoring of anthracycline-induced cardiotoxity.

AU - Vogelsang, T.W.

AU - Jensen, R.J.

AU - Hesse, B.

AU - Kjaer, A.

N1 - Keywords: Adult; Aged; Anthracyclines; Cohort Studies; Confidence Intervals; Evaluation Studies as Topic; Female; Gated Blood-Pool Imaging; Heart; Heart Failure; Humans; Male; Middle Aged; Monitoring, Physiologic; Natriuretic Peptide, Brain; Predictive Value of Tests; Probability; Risk Assessment; Sensitivity and Specificity; Stroke Volume; Ventricular Dysfunction, Left

PY - 2007

Y1 - 2007

N2 - BACKGROUND: Cardiotoxity is a side-effect of cancer treatment with anthracycline that is currently monitored by measuring the left ventricular ejection fraction (LVEF) by gated equilibrium radionuclide ventriculography (RNV). We hypothesized that BNP measurements could replace, at least in part, the RNV examinations. Therefore, we studied whether BNP could be used, alone or in combination with RNV, in the monitoring of anthracycline-induced cardiotoxity. METHODS: A total of 333 patients undergoing anthracycline treatment had LVEF and BNP concentration measured. Of these, 73 had more than one determination. In the 333 patients we compared the BNP concentration to LVEF, and further, for the 73 patient with more than one examination, we compared the changes in LVEF and BNP. We evaluated different BNP cut-off values for detection of LVEF below 0.50, 0.45 and 0.40, respectively. RESULTS: Using LVEF below 0.50 and a BNP cut-off value of 100 pg ml(-1) it was possible to save 90% of the RNV determinations with the cost of overlooking 68% of the patients with reduced LVEF. Using LVEF below 0.45 and a BNP cut-off value of 30 pg ml(-1) it was possible to save 59% of the RNV determination, with the cost of overlooking 15% of the patients with reduced LVEF. CONCLUSION: BNP cannot safely be used as an alternative to RNV determination of LVEF in patient undergoing anthracycline treatment if the standard limit of an LVEF of 0.50 was used. However, if only lower LVEF were to be detected BNP could be used to save RNV determinations Udgivelsesdato: 2008/2/29

AB - BACKGROUND: Cardiotoxity is a side-effect of cancer treatment with anthracycline that is currently monitored by measuring the left ventricular ejection fraction (LVEF) by gated equilibrium radionuclide ventriculography (RNV). We hypothesized that BNP measurements could replace, at least in part, the RNV examinations. Therefore, we studied whether BNP could be used, alone or in combination with RNV, in the monitoring of anthracycline-induced cardiotoxity. METHODS: A total of 333 patients undergoing anthracycline treatment had LVEF and BNP concentration measured. Of these, 73 had more than one determination. In the 333 patients we compared the BNP concentration to LVEF, and further, for the 73 patient with more than one examination, we compared the changes in LVEF and BNP. We evaluated different BNP cut-off values for detection of LVEF below 0.50, 0.45 and 0.40, respectively. RESULTS: Using LVEF below 0.50 and a BNP cut-off value of 100 pg ml(-1) it was possible to save 90% of the RNV determinations with the cost of overlooking 68% of the patients with reduced LVEF. Using LVEF below 0.45 and a BNP cut-off value of 30 pg ml(-1) it was possible to save 59% of the RNV determination, with the cost of overlooking 15% of the patients with reduced LVEF. CONCLUSION: BNP cannot safely be used as an alternative to RNV determination of LVEF in patient undergoing anthracycline treatment if the standard limit of an LVEF of 0.50 was used. However, if only lower LVEF were to be detected BNP could be used to save RNV determinations Udgivelsesdato: 2008/2/29

U2 - 10.1016/j.ijcard.2007.02.003

DO - 10.1016/j.ijcard.2007.02.003

M3 - Journal article

C2 - 17433473

VL - 124

SP - 193

EP - 197

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 2

ER -