Clinical TrialThe Role of N-terminal PRO-Brain Natriuretic Peptide and Echocardiography for Screening Asymptomatic Left Ventricular Dysfunction in a Population at High Risk for Heart Failure. The PROBE-HF Study
Section snippets
Methods
From the primary care population database of “Cooperativa Leonardo,” which includes 110 general practitioners for a population of about 130,000 citizens, 1012 consecutive subjects (486 males, 48.0%; 526 females, 52.0%; mean age 66.4 ± 7.8 years, range 36-88) with 1 or both the following risk factors for HF have been selected: type 2 diabetes, on medication at least for the last 6 months or systemic hypertension, on medication at least for the last 6 months with 2 or more drugs. All these
Study Protocol and Definition of Terms
Selected subjects were invited to visit their general practitioner where the following tests were performed in a single blind manner: 1) B-type natriuretic peptide (NT-proBNP) plasma concentration assay was measured in plasma-EDTA samples by noncompetitive immunoassay and electrochemiluminescence detection. The assay was run by a full automatic analyzer (Elecsys Modular E)15—both the reagents and the machine were supplied by Roche Diagnostic (Basel, Switzerland); 2) a complete color-Doppler
Results
Hypertension was present in 929/1012 patients (91.8%); diabetes in 413/1012 (40.8%). A total of 682 of 1012 (67.4%) subjects presented a single risk factor: hypertension in 599/1012 (59.2%) and diabetes in 83/1012 (8.2%). Both risk factors were present in 330/1012 (32.6%) subjects.
A total of 633/1012 (62.5%) subjects had a normal echocardiographic study without evidence of systolic or diastolic dysfunction. Diastolic dysfunction was present in 368/1012 subjects (36.4%): 327 (32.4%) mild; 41
Discussion
Population studies estimate that the prevalence of ALVD ranges from 0.9% to 5.9%,17 with higher figures in subjects with hypertension or diabetes.18, 19, 20
In the present study, ALVD was documented by echocardiography in 37.5% of population of subjects with hypertension or diabetes: 36.4% showed an isolated LV diastolic dysfunction, whereas 1.1% had a combined systolic and mild diastolic impairment. Pooling moderate-to-severe isolated diastolic dysfunction with systolic dysfunction to achieve a
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Conflict of interest:
Partially supported by an unrestricted grant from Roche Diagnostics.