Acute changes in N-terminal pro-brain natriuretic peptide induced by dobutamine stress echocardiography

Abstract

Aims Aim of the study was to determine the effect of dobutamine stress echocardiography (DSE)-induced ischemia on circulating levels of N-terminal fragment of B-type natriuretic peptide (NT-pro-BNP).

Methods and results One hundred and twenty-eight patients underwent DSE for the evaluation of known or suspected coronary artery disease. NT-pro-BNP levels were measured before and 1h after completion of DSE. NT-pro-BNP levels were similar before and after DSE regardless of whether patients had (123±101.8 vs. 124.2±108.3, p =NS) or did not have inducible ischemia (96.5±70.5 vs. 100.5±71.1, p =NS). Patients with inducible myocardial ischemia had no different NT-pro-BNP levels compared to patients without inducible ischemia both before (123±101.8 vs. 96.5±70pg/ml, p =0.37) and after DSE (124.2±108.3 vs. 100.5±71.1pg/ml, p =0.55). Patients with severe inducible ischemia had significantly higher NT-pro-BNP levels compared to patients with mild or moderate inducible ischemia and patients without inducible ischemia, both before (208.5±125.5 vs. 96±78.9 vs. 96.5±70pg/ml, p =0.017 and p =0.025, respectively) and after DSE (212.5±138.1 vs. 94.8±81.1 vs. 100.5±71.1pg/ml, p =0.015 and p =0.023, respectively). NT-pro-BNP levels before DSE could be independently predicted by age ( p <0.0001), presence of diabetes mellitus ( p =0.002), and ejection fraction ( p =0.005), but not DSE inducible ischemia.

Conclusion NT-pro-BNP is not affected by DSE-induced ischemia and cannot be used in clinical practice to improve diagnostic accuracy of DSE.

Dobutamine stress echocardiography, Brain natriuretic peptide