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European Journal of Echocardiography 2007 8(4):265-274; doi:10.1016/j.euje.2006.06.003
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Copyright © 2006, The European Society of Cardiology

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

Ilias Karabinosa, Evangelia Karvounia, Nicolaos Chiotinisb, Anastasios Papadopoulosa, Phevos Simeonidisa, Orestis Tsolasb and Demosthenes Katritsisa,*

aDepartment of Cardiology, Athens Euroclinic, 9 Athanasiadou Street, Athens 11521, Greece
bCentral Laboratories, Athens Euroclinic, 9 Athanasiadou Street, Athens 11521, Greece

Received 15 March 2006; received in revised form 24 May 2006; accepted after revision 2 June 2006.

dkatritsis{at}euroclinic.gr

* Corresponding author. Tel.: +30 210 6416600/6416664; fax: +30 210 6416738.


  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.

Keywords: Dobutamine stress echocardiography; Brain natriuretic peptide


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