Cortés Raquel, Rivera Miguel, Salvador Antonio, García de Burgos Fernando, Bertomeu Vicente, Roselló-Lletí Esther, Martínez-Dolz Luís, Payá Rafael, Almenar Luis, Portolés Manuel
Cardiology Unit, Research Center, Hospital Universitario La Fe, Valencia, Spain.
J Card Fail. 2007 Sep;13(7):549-55. doi: 10.1016/j.cardfail.2007.04.007.
Plasma B-type natriuretic peptide (BNP) is a useful biomarker for diagnosis and prognosis of heart failure (HF); however, urine BNP has never been calculated. We sought to compare urinary and plasma BNP levels and to investigate the potential diagnostic and prognostic value of this peptide in HF.
Urine and plasma BNP levels were measured in 92 HF patients and 30 control subjects. Urinary BNP levels were higher in HF patients than in control subjects (P < .0001), correlating with plasma BNP levels (r = 0.64, P < .0001). Urine BNP was a good tool for the diagnosis of HF, the area under the curve (AUC) being 0.91 +/- 0.06 (P < .0001). Urinary BNP levels had prognostic power for cardiac events (cardiac admissions + mortality) with an odds ratio of 6.6 (P < .05). To determine the prognostic power of urinary BNP in detecting 12-month cardiac mortality, we obtained an AUC of 0.76 +/- 0.6 (P = .014).
The data suggest that urine BNP is a new candidate marker for diagnosis and prognosis of HF mortality and cardiac events. This raises the possibility of using this relatively simple noninvasive test in primary care settings or in specific conditions where the collection of blood samples could be difficult.
血浆B型利钠肽（BNP）是心力衰竭（HF）诊断和预后的有用生物标志物；然而，尿BNP从未被计算过。我们旨在比较尿BNP和血浆BNP水平，并研究该肽在HF中的潜在诊断和预后价值。
测量了92例HF患者和30例对照者的尿BNP和血浆BNP水平。HF患者的尿BNP水平高于对照者（P <.0001），与血浆BNP水平相关（r = 0.64，P <.0001）。尿BNP是HF诊断的良好工具，曲线下面积（AUC）为0.91±0.06（P <.0001）。尿BNP水平对心脏事件（心脏住院+死亡率）具有预后价值，优势比为6.6（P <.05）。为了确定尿BNP在检测12个月心脏死亡率方面的预后价值，我们获得的AUC为0.76±0.6（P =.014）。
数据表明尿BNP是HF死亡率和心脏事件诊断及预后的新候选标志物。这增加了在基层医疗环境或采集血样困难的特定情况下使用这种相对简单的非侵入性检测的可能性。
