Evidence-Based Application of Natriuretic Peptides in the Evaluation of Chronic Heart Failure With Preserved Ejection Fraction in the Ambulatory Outpatient Setting
In patients with chronic unexplained dyspnea, current rule-in and rule-out NT-proBNP diagnostic thresholds lead to unacceptably high error rates, with important interactions by obesity and AF status. In our study, NT-proBNP provided little value in those with AF and dyspnea because the presence of AF is by itself a robust biomarker of HFpEF. Use of separate rule-in and rule-out diagnostic thresholds stratified by BMI reduces miscategorization and can guide more appropriate use of exercise testing for possible HFpEF.
Authors
- Masaru Obokata (ORCID: https://orcid.org/0000-0002-5473-0688)
- David M. Kaye (ORCID: https://orcid.org/0000-0003-4058-0372)
- Rickey E. Carter (ORCID: https://orcid.org/0000-0002-0818-273X)
- M. Louis Handoko (ORCID: https://orcid.org/0000-0002-8942-7865)
- Margaret M. Redfield (ORCID: https://orcid.org/0000-0002-0946-7518)
- Mads J. Andersen (ORCID: https://orcid.org/0000-0002-9320-8227)
- Barry A. Borlaug (ORCID: https://orcid.org/0000-0001-9375-0596)
- Yogesh N.V. Reddy (ORCID: https://orcid.org/0000-0001-5322-0902)
- Kavita Sharma (ORCID: https://orcid.org/0000-0002-3012-1765)
- Ryan J. Tedford (ORCID: https://orcid.org/0000-0001-9045-7722)
- Atsushi Tada (ORCID: https://orcid.org/0009-0000-7998-1881)
Institutions
- Mayo Clinic (US)
- Johns Hopkins University (US)
- Medical University of South Carolina (US)
- Gunma University (JP)
- Johns Hopkins Medicine (US)
- Jacksonville College (US)
- The Alfred Hospital (AU)
- Aarhus University Hospital (DK)
- Mayo Clinic in Arizona (US)
- Mayo Clinic in Florida (US)
- Vrije Universiteit Amsterdam (NL)
Publication Details
- Journal
- Circulation
- Published
- 2025-01-22
- DOI
- https://doi.org/10.1161/circulationaha.124.072156
- Citations
- 41
- Primary Topic
- Heart Failure Treatment and Management
- Type
- article
- Field-Weighted Citation Impact
- 56.92
Funders
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- Edwards Lifesciences
- United Therapeutics Corporation
- Boston Scientific Corporation
- Japan Agency for Medical Research and Development
- Acceleron
- Cytokinetics
- Nippon Shinyaku
- Abiomed
- Fukuda Foundation for Medical Technology
- Japanese Circulation Society
- Mochida Memorial Foundation for Medical and Pharmaceutical Research
- Otsuka Pharmaceutical
- Medical Research Council
- National Health and Medical Research Council
- Japan Society for the Promotion of Science