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Cardiology Research and Practice
Volume 2010, Article ID 642045, 8 pages
http://dx.doi.org/10.4061/2010/642045
Clinical Study

Additive Value of B-Type Natriuretic Peptide on Rest -Dipyridamole Stress -Sestamibi Gated Myocardial SPECT in Patients with Normal Left Ventricular Systolic Function

1Department of Internal Medicine, Inje University College of Medicine, Busan 614-735, South Korea
2Department of Internal Medicine, Seoul National University College of Medicine, Seoul 156-707, South Korea
3Cardiovascular Center, Seoul National University Bundang Hospital, Seoul 110-799, South Korea
4Seoul National University Boramae Medical Center, Seongnam-si, Gyeonggi-do 463-707, South Korea
5Cardiovascular Center, Seoul National University Boramae Medical Center, Shindaebang 2-Dong 425, Dongjak-Gu, Seoul 110-779, South Korea
6Cardiovascular Center, Seoul National University Hospital, Seoul 110-799, South Korea

Received 30 September 2009; Revised 1 February 2010; Accepted 8 February 2010

Academic Editor: Christian Wilhelm Hamm

Copyright © 2010 Jung-Ju Sir et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We evaluated whether BNP has additive value to SPECT in patients with normal left ventricular (LV) systolic function. Data from 224 consecutive patients who underwent rest -dipyridamole stress -sestamibi gated SPECT and coronary angiography due to chest pain were analyzed. Patients with true positive SPECT showed significant higher BNP level than those with false positive defect (38.5 (19.0–79.8) versus 19.0 (9.3–35.8), ). Patients with true negative SPECT also showed significantly lower BNP level than those with false negative SPECT (39.0 (23.0–77.0) versus 22.0 (15.0–43.0), ). In multivariate analyses, elevated BNP level (using a cut-off value of 23.0 pg/mL) was the strongest and independent predictor of CAD in overall patients (OR 2.75, 95% CI: 1.50–5.023, ) and patients with positive SPECT (OR 3.34, 95% CI: 1.51–7.37, ). The area under the receiver-operating characteristic curve for CAD in overall patients and patients with positive SPECT was 0.673 (95% CI: 0.603–0.743, ) and 0.694 (95% CI: 0.602–0.786, ), respectively. This study suggests that BNP level has additive diagnostic value to SPECT findings in predicting CAD in patients with normal LV systolic function.