TY - JOUR
T1 - Natriuretic peptides for the detection of diastolic dysfunction and heart failure with preserved ejection fraction-a systematic review and meta-analysis
AU - Remmelzwaal, Sharon
AU - van Ballegooijen, Adriana J.
AU - Schoonmade, Linda J.
AU - Dal Canto, Elisa
AU - Handoko, M. Louis
AU - Henkens, Michiel T. H. M.
AU - van Empel, Vanessa
AU - Heymans, Stephane R. B.
AU - Beulens, Joline W. J.
N1 - Funding Information:
This work was supported by the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation (CVON2016-Early HFPEF). JWJB is supported by a ZonMw VIDI grant (91718304). Acknowledgements
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/10/30
Y1 - 2020/10/30
N2 - Background: An overview of the diagnostic performance of natriuretic peptides (NPs) for the detection of diastolic dysfunction (DD) and heart failure with preserved ejection fraction (HFpEF), in a non-acute setting, is currently lacking.Methods: We performed a systematic literature search in PubMed and (May 13, 2019). Studies were included when they (1) reported diagnostic performance measures, (2) are for the detection of DD or HFpEF in a non-acute setting, (3) are compared with a control group without DD or HFpEF or with patients with heart failure with reduced ejection fraction, (4) are in a cross-sectional design. Two investigators independently assessed risk of bias of the included studies according to the QUADAS-2 checklist. Results were meta-analysed when three or more studies reported a similar diagnostic measure.Results: From 11,728 titles/abstracts, we included 51 studies. The meta-analysis indicated a reasonable diagnostic performance for both NPs for the detection of DD and HFpEF based on AUC values of approximately 0.80 (0.73-0.87; I-2 = 86%). For both NPs, sensitivity was lower than specificity for the detection of DD and HFpEF: approximately 65% (51-85%; I-2 = 95%) versus 80% (70-90%; I-2 = 97%), respectively. Both NPs have adequate ability to rule out DD: negative predictive value of approximately 85% (78-93%; I-2 = 95%). The ability of both NPs to prove DD is lower: positive predictive value of approximately 60% (30-90%; I-2 = 99%).Conclusion: The diagnostic performance of NPs for the detection of DD and HFpEF is reasonable. However, they may be used to rule out DD or HFpEF, and not for the diagnosis of DD or HFpEF.
AB - Background: An overview of the diagnostic performance of natriuretic peptides (NPs) for the detection of diastolic dysfunction (DD) and heart failure with preserved ejection fraction (HFpEF), in a non-acute setting, is currently lacking.Methods: We performed a systematic literature search in PubMed and (May 13, 2019). Studies were included when they (1) reported diagnostic performance measures, (2) are for the detection of DD or HFpEF in a non-acute setting, (3) are compared with a control group without DD or HFpEF or with patients with heart failure with reduced ejection fraction, (4) are in a cross-sectional design. Two investigators independently assessed risk of bias of the included studies according to the QUADAS-2 checklist. Results were meta-analysed when three or more studies reported a similar diagnostic measure.Results: From 11,728 titles/abstracts, we included 51 studies. The meta-analysis indicated a reasonable diagnostic performance for both NPs for the detection of DD and HFpEF based on AUC values of approximately 0.80 (0.73-0.87; I-2 = 86%). For both NPs, sensitivity was lower than specificity for the detection of DD and HFpEF: approximately 65% (51-85%; I-2 = 95%) versus 80% (70-90%; I-2 = 97%), respectively. Both NPs have adequate ability to rule out DD: negative predictive value of approximately 85% (78-93%; I-2 = 95%). The ability of both NPs to prove DD is lower: positive predictive value of approximately 60% (30-90%; I-2 = 99%).Conclusion: The diagnostic performance of NPs for the detection of DD and HFpEF is reasonable. However, they may be used to rule out DD or HFpEF, and not for the diagnosis of DD or HFpEF.
KW - Diastolic dysfunction
KW - Heart failure with preserved ejection fraction
KW - Natriuretic peptides
KW - Systematic review
KW - Diagnostic test
KW - DIFFERENTIATION FACTOR 15
KW - NT-PROBNP
KW - VENTRICULAR DYSFUNCTION
KW - CORONARY-DISEASE
KW - EUROPEAN-SOCIETY
KW - DIAGNOSTIC-TEST
KW - TASK-FORCE
KW - ECHOCARDIOGRAPHY
KW - ASSOCIATION
KW - BIOMARKERS
U2 - 10.1186/s12916-020-01764-x
DO - 10.1186/s12916-020-01764-x
M3 - (Systematic) Review article
C2 - 33121502
SN - 1741-7015
VL - 18
JO - BMC Medicine
JF - BMC Medicine
IS - 1
M1 - 290
ER -