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Neurol Int. 2018 Dec 20;10(4):7917. doi: 10.4081/ni.2018.7917. eCollection 2018 Dec 5.

Accuracy of B-natriuretic peptide for the diagnosis of decompensated heart failure in muscular dystrophies patients with chronic respiratory failure.

Author information

1
Service of Medical Resuscitation, Home Ventilation Unit, Raymond Poincaré, University of Versailles Saint Quentin en Yvelines, Garches.
2
Center of Clinical Investigation Paris-Est, Pitié Salpetrière, Sorbonne University, Paris.
3
Biochemistry Department, Raymond Poincaré, University of Versailles Saint Quentin en Yvelines, Garches.
4
Clinical Investigation and Technological Innovation Centre, INSERM, Garches.
5
Physiology Department - Functional Explorations, Raymond Poincaré, University of Versailles Saint Quentin en Yvelines, Garches.
6
Institute of Myology, Pitié Salpetrière, Paris, France.

Abstract

Heart failure and restrictive respiratory insufficiency are complications in muscular dystrophies. We aimed to assess the accuracy of the B-natriuretic peptide (BNP) for the diagnosis of decompensated heart failure in muscular dystrophy. We included patients with muscular dystrophy and chronic respiratory insufficiency admitted in the Intensive Care Unit of the Raymond Poincare hospital (Garches, France) for suspected decompensated heart failure. Thirtyseven patients were included, among them, 23 Duchenne muscular dystrophy (DMD) (62%), 10 myotonic dystrophy type 1(DM1) (27%). Median age was 35 years [27.5; 48.5]. 86.5% of patients were on home mechanical ventilation (HMV). Median left ventricular ejection fraction (LVEF) was 47% [35.0; 59.5]. Median BNP blood level was 104 pg/mL [50; 399]. The BNP level was significantly inversely associated with LVEF (r= -0.37, p 0.03) and positively associated with the LVEDD (left ventricular end diastolic diameter) (r=0.59, P<0.001). The discriminative value of the BNP level for the diagnosis of decompensated heart failure was high with an AUROC=0.94 (P<0.001). The best discriminating BNP threshold was 307 pg/mL (Youden index 0.85). The BNP level measurement may add a supplemental key for the final diagnosis of decompensated heart failure.

KEYWORDS:

BNP; heart failure; muscular dystrophy

Conflict of interest statement

Conflict of interest: the authors declare no potential conflict of interest.

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