UNIVERSITAS AIRLANGGA



Detail Article

Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 18 / No. 1 / Published : 2011-01

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Original Article :

Diagnostic test nt pro natriuretic peptide (ntprobnp) on congestive heart failure

Author :

  1. Dewi Indah Noviana Pratiwi*1
  2. Suwarso*2
  3. Osman Sianipar*3
  1. Bagian Patologi Klinik Fakultas Kedokteran Universitas Gadjah Mada
  2. Bagian Patologi Klinik Fakultas Kedokteran Universitas Gadjah Mada
  3. Bagian Patologi Klinik Fakultas Kedokteran Universitas Gadjah Mada

Abstract :

  Congestive Heart Failure (CHF) is a syndrome associated with disturbances of heart structure and function, as a result of various cardiovascular diseases. These disturbances decrease ventricle ability to pump or fill blood in physiological pressure, which causes limitation on the ability to excercise or daily activities without dyspnea and fatigue.Early diagnosis is important to initiate prompt treatment that can prevent further disease development. To measure heart hormone in this case, NT pro Natriuretic Peptide (NT pro BNP) can be use as a more ideal examination for early detection of CHF. The aim of this study is to investigate the clinical performance of NT pro BNP and assess the cut-off point 125 pg/mL compared to clinic (Framingham criteria) and or echocardiogram in the diagnosis CHF.The diagnostic test was carried out using clinical (Framingham criteria) and or echocardiography as reference methods. The subject of this research was patients with cardiac and blood vessel disorders complaints at risk of developing congestive heart failure, who came to the Emergency Department at Dr. Sardjito Hospital Yogyakarta, supported by clinical data, radiology, other laboratory test, electrocardiography and echocardiography. The diagnosis of CHF was obtained by conducting investigation toward echocardiography examination reading in patient’s medical record. Receiver Operating Characteristics (ROC) curve analysis was conducted using SPSS 13.0 program. Sensitivity, specificity, positive and negative predictive value, accuracy and likelihood ratios were measured with 2x2 table by CAT marker program. Forty-six of fifty-seven specimens were from congestive heart failure (CHF). At 125 pg/mL as a cut-off point, regardless the interval between the onset of the symptoms and taking of blood samples, the sensitivity, specificity, positive and negative predictive value and diagnostic accuracy are 96%, 36%, 86%, 67%, 84%  respectively. Likelihood ratios for positive and negative results are 1.50 and 0.12. NT pro BNP measuring is expected to give more benefit than the conventional signal, so that an early diagnosis can be achieved accurately in a timely manner.     Gagal jantung sesak (kongestif) merupakan gejala yang berhubungan dengan gangguan susunan dan fungsi jantung, akibat berbagai penyakit pembuluh darah jantung (kardiovaskular). Gangguan ini menurunkan kemampuan bilik jantung (ventrikel) untuk memompa atau mengisi darah dengan tekanan fisiologis, yang menyebabkan kemampuan untuk berkegiatan sehari-hari terbatas tanpa gejala dyspnea (sesak napas) dan rasa lelah. Pengenalian adalah awal penting yang perlu dilakukan untuk memulai penanganan secara lebih dini, yang dapat mencegah perkembangan penyakit lebih lanjut. Pengukuran hormon jantung dalam hal ini  NT pro Natriuretic Peptide (NT pro BNP) dapat menjadi pemeriksaan yang lebih bagus untuk menemukan secara dini gagal jantung kongestif. Tujuan penelitian adalah menguji kepekaan diagnosis NT pro BNP di cut-off 125 pg/mL dibandingkan dengan rekam pantulan detak jantung (ekokardiografi) untuk diagnosis gagal jantung kongestif. Penelitian ini menggunakan rancangan uji diagnosis dengan patokan klinik (patokan Framingham) dan atau ekokardiografi sebagai cara merujukkan gagal jantung kongestif. Subyek penelitian adalah pasien dengan keluhan kelainan jantung dan pembuluh darah yang berkebahayaan gagal jantung kongestif yang datang ke RSUP Dr. Sardjito Yogyakarta dan didukung oleh data: klinik, laboratorik lain, radiologik, elektrokardiografik (EKG). Diagnosis gagal jantung kongestif diperoleh dengan menelusur patokan klinik dan atau hasil periksaan ekokardiografi yang ada di borang rekam medik pasien. Analisis kurva ciri penerima pengolahan/ROC (Receiver Operating Characteristics) dilakukan menggunakan program SPSS 13,0. Kepekaan, kekhasan, nilai ramal positif dan negatif, kecermatan dan angka banding besar kemungkinan (likelihood ratio) dihitung dengan tabel 2 x 2 menggunakan program CAT marker. Penelitian dilakukan di 57 subyek, 46 subyek di antaranya berdiagnosis gagal jantung kongestif (CHF). Kadar NT pro BNP 125 pg/mL, tanpa memperhitungkan waktu antara mulainya penyakit (onset) dan saat pasien datang ke rumah sakit, berkepekaan 96%, kekhasan 36% NRP 86%, NRN 67%, kecermatan 84%, LR + 1,50 dan LR – 0,12. Pemeriksaan NT pro BNP diharapkan lebih bermanfaat dibandingkan dengan petanda yang konvensional, sehingga temuan dini pasien gagal jantung kongestif dapat diberikan secara tepat dan cepat.

Keyword :

Congestive heart failure, NT pro BNP, diagnostic test,


References :

Bhalla, V., Maisel, A. S,(2004) B-Type Natriuretic peptide, A biomarker for all the right reason Italia : Ital Heart J

Suryadipraja, R.M,(2003) Gagal Jantung Kronik Berat. Dalam Cardiovascular Respiratory Immunology From Pathogenesis To Clinical Application Jakarta : Bagian Ilmu Penyakit Dalam FKUI

Irawan B,(2001) Patofisiologi Gagal Jantung Kongestif Jakarta : Berkala Kesehatan Klinik

Rahayoe, A.U,(2006) Pemeriksaan penyakit jantung koroner pada wanita, artikel seputar jantung Jakarta : http://.pusat jantung nasional harapan kita.htm

5. Shapiro, B.P., Chen, H.H., Burnett, J.C., Redfield, M.M,(2003) Use of plasma brain natriuretic peptide concentration to aid in the diagnosis of heart failure USA : Mayo Clin Proc





Archive Article

Cover Media Content

Volume : 18 / No. : 1 / Pub. : 2011-01
  1. Aerob Microbes Pattern And Antimicrobial Sensitivity Of Diabetic Foot Ulcer
  2. Plasma Levels Of Interleukin 10 (il-10) In Malaria And Anaemia
  3. Identification Of Cryptosporidiosis In Paediatric Hiv-infected Patients With Chronic Diarrhoea At Paediatric Gastro
  4. Immunoglobulin A In Dengue Hemorrhagic Fever
  5. (comparison Of Determination For Thyroxine With Enzyme Linked Immunofluorescent Assay (elfa) And Enzyme Linked Immunosorbant Assay (elisa)}
  6. Plasma Interleukin-10 And Cd4+ Lymphocyte-t In Hiv Infected Patients
  7. Detecting Fluoroquinolone Resistance Of Salmonella Sp Using Nalidixic Acid Succeptibility Test
  8. Phyllanthus Niruri L The Effects Of Extract On Cellular Immunity Mice
  9. Fitoestrogen Dalam Beberapa Daun Dan Buah
  10. Diagnostic Test Nt Pro Natriuretic Peptide (ntprobnp) On Congestive Heart Failure
  11. Human Immunodeficiency Virus (hiv) Infection In Babies And Children
  12. Decompensated Cirrhosis Hepatic In Children
  13. Human Resources Management In The Clinical Laboratory

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