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Age and Ageing Advance Access originally published online on August 27, 2009
Age and Ageing 2009 38(6):655-662; doi:10.1093/ageing/afp157
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© The Author 2009. Published by Oxford University Press [on behalf of the British Geriatrics Society]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Systematic Review

The accuracy of plasma natriuretic peptide levels for diagnosis of cardiac dysfunction and chronic heart failure in community-dwelling elderly: a systematic review

Bert Vaes1, Wouter de Ruijter2, Jacobijn Gussekloo2 and Jan Degryse3

1 Department of General Practice, Université Catholique de Louvain, 1200 Woluwe-Saint-Lambert, Belgium
2 Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
3 Department of General Practice, Université Catholique de Louvain, 1200 Woluwe-Saint-Lambert, Belgium

Address correspondence to: B. Vaes. Tel: (+32) 2 7645344; Fax: (+32) 2 7645327. Email: Bert.Vaes{at}uclouvain.be

Background: measurement of plasma natriuretic peptide levels has been proposed as a simple, accessible test to assist the diagnosis of cardiac dysfunction and heart failure. Most studies have been hospital based and have investigated the relationship between natriuretic peptides and cardiac dysfunction or heart failure in younger populations.

Objective: we performed a systematic review to evaluate the diagnostic accuracy of plasma natriuretic peptide measurement in elderly patients from the general population.

Methods: electronic searches of MEDLINE and EMBASE from January 1985 to May 2008 were performed. Diagnostic cohort and cross-sectional studies on the accuracy of natriuretic peptides for diagnosis of cardiac dysfunction or chronic heart failure in people aged 75 and over in the community were included. The quality of the selected studies was assessed with the modified QUADAS tool and the data extracted by two independent reviewers.

Results: five studies were included. The general quality of the studies was moderate. The extracted data could not be pooled. Negative likelihood ratios for cardiac dysfunction ranged from 0.09 to 0.29.

Conclusion: we found limited evidence supporting the use of plasma natriuretic peptide measurement for diagnosis of cardiac dysfunction or heart failure in the elderly of 75 years and over in the general population. Important questions about the implementation of plasma natriuretic peptide measurement in daily practice remain unresolved.

Keywords: aged, natriuretic peptides, heart failure, cardiac dysfunction, diagnosis, community, elderly

Received 12 November 2008; accepted in revised form 8 July 2009.


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