Diagnostic accuracy of ECG and N-terminal pro B-type natriuretic peptide for cardiac dysfunction among asymptomatic long-term breast cancer survivors.

IF 2.9 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Journal of Cardiovascular Medicine Pub Date : 2025-05-01 Epub Date: 2025-03-27 DOI:10.2459/JCM.0000000000001710
Rachel Knol, Laurine T van der Wal, Jozine M Ter Maaten, Geertruida H de Bock, Saskia W M C Maass, Daan Brandenbarg
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引用次数: 0

Abstract

Background: With a growing population of breast cancer survivors, it is important to acknowledge long-term consequences of breast cancer treatment, including left ventricular systolic dysfunction (LVSD). Although echocardiography is a reliable technique to diagnose LVSD, its limited accessibility in primary care poses challenges.

Methods: A cross-sectional diagnostic accuracy study among 350 long-term breast cancer survivors, at least 5 years after breast cancer diagnosis, comparing the diagnostic performance of index tests ECG and N-terminal pro B-type natriuretic peptide (NT-proBNP) to the reference test echocardiography. LVSD was defined as left ventricular ejection fraction (LVEF) less than 54% or LVEF less than 50% on echocardiography.

Results: The median age at time of investigation was 63 years (IQR 57-68), with a median follow-up duration since breast cancer diagnosis of 10 years (IQR 7-14). An abnormal ECG demonstrated a sensitivity of 63.0% (IQR 48.7-75.7), a corresponding specificity of 51.7 (IQR 45.8-57.6) and a negative likelihood ratio of 0.7 (IQR 0.5-1.0) for detecting a LVEF less than 54%. An abnormal ECG showed a sensitivity of 75.0 (IQR 47.6-92.7), a corresponding specificity of 50.6 (IQR 45.1-56.2) and a negative likelihood ratio of 0.5 (0.2-1.2) for detecting LVSD defined as LVEF less than 50%. The area under the curve for NT-proBNP was 0.59 (95% confidence interval: 0.50-0.68) for detecting LVEF less than 54% and 0.56 (95% confidence interval: 0.39-0.74) for detecting LVEF less than 50%.

Discussion: ECG and NT-proBNP are inadequate diagnostic tools to screen for LVSD among asymptomatic long-term breast cancer survivors.

心电图和n端前b型利钠肽对无症状长期乳腺癌幸存者心功能障碍的诊断准确性
背景:随着乳腺癌幸存者人数的增加,认识到乳腺癌治疗的长期后果,包括左心室收缩功能障碍(LVSD)是很重要的。虽然超声心动图是诊断LVSD的可靠技术,但其在初级保健中的可及性有限,带来了挑战。方法:对350例乳腺癌确诊后至少5年的长期乳腺癌幸存者进行横断面诊断准确性研究,比较心电图指标试验和n端前b型利钠肽(NT-proBNP)与参考试验超声心动图的诊断效果。LVSD定义为超声心动图左心室射血分数(LVEF)小于54%或LVEF小于50%。结果:调查时的中位年龄为63岁(IQR 57-68),自乳腺癌诊断以来的中位随访时间为10年(IQR 7-14)。异常心电图检测LVEF小于54%的敏感性为63.0% (IQR 48.7 ~ 75.7),特异性为51.7 (IQR 45.8 ~ 57.6),阴性似然比为0.7 (IQR 0.5 ~ 1.0)。异常心电图检测LVEF小于50%的LVSD的敏感性为75.0 (IQR 47.6-92.7),特异性为50.6 (IQR 45.1-56.2),负似然比为0.5(0.2-1.2)。检测LVEF小于54%时NT-proBNP曲线下面积为0.59(95%置信区间:0.50 ~ 0.68),检测LVEF小于50%时NT-proBNP曲线下面积为0.56(95%置信区间:0.39 ~ 0.74)。讨论:心电图和NT-proBNP是不充分的诊断工具筛选无症状的长期乳腺癌幸存者LVSD。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Cardiovascular Medicine
Journal of Cardiovascular Medicine 医学-心血管系统
CiteScore
3.90
自引率
26.70%
发文量
189
审稿时长
6-12 weeks
期刊介绍: Journal of Cardiovascular Medicine is a monthly publication of the Italian Federation of Cardiology. It publishes original research articles, epidemiological studies, new methodological clinical approaches, case reports, design and goals of clinical trials, review articles, points of view, editorials and Images in cardiovascular medicine. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool. ​
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