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Year : 2017  |  Volume : 5  |  Issue : 4  |  Page : 152-156

Prevalence of subclinical myocardial involvement among acute rheumatic fever patients without overt clinical carditis in Northern India: An evidence from plasma N-terminal pro-brain natriuretic peptide assessment

1 Department of Cardiology, LPS Institute, Kanpur, Uttar Pradesh, India
2 Department of Cardiology, King George Medical University, Lucknow, Uttar Pradesh, India

Correspondence Address:
Gaurav kumar Chaudhary
Department of Cardiology, King George Medical University, Chowk, Lucknow - 226 003, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/heartindia.heartindia_31_17

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Objectives: It is important to diagnose subclinical carditis in acute rheumatic fever (ARF) since it has a bearing on prognosis and duration of prophylaxis. Plasma N-terminal pro-brain natriuretic peptide (NT pro-BNP) has been used as both diagnostic and prognostic tools, and it was hypothesized that it may prove useful in ARF without overt carditis. The study was undertaken to measure the plasma levels of NT pro-BNP in patients of ARF who did not have overt clinical carditis and to correlate the same with echocardiographic (ECHO) parameters of subclinical myocardial involvement. Materials and Methods: A total of 27 ARF patients without overt clinical carditis were enrolled in this prospective follow-up study. Plasma NT pro-BNP levels of these patients were assessed on day 1 of presentation and then after 6 weeks. ECHO was performed and patients were divided into two groups: group I, patients with subclinical carditis (n = 18) and group II, patients without subclinical carditis (n = 9). Results: The mean plasma NT pro-BNP levels were significantly higher in patients with subclinical carditis (509.16 ± 282.9 pg/ml) compared to those without subclinical carditis (109.33 ± 82.95 pg/ml) (P < 0.001). A cutoff value of 134 pg/ml of NT pro-BNP had a sensitivity of 94.4% and specificity of 88.9% for detecting subclinical rheumatic carditis in ARF. Conclusions: The present study suggests that elevated levels of NT pro-BNP may be used to diagnose subclinical myocardial involvement in patients of ARF without overt clinical carditis.

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