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Arq Bras Cardiol. 2002 Dec;79(6):569-72, 564-8.

The role of B-type natriuretic peptide in the diagnosis of congestive heart failure in patients presenting to an emergency department with dyspnea.

[Article in English, Portuguese]

Author information

  • 1Hospital Pró-Cardíaco - Unidade de Emergência, Rio de Janeiro, RJ - Brasil. huvillacorta@globo.com

Abstract

OBJECTIVE:

To determine the utility of B-type natriuretic peptide (BNP) in the diagnosis of congestive heart failure (CHF) in patients presenting with dyspnea to an emergency department (ED).

METHODS:

Seventy patients presenting with dyspnea to an ED from April to July 2001 were included in the study. Mean age was 72+/-16 years and 33 (47%) were male. BNP was measured in all patients at the moment of admission to the ED. Emergency-care physicians, blinded to BNP values, were required to assign a probable initial diagnosis. A cardiologist retrospectively reviewed the data (blinded to BNP measurements) and assigned a definite diagnosis, which was considered the gold standard for assessing the diagnostic performance of BNP.

RESULTS:

The mean BNP concentration was higher in patients with CHF (n=36) than in those with other diagnoses (990+/-550 vs 80+/-67 pg/mL, p<0.0001). Patients with systolic dysfunction had higher BNP levels than those with preserved systolic function (1,180+/-641 vs 753+/-437 pg/mL, p=0.03). At a blood concentration of 200 pg/mL, BNP showed a sensitivity of 100%, specificity of 97.1%, positive predictive value of 97.3%, and negative predictive value of 100%. The application of BNP could have potentially corrected all 16 cases in which the diagnosis was missed by the emergency department physician.

CONCLUSION:

BNP measurement is a useful tool in the diagnosis of CHF in patients presenting to the ED with dyspnea.

PMID:
12532240
[PubMed - indexed for MEDLINE]
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