N‐terminal probrain natriuretic peptide (NT‐proBNP) in the emergency diagnosis and in‐hospital monitoring of patients with dyspnoea and ventricular dysfunction
Open Access
- 1 March 2004
- journal article
- research article
- Published by Wiley in European Journal of Heart Failure
- Vol. 6 (3), 301-308
- https://doi.org/10.1016/j.ejheart.2003.12.013
Abstract
Objective: To evaluate the utility of NT‐proBNP in the emergency diagnosis and in‐hospital monitoring of patients with acute dyspnoea and ventricular dysfunction. Background: Misdiagnosis of heart failure (HF) is common in the urgent care setting using clinical diagnostic tests. Reports show that BNP is useful to diagnose HF in patients with acute dyspnoea. Methods: Prospective study of 100 patients attending the Emergency Department (ED) for acute dyspnoea. Final diagnosis was determined on the basis of ED data sheets, echocardiography and pulmonary function tests. NT‐proBNP levels were obtained on admission, at 24 h and at day 7. Results: Patients with ventricular dysfunction were sub‐classified into decompensated HF and masked HF, defined as HF with concomitant signs of pulmonary disease. Decompensated and masked HF patients had significantly higher NT‐proBNP values than patients with non‐cardiac dyspnoea (normal ventricular function) (920±140 and 978±363 vs. 50±15 pmol/L; PPP115 pmol/l was the strongest independent predictor of ventricular dysfunction (odds ratio 45.4; 95% CI: 4.5–452.3). At day 7, a significant and similar reduction in NT‐proBNP was observed in the two groups of patients with ventricular dysfunction (PP<0.05 vs. decompensated HF). Conclusions: NT‐proBNP is a new candidate marker for the detection and exclusion of ventricular dysfunction in patients attending the ED for acute dyspnoea. NT‐proBNP may also serve to monitor outcome during hospitalization.This publication has 27 references indexed in Scilit:
- N -Terminal Pro–Brain Natriuretic Peptide and Other Risk Markers for the Separate Prediction of Mortality and Subsequent Myocardial Infarction in Patients With Unstable Coronary Artery DiseaseCirculation, 2003
- Impact of heart failure and left ventricular systolic dysfunction on quality of life. A cross-sectional study comparing common chronic cardiac and medical disorders and a representative adult populationEuropean Heart Journal, 2002
- B-Type Natriuretic Peptide and Clinical Judgment in Emergency Diagnosis of Heart FailureCirculation, 2002
- Rapid Measurement of B-Type Natriuretic Peptide in the Emergency Diagnosis of Heart FailureThe New England Journal of Medicine, 2002
- The Prognostic Value of B-Type Natriuretic Peptide in Patients with Acute Coronary SyndromesThe New England Journal of Medicine, 2001
- European survey of primary care physician perceptions on heart failure diagnosis and management (Euro-HF)European Heart Journal, 2000
- Profile of plasma N-terminal proBNP following acute myocardial infarction. Correlation with left ventricular systolic dysfunctionEuropean Heart Journal, 2000
- Natriuretic PeptidesThe New England Journal of Medicine, 1998
- Brain natriuretic factor: regional plasma concentrations and correlations with haemodynamic state in cardiac disease.Heart, 1993
- Effects of prehospital medications on mortality and length of stay in congestive heart failureAnnals of Emergency Medicine, 1992