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

Autor:	Villacorta H; Hospital Pró-Cardíaco - Unidade de Emergência, Rio de Janeiro, RJ - Brasil. huvillacorta@globo.com, Duarte A, Duarte NM, Carrano A, Mesquita ET, Dohmann HJ, Ferreira FE
Jazyk:	English; Portuguese
Zdroj:	Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2002 Dec; Vol. 79 (6), pp. 569-72, 564-8.
DOI:	10.1590/s0066-782x2002001500002
Abstrakt:	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.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu