Pleural Fluid Amino-Terminal Brain Natriuretic Peptide in Patients With Pleural Effusions
| Autor: | Gulsevil Ozgul, Beste Ozben, Sait Karakurt, Azra Meryem Tanrikulu, Yasin Abul, Nurhayat Topaloglu, Ahmet Oktay, Altug Cincin |
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| Přispěvatelé: | Cincin, Altug, Abul, Yasin, Ozben, Beste, Tanrikulu, Azra, Topaloglu, Nurhayat, Ozgul, Gulsevil, Karakurt, Sait, Oktay, Ahmet |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
Pathology Pleural effusion BIOCHEMICAL PARAMETERS medicine.medical_treatment heart failure Critical Care and Intensive Care Medicine Gastroenterology SERUM pleural effusion Cytology Positive predicative value Natriuretic Peptide Brain Natriuretic peptide Medicine Diuretics UTILITY ALBUMIN GRADIENT Exudates and Transudates General Medicine Middle Aged respiratory system Brain natriuretic peptide Light's criteria Predictive value of tests SEPARATION HEART-FAILURE Female Adult Pulmonary and Respiratory Medicine medicine.medical_specialty NT-PROBNP medicine.drug_class Thoracentesis DIAGNOSIS Diagnosis Differential Predictive Value of Tests Internal medicine DISTINGUISH Humans Tuberculosis Empyema Aged business.industry medicine.disease Peptide Fragments DYSFUNCTION Pleural Effusion Malignant respiratory tract diseases ROC Curve Heart failure amino-terminal brain natriuretic peptide business Biomarkers |
| Popis: | BACKGROUND: Definite diagnosis of transudative or exudative pleural fluids often presents a diagnostic dilemma. The aim of this study was to evaluate whether amino-terminal brain natriuretic peptide (NT-proBNP) levels in pleural fluid has a diagnostic value for discriminating heart-failure-related pleural effusions from non-heart-failure effusions. METHODS: Sixty-six subjects (40 male, mean age 61 ± 18 y) with pleural effusions were included. Samples of pleural fluid and serum were obtained simultaneously from each subject. Biochemical analysis, bacterial and fungal culture, acid-fast bacilli smear and culture, and cytology were performed on the pleural fluid. RESULTS: Subjects with heart-failure-related pleural effusion had significantly higher pleural NT-proBNP levels than other subjects ( P < .001). Pleural and serum NT-proBNP measures were closely correlated (r = 0.90, P < .001). An NT-proBNP cutoff value of ≥ 2,300 pg/mL in pleural fluid had a sensitivity of 70.8%, a specificity of 97.6%, and positive and negative predictive values of 94.4% and 85.4%, respectively, for discriminating transudates caused by heart failure from exudates. Eight heart-failure subjects were misclassified as exudates by Light's criteria, 5 of whom received diuretics before thoracentesis. All misclassified subjects had pleural NT-proBNP levels higher than 1,165 pg/mL, which predicted heart-failure-associated transudates with 95.8% sensitivity and 85.7% specificity. CONCLUSIONS: Pleural fluid NT-proBNP measurement in the routine diagnostic panel may be useful in differentiation of heart-failure-related pleural effusions and exudative pleural fluids with reasonable accuracy, especially in heart-failure patients treated with diuretics. |
| Databáze: | OpenAIRE |
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