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Review: ECG, BNP, and N terminal-pro BNP are more sensitive than specific for chronic left ventricular systolic dysfunction

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 Q How do electrocardiography (ECG), brain natriuretic peptide (BNP), and N terminal-pro brain natriuretic peptide (NT-pro BNP) perform in diagnosing chronic left ventricular systolic dysfunction (LVSD)?

Clinical impact ratings IM/Ambulatory care ★★★★★★☆ GP/FP/Primary care ★★★★★★☆ Internal medicine ★★★★★★☆ Cardiology ★★★★☆☆☆ Emergency medicine ★★★★☆☆☆


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Medline, EMBASE/Excerpta Medica (1980 to March 2004), Cochrane Library (Issue 4, 2003), hand searches of selected proceedings and cardiology journals, and citations from relevant studies and reviews.

Embedded ImageStudy selection and assessment

cohort studies that compared ECG, BNP, NT-pro BNP, or combinations with a reference standard (nuclear cardiology techniques or 2 dimensional echocardiography) in patients with suspected LVSD. Trials with insufficient data to calculate sensitivity and specificity and those that studied patients with acute heart failure (HF) or suspected ventricular diastolic dysfunction or patients receiving long term treatment with angiotensin converting enzyme (ACE) inhibitors or diuretics for presumed HF were excluded. …

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  • For correspondence: Dr C Davenport, University of Birmingham, Birmingham, UK. C.F.Davenport{at}

  • Source of funding: not stated.