Clinical studyDiagnostic value of B-Type natriuretic peptide and chest radiographic findings in patients with acute dyspnea
Section snippets
Patients
The Breathing Not Properly Multinational Study included 1586 patients recruited from five U.S. and two European teaching hospitals (Veterans Affairs Medical Center, California; Henry Ford Hospital, Michigan; University of Cincinnati College of Medicine, Ohio; Hospital of the University of Pennsylvania; Hartford Hospital, Connecticut; Hôpital Bichat, France; Ullevål University Hospital, Norway) from June 1999 to December 2000. To be eligible for the study, patients had to present to the
Results
The analysis comprised 880 patients with a mean (± SD) age of 64 ± 16 years, of whom 55% (n = 482) were men. Fifty-six percent were black (n = 495) and 39% (n = 340) were white. The most common final diagnosis was acute heart failure (51%) (Table 1). Four percent were considered to have a history of chronic heart failure, but current dyspnea due to other condition, and 45% had no current or past heart failure. The Framingham criteria for heart failure were fulfilled in 66% of patients (n =
Discussion
In our study of patients presenting to the emergency department with acute dyspnea, we found that BNP measurements and chest radiographs provided complementary diagnostic information beyond that derived from historical and clinical variables. Although BNP appeared to be the single strongest predictor of the diagnosis of acute heart failure, suggesting that BNP measurement should be performed routinely in the acutely dyspneic patient, these results also support the continued practice of
References (18)
- et al.
Clinical diagnosis of congestive heart failure in patients with acute dyspnea
Chest
(1990) - et al.
B-type natriuretic peptide predicts future cardiac events in patients presenting to the emergency department with dyspnea
Ann Emerg Med
(2002) - et al.
Utility of a rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea
J Am Coll Cardiol
(2002) - et al.
Prevalence and mortality rate of congestive heart failure in the United States
J Am Coll Cardiol
(1992) - et al.
Biochemical detection of left-ventricular systolic dysfunction
Lancet
(1998) - et al.
Value of natriuretic peptides in assessment of patients with possible new heart failure in primary care
Lancet
(1997) - et al.
Clinical criteria and biochemical markers for the detection of systolic dysfunction
J Card Fail
(2000) - et al.
Plasma brain natriuretic peptide in assessment of acute dyspnoea
Lancet
(1994) - et al.
How well can the chest radiograph diagnose left ventricular dysfunction?
J Gen Intern Med
(1996)
Cited by (128)
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
2022, Journal of the American College of CardiologySimple quantitative chest CT for pulmonary edema
2020, European Journal of Radiology OpenVisualization of the inferoposterior thoracic wall (VIP) and boomerang signs-novel sonographic signs of right pleural effusion
2018, American Journal of Emergency MedicineApproach to Acute Heart Failure in the Emergency Department
2017, Progress in Cardiovascular DiseasesCitation Excerpt :While highly specific for AHF, these radiographic findings are poorly sensitive.25,38,39 One series found that cardiomegaly alone had moderate sensitivity (79%) and specificity (80%).25 Lung ultrasound has emerged as a useful point-of-care tool for identifying pulmonary edema and diagnosing AHF.40,41
Usefulness of natriuretic peptide testing and Doppler echocardiography at bedside in the diagnosis of acute heart failure
2016, Annales de Cardiologie et d'Angeiologie