Cardiac ultrasound helps for differentiating the causes of acute dyspnea with available B-type natriuretic peptide tests.

Abstract

INTRODUCTION:

The aim of this study was to evaluate the role of cardiac ultrasound in diagnosing acute heart failure (AHF) in patients with acute dyspnea with available plasma B-type natriuretic peptide (BNP) level.

METHODS:

Patients with acute dyspnea presenting to the emergency department (ED) of a tertiary medical center were prospectively enrolled. The enrolled 84 patients received both BNP tests and cardiac ultrasound studies and were classified into AHF and non-heart failure groups.

RESULTS:

Plasma BNP levels were higher in the AHF group (1236 ± 1123 vs 354 ± 410 pg/mL; P < .001). The AHF group had larger left ventricular end-diastolic dimension (LVEDD; 32 ± 7 vs 27 ± 4 mm/m(2); P < .001) and worse left ventricular ejection fraction (52% ± 18% vs 64% ± 15%; P = .003). Multiple logistic regression analysis showed that both BNP levels more than 100 pg/mL and LVEDD were independent predictors for AHF. In patients with plasma BNP levels within gray zone of 100 to 500 pg/mL, LVEDD was larger in the AHF group than that in the non-heart failure group (29 ± 4 vs 26 ± 4 mm/m(2); P = .044).

CONCLUSION:

Both LVEDD by cardiac ultrasound and BNP levels can help emergency physicians independently diagnose AHF in the ED. In patients with plasma BNP levels within 100 to 500 pg/mL, cardiac ultrasound can help differentiate heart failure or not.

• Authors: Hsien-Kuo Wang, Min-Shan Tsai, Jia-How Chang, Tzung-Dau Wang, Wen-Jone Chen, Chien-Hua Huang
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 28 Issue 9 Pg. 987-93 (Nov 2010) ISSN: 1532-8171 [Electronic] United States
• PMID: 20825928 (Publication Type: Journal Article)
• Copyright: Copyright © 2010 Elsevier Inc. All rights reserved.

Chemical References

• Natriuretic Peptide, Brain

Topics

• Aged
• Chi-Square Distribution
• Diagnosis, Differential
• Dyspnea (diagnosis, etiology, physiopathology)
• Echocardiography
• Emergency Service, Hospital
• Female
• Heart Failure (blood, diagnosis, diagnostic imaging, physiopathology)
• Humans
• Logistic Models
• Male
• Natriuretic Peptide, Brain (blood)
• Prospective Studies
• ROC Curve
• Stroke Volume (physiology)