[The diagnostic value of NT-proBNP in heart failure: in depth analysis].

Abstract

A 77-year-old man with dyspnoea was suspected to have a decompensatio cordis by the general practitioner. A diuretic was prescribed. Additional radiological and laboratory investigation (e.g. natriuretic peptides and D-dimers) showed pulmonary embolism instead of heart failure. A second patient, a woman aged 79 years, with a history of leukaemic mantle cell lymphoma, was treated with poly-chemotherapy (R-CHOP), after which remission was achieved. Four years later the lymphoma recurred and R-CHOP treatment was started. However this was without success, after which R-CHOP treatment was repeated. Subsequently the patient developed dyspnoea and pneumonia. Following additional radiological and laboratory investigation (e.g. natriuretic peptides) the patient was finally diagnosed with doxorubicin-induced heart failure. Based upon these case studies, the role of brain-natriuretic peptides in the differential diagnostic work-up of dyspnoea is highlighted. Test performance, correlation with disease, monitoring, prognostics, differential diagnostic power, reference values and pitfalls of brain natriuretic peptides are discussed.

• Authors: André P van Rossum, L Tom Vlasveld, Lianne S M Boesten
• Journal: Nederlands tijdschrift voor geneeskunde (Ned Tijdschr Geneeskd) Vol. 155 Pg. A2885 ( 2011) ISSN: 1876-8784 [Electronic] Netherlands
• Vernacular Title: De diagnostische waarde van NT-proBNP bij hartfalen.
• PMID: 21447210 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Peptide Fragments
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain
• Doxorubicin

Topics

• Aged
• Diagnosis, Differential
• Doxorubicin (adverse effects, therapeutic use)
• Female
• Heart Failure (blood, chemically induced, diagnosis)
• Humans
• Male
• Natriuretic Peptide, Brain (blood)
• Peptide Fragments (blood)
• Predictive Value of Tests
• Pulmonary Embolism (blood, diagnosis)
• Sensitivity and Specificity