Document Detail

Differential diagnosis of acute dyspnea: the value of B natriuretic peptides in the emergency department.
MedLine Citation:
PMID:  18664534     Owner:  NLM     Status:  MEDLINE    
Congestive heart failure (CHF) is the main cause of acute dyspnea in patients presenting to an emergency department (ED) and is associated with high morbidity and mortality. B-type natriuretic peptide (BNP) is a polypeptide, released by ventricular myocytes in direct proportion to wall tension, which lowers renin-angiotensin-aldosterone activation. For the diagnosis of CHF, both BNP and the biologically inactive NT-proBNP have similar accuracy. Threshold values are higher in an elderly population, and in patients with renal dysfunction. They might also have a prognostic value. Studies have demonstrated that the use of BNP or NT-proBNP in dyspneic patients early following admission to the ED, reduced the time to discharge and total treatment cost. BNP and NT-proBNP should be available in every ED 24 h a day, because the literature strongly suggests the beneficial impact of an early appropriate diagnosis and treatment in dyspneic patients. The purpose of this review is to indicate recent developments in biomarkers of heart failure and to evaluate their impact on clinical use in the emergency setting.
P Ray; S Delerme; P Jourdain; C Chenevier-Gobeaux
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Publication Detail:
Type:  Journal Article; Review     Date:  2008-07-29
Journal Detail:
Title:  QJM : monthly journal of the Association of Physicians     Volume:  101     ISSN:  1460-2393     ISO Abbreviation:  QJM     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-21     Completed Date:  2008-12-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9438285     Medline TA:  QJM     Country:  England    
Other Details:
Languages:  eng     Pagination:  831-43     Citation Subset:  IM    
Service d'Accueil des Urgences, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
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MeSH Terms
Acute Disease
Biological Markers / blood
Diagnosis, Differential
Dyspnea / etiology*
Emergency Service, Hospital
Heart Failure / complications*,  diagnosis
Natriuretic Peptide, Brain / blood*
Natriuretic Peptides / blood*
Peptide Fragments / blood*
Sensitivity and Specificity
Reg. No./Substance:
0/Biological Markers; 0/Natriuretic Peptides; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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