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Pleural Fluid Amino-Terminal Brain Natriuretic Peptide in Patients With Pleural Effusions.
MedLine Citation:
PMID:  22710710     Owner:  NLM     Status:  Publisher    
BACKGROUND: Definite diagnosis of transudative or exudative pleural fluids often presents a diagnostic dilemma. The aim of this study was to evaluate whether amino-terminal brain natriuretic peptide (NT-proBNP) levels in pleural fluid has a diagnostic value for discriminating heart failure (HF) related pleural effusions from non-HF effusions. METHODS: Sixty-six patients (40 male, mean age: 61±18 years) with pleural effusions were included. Samples of pleural fluid and serum were obtained simultaneously from each patient. Biochemical analysis, bacterial and fungal culture, acid-fast bacilli smear and culture and cytology were performed on the pleural fluid. RESULTS: Patients with HF related pleural effusion had significantly higher pleural NTproBNP levels than other patients (p<0.001). Pleural and serum NT-proBNP measures were closely correlated (r=0.900; p<0.001). An NT-proBNP cut-off value of ≥2300 pg/mL in pleural fluid had a sensitivity of 70.8%, specificity of 97.6% with positive and negative predictive values of 94.4% and 85.4%, respectively for discriminating transudates caused by HF from exudates. Eight HF patients were misclassified as exudates by Light's criteria, 5 of which received diuretics before thoracentesis. All misclassified patients had pleural NTproBNP levels higher than 1165pg/mL, which predicted HF associated transudates with 95.8% sensitivity and 85.7% specificity. CONCLUSION: Pleural fluid NT-proBNP measurement in the routine diagnostic panel may be useful in differentiation of HF related pleural effusions and exudative pleural fluids with reasonable accuracy, especially in HF patients treated with diuretics.
Altug Cincin; Yasin Abul; Beste Ozben; Azra Tanrikulu; Nurhayat Topaloglu; Gulsevil Ozgul; Sait Karakurt; Ahmet Oktay
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-15
Journal Detail:
Title:  Respiratory care     Volume:  -     ISSN:  0020-1324     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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