Document Detail

Rapid brain natriuretic peptide test and Doppler echocardiography for early diagnosis of mild heart failure.
MedLine Citation:
PMID:  16873293     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The early identification of patients at risk for the development of clinical heart failure (HF) is a new challenge in an effort to improve outcomes. METHODS: We prospectively evaluated whether the combination of brain natriuretic peptide (BNP) measurements (Triage BNP test, Biosite Diagnostics) and echocardiography would effectively stratify patients with new symptoms in a cost-effective HF program aimed at early diagnosis of mild HF. A total of 252 patients were referred by 100 general practitioners. RESULTS: Among the study population, the median BNP value was 78 ng/L (range, 5-1491 ng/L). BNP concentrations were lower among patients without heart disease [median 15 ng/L (range, 5-167 ng/L); n = 96] than among patients with confirmed HF [median, 165 ng/L (22-1491 ng/L); n = 157; Mann-Whitney U-test, 12.3; P <0.001]. Patients were grouped into diastolic dysfunction [BNP, 195 (223) ng/L], systolic dysfunction [BNP, 290 (394) ng/L], and both systolic and diastolic dysfunction [BNP, 776 (506) ng/L]. In this model, a cutoff value of 50 ng/L BNP increases the diagnostic accuracy in predicting mild HF, avoiding 41 echocardiograms per 100 patients studied, with a net saving of 14% of total costs. CONCLUSIONS: Blood BNP concentrations, in a cost effective targeted screening, can play an important role in diagnosing mild HF and stratifying patients into risk groups of cardiac dysfunction.
Nadia Aspromonte; Vincenzo Ceci; Antonella Chiera; Claudio Coletta; Alessandra D'Eri; Mauro Feola; Prospero Giovinazzo; Loredano Milani; Federica Noventa; Angela Beatrice Scardovi; Augusto Sestili; Roberto Valle
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2006-07-27
Journal Detail:
Title:  Clinical chemistry     Volume:  52     ISSN:  0009-9147     ISO Abbreviation:  Clin. Chem.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-30     Completed Date:  2006-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421549     Medline TA:  Clin Chem     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1802-8     Citation Subset:  IM    
Heart Failure Unit and Department of Cardiology, Santo Spirito Hospital, Rome, Italy.
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MeSH Terms
Aged, 80 and over
Cardiac Output, Low / blood,  diagnosis*,  ultrasonography
Cardiology Service, Hospital
Early Diagnosis
Echocardiography, Doppler
Logistic Models
Middle Aged
Multivariate Analysis
Natriuretic Peptide, Brain / blood*
Prospective Studies
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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