The role of plasma B-type natriuretic peptide measurements in the differential diagnosis of acute dyspnea

Ji-yong Moon, Joong Ho Bae, Tae-Hyung Kim, Won Sohn Jang, Ho Joo Yoon, Dong Ho Shin, Sung Soo Park

Research output: Contribution to journalArticle

Abstract

Background: The B-type natriuretic peptide (BMP) is a cardiac neurohormone that is specifically secreted from the ventricles in response to volume expansion and a pressure overload Differentiating congestive heart failure from the pulmonary causes of dyspnea is very important for patients presenting with acute dyspnea Methods: A retrospective study was carried out on 261 patients who were admitted to the emergency department of Hanyang University Hospital due to acute dyspnea from March to July 2004. The serum BNP levels of the patients were measured using the ELISA method. Results: The BNP levels were 382, 111-1140 pg/ml (median, interquartile range) in the heart failure group (n=119) and 29, 7-81 pg/ml in the non-heart failure group (n=142). The BNP levels according to the subgroups of heart failure were 820, 354-1620 pg/ml, 1650, 239-1990 pg/ml, and 378, 106-1120 pg/ml for the chronic obstructive pulmonary disease (COPD) with combined left heart failure (n=5), cor pulmonale (n=3), and left heart failure groups (n=111), respectively. The BNP levels according to the subgroups of non-heart failure were 39, 21-101 pg/ml, 59, 10-129 pg/ml, and 15, 647 pg/ml for the COPD (n=20), other pulmonary diseases (n=56), and other causes groups (n=66), respectively. The BNP levels were significantly different according to the underlying etiology (p<0.001), and were significantly higher in the COPD patients with left heart failure than in those without (p=0.002). When the patients with no cardiovascular risk factor such as diabetes mellitus, hypertension, smoking or renal failure were analyzed the BNP levels were also significantly higher in the patients with heart failure than in those without (p<0.001). When 133 pg/ml was designated as the BNP cut-off level the sensitivity for predicting heart failure was 73 percent and the specificity was 87 percent. Conclusion: BNP measurements are useful for determining the presence of heart failure in the patients presenting with acute dyspnea. The possibility of heart failure must be seriously considered in patients with high BNP levels even when they have a pre-existing pulmonary disease such as COPD or no risk factors for heart failure.

Original languageEnglish
Pages (from-to)656-663
Number of pages8
JournalTuberculosis and Respiratory Diseases
Volume59
Issue number6
DOIs
StatePublished - 2005 Jan 1

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Brain Natriuretic Peptide
Dyspnea
Differential Diagnosis
Heart Failure
Chronic Obstructive Pulmonary Disease
Lung Diseases
Pulmonary Heart Disease
Preexisting Condition Coverage
Renal Insufficiency
Neurotransmitter Agents
Hospital Emergency Service
Diabetes Mellitus
Retrospective Studies
Smoking
Enzyme-Linked Immunosorbent Assay
Hypertension
Pressure

Keywords

  • Dyspnea
  • Heart failure, congestive
  • Natriuretic Peptide, Brain
  • Pulmonary Disease, Chronic Obstructive

Cite this

@article{5927db92991a4f69a7d95de72518b897,
title = "The role of plasma B-type natriuretic peptide measurements in the differential diagnosis of acute dyspnea",
abstract = "Background: The B-type natriuretic peptide (BMP) is a cardiac neurohormone that is specifically secreted from the ventricles in response to volume expansion and a pressure overload Differentiating congestive heart failure from the pulmonary causes of dyspnea is very important for patients presenting with acute dyspnea Methods: A retrospective study was carried out on 261 patients who were admitted to the emergency department of Hanyang University Hospital due to acute dyspnea from March to July 2004. The serum BNP levels of the patients were measured using the ELISA method. Results: The BNP levels were 382, 111-1140 pg/ml (median, interquartile range) in the heart failure group (n=119) and 29, 7-81 pg/ml in the non-heart failure group (n=142). The BNP levels according to the subgroups of heart failure were 820, 354-1620 pg/ml, 1650, 239-1990 pg/ml, and 378, 106-1120 pg/ml for the chronic obstructive pulmonary disease (COPD) with combined left heart failure (n=5), cor pulmonale (n=3), and left heart failure groups (n=111), respectively. The BNP levels according to the subgroups of non-heart failure were 39, 21-101 pg/ml, 59, 10-129 pg/ml, and 15, 647 pg/ml for the COPD (n=20), other pulmonary diseases (n=56), and other causes groups (n=66), respectively. The BNP levels were significantly different according to the underlying etiology (p<0.001), and were significantly higher in the COPD patients with left heart failure than in those without (p=0.002). When the patients with no cardiovascular risk factor such as diabetes mellitus, hypertension, smoking or renal failure were analyzed the BNP levels were also significantly higher in the patients with heart failure than in those without (p<0.001). When 133 pg/ml was designated as the BNP cut-off level the sensitivity for predicting heart failure was 73 percent and the specificity was 87 percent. Conclusion: BNP measurements are useful for determining the presence of heart failure in the patients presenting with acute dyspnea. The possibility of heart failure must be seriously considered in patients with high BNP levels even when they have a pre-existing pulmonary disease such as COPD or no risk factors for heart failure.",
keywords = "Dyspnea, Heart failure, congestive, Natriuretic Peptide, Brain, Pulmonary Disease, Chronic Obstructive",
author = "Ji-yong Moon and Bae, {Joong Ho} and Tae-Hyung Kim and Jang, {Won Sohn} and Yoon, {Ho Joo} and Shin, {Dong Ho} and Park, {Sung Soo}",
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The role of plasma B-type natriuretic peptide measurements in the differential diagnosis of acute dyspnea. / Moon, Ji-yong; Bae, Joong Ho; Kim, Tae-Hyung; Jang, Won Sohn; Yoon, Ho Joo; Shin, Dong Ho; Park, Sung Soo.

In: Tuberculosis and Respiratory Diseases, Vol. 59, No. 6, 01.01.2005, p. 656-663.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The role of plasma B-type natriuretic peptide measurements in the differential diagnosis of acute dyspnea

AU - Moon, Ji-yong

AU - Bae, Joong Ho

AU - Kim, Tae-Hyung

AU - Jang, Won Sohn

AU - Yoon, Ho Joo

AU - Shin, Dong Ho

AU - Park, Sung Soo

PY - 2005/1/1

Y1 - 2005/1/1

N2 - Background: The B-type natriuretic peptide (BMP) is a cardiac neurohormone that is specifically secreted from the ventricles in response to volume expansion and a pressure overload Differentiating congestive heart failure from the pulmonary causes of dyspnea is very important for patients presenting with acute dyspnea Methods: A retrospective study was carried out on 261 patients who were admitted to the emergency department of Hanyang University Hospital due to acute dyspnea from March to July 2004. The serum BNP levels of the patients were measured using the ELISA method. Results: The BNP levels were 382, 111-1140 pg/ml (median, interquartile range) in the heart failure group (n=119) and 29, 7-81 pg/ml in the non-heart failure group (n=142). The BNP levels according to the subgroups of heart failure were 820, 354-1620 pg/ml, 1650, 239-1990 pg/ml, and 378, 106-1120 pg/ml for the chronic obstructive pulmonary disease (COPD) with combined left heart failure (n=5), cor pulmonale (n=3), and left heart failure groups (n=111), respectively. The BNP levels according to the subgroups of non-heart failure were 39, 21-101 pg/ml, 59, 10-129 pg/ml, and 15, 647 pg/ml for the COPD (n=20), other pulmonary diseases (n=56), and other causes groups (n=66), respectively. The BNP levels were significantly different according to the underlying etiology (p<0.001), and were significantly higher in the COPD patients with left heart failure than in those without (p=0.002). When the patients with no cardiovascular risk factor such as diabetes mellitus, hypertension, smoking or renal failure were analyzed the BNP levels were also significantly higher in the patients with heart failure than in those without (p<0.001). When 133 pg/ml was designated as the BNP cut-off level the sensitivity for predicting heart failure was 73 percent and the specificity was 87 percent. Conclusion: BNP measurements are useful for determining the presence of heart failure in the patients presenting with acute dyspnea. The possibility of heart failure must be seriously considered in patients with high BNP levels even when they have a pre-existing pulmonary disease such as COPD or no risk factors for heart failure.

AB - Background: The B-type natriuretic peptide (BMP) is a cardiac neurohormone that is specifically secreted from the ventricles in response to volume expansion and a pressure overload Differentiating congestive heart failure from the pulmonary causes of dyspnea is very important for patients presenting with acute dyspnea Methods: A retrospective study was carried out on 261 patients who were admitted to the emergency department of Hanyang University Hospital due to acute dyspnea from March to July 2004. The serum BNP levels of the patients were measured using the ELISA method. Results: The BNP levels were 382, 111-1140 pg/ml (median, interquartile range) in the heart failure group (n=119) and 29, 7-81 pg/ml in the non-heart failure group (n=142). The BNP levels according to the subgroups of heart failure were 820, 354-1620 pg/ml, 1650, 239-1990 pg/ml, and 378, 106-1120 pg/ml for the chronic obstructive pulmonary disease (COPD) with combined left heart failure (n=5), cor pulmonale (n=3), and left heart failure groups (n=111), respectively. The BNP levels according to the subgroups of non-heart failure were 39, 21-101 pg/ml, 59, 10-129 pg/ml, and 15, 647 pg/ml for the COPD (n=20), other pulmonary diseases (n=56), and other causes groups (n=66), respectively. The BNP levels were significantly different according to the underlying etiology (p<0.001), and were significantly higher in the COPD patients with left heart failure than in those without (p=0.002). When the patients with no cardiovascular risk factor such as diabetes mellitus, hypertension, smoking or renal failure were analyzed the BNP levels were also significantly higher in the patients with heart failure than in those without (p<0.001). When 133 pg/ml was designated as the BNP cut-off level the sensitivity for predicting heart failure was 73 percent and the specificity was 87 percent. Conclusion: BNP measurements are useful for determining the presence of heart failure in the patients presenting with acute dyspnea. The possibility of heart failure must be seriously considered in patients with high BNP levels even when they have a pre-existing pulmonary disease such as COPD or no risk factors for heart failure.

KW - Dyspnea

KW - Heart failure, congestive

KW - Natriuretic Peptide, Brain

KW - Pulmonary Disease, Chronic Obstructive

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