Abstract

Dharminder K. Angurana, Nazir A. Lone, Khursheed A. Khan*, S. Jalal, Rimpi Sangral, Hilal A. Rather, Mohammad S. Alai, Kaiser Habib and Badri N. Bhogal and Vicar M. Jan

The goal of this study was to evaluate the utility of a rapid measurement of BNP in diagnosing heart failure in patients presenting to the emergency department with dyspnea. B- Type natriuretic peptide (BNP) is a protein secreted from the cardiac ventricles in response to pressure and volume overload. One potential application of measurement of BNP is to distinguish dyspnea of cardiac origin from non cardiac causes. BNP levels were measured in 72 patients presenting with dyspnea to the emergency department of a tertiary care hospital. Results of BNP levels were withheld from emergency physician. Two cardiologists reviewed the clinical data, laboratory parameters which included echocardiography and reached a consensus opinion about the diagnosis while being blinded to BNP results. The diagnostic accuracy of the BNP estimation was tested. The mean BNP concentration in patients with CHF (n= 44) was significantly higher than in patients without CHF (399+289.2 pg/ml versus 84.9+42.4 pg/ml (p<0. 001). Univariate analysis of plasma BNP level at different cut off levels revealed that, a value of 175 pg/ml had a sensitivity of 81.8%, specificity of 96.4% and accuracy of 87.5% for differentiating CHF from lung disease. BNP measurements added significant, independent explanatory power to other clinical variables used in predicting CHF. Rapid measurement of BNP appears to be a sensitive and specific test for differentiating patients with heart failure from those without, in urgent care setting.