PMID- 12866774
OWN - NLM
STAT- MEDLINE
DCOM- 20030822
LR  - 20191210
IS  - 0125-2208 (Print)
IS  - 0125-2208 (Linking)
VI  - 86 Suppl 1
DP  - 2003 May
TI  - Role of the plasma brain natriuretic peptide in differentiating patients with 
      congestive heart failure from other diseases.
PG  - S87-95
AB  - BACKGROUND: Heart failure (HF) is primarily a disease of the elderly. The 
      incidence of congestive heart failure (CHF) in Thailand has been increasing 
      during the last 10 years. Unlike other diseases, physicians have only rough 
      patients' symptoms and physical findings to guide the adequacy of treatment. 
      Recently, there has been evidence of the role of brain natriuretic peptide (BNP) 
      and its use in HF concerning diagnosis, prognosis, and treatment follow-up. The 
      purpose of this study was to determine the sensitivity and specificity of 
      N-terminal part of brain natriuretic peptide plasma level (NT-proBNP) in the 
      diagnosis of HF in Thai patients who presented with dyspnea. METHOD: The design 
      was a cross sectional study. The authors enrolled 50 consecutive patients from 
      the Respiratory Unit with dyspnea from chronic obstructive pulmonary disease 
      (COPD), asthma, or anxiety. The cardiovascular cause of dyspnea such as pulmonary 
      emboli and poor left ventricular ejection fraction (LVEF) were excluded. Forty 
      eight consecutive patients with evidence of HF who presented to the Cardiac 
      Center with a history of dyspnea on exertion were assigned as cases. Five 
      milliliters of venous blood samples were taken and sent together with 200 samples 
      from a normal healthy population from the check up department for NT-proBNP 
      measurement. RESULTS: In case and control groups, there were no statistical 
      significances in sex (males 68.8% vs females 52.0%, p > 0.05) and age (63.3 +/- 
      14.9 vs 55.6 +/- 16.9; p > 0.05). The mean left ventricular ejection fraction in 
      the case group was 32.4 +/- 9.7 per cent. There was significant difference 
      between value of NT-proBNP in the control group (386 +/- 1,041 pg/ml) and in the 
      case group (8,912 +/- 12,525 pg/ml, p < 0.001). To diagnose HF in patients who 
      presented with dyspnea using the cut-off value of NT-proBNP at > 150 pg/ml in 
      patients with dyspnea the sensitivity was 96 per cent, and the specificity of 72 
      per cent; at > 200 pg/ml the sensitivity was 96 per cent and the specificity was 
      80 per cent and at > 300 pg/ml the sensitivity was 94 per cent and specificity of 
      82 per cent. Plasma level of NT-proBNP increased significantly with increasing 
      New York Heart Association (NYHA) functional class (class II: 1,107 +/- 1,091 
      pg/ml; class III: 5,097 +/- 4,201 pg/ml, class IV: 19,389 +/- 15,966 pg/ml p < 
      0.01). There was no significant difference of plasma NT-proBNP levels in patients 
      with ischemic (8,586 +/- 11,601 pg/ml; n = 35) and those with non ischemic 
      cardiomyopathy (9,789 +/- 15,229 pg/ml; n = 13). Plasma NT-proBNP was associated 
      with neck vein distension (p < 0.05) but there was no significant association 
      with S3, paroxysmal nocturnal dyspnea, rales, cardiomegaly, acute pulmonary 
      edema, serum sodium (r = 0.22), ejection fraction (r = -0.18) and subsequent 
      hospital death (p > 0.05). CONCLUSION: Measurement of plasma NT-proBNP proved to 
      be a useful diagnostic test in differentiating HF from other causes in patients 
      who presented with dyspnea.
FAU - Sirithunyanont, Chirasak
AU  - Sirithunyanont C
AD  - Bangkok Heart Institute, Bangkok Hospital, Bangkok 10320, Thailand.
FAU - Leowattana, Wattana
AU  - Leowattana W
FAU - Sukumalchantra, Yosvi
AU  - Sukumalchantra Y
FAU - Chaisupamonkollarp, Somsak
AU  - Chaisupamonkollarp S
FAU - Watanawaroon, Sermkit
AU  - Watanawaroon S
FAU - Chivatanaporn, Bhanu
AU  - Chivatanaporn B
FAU - Bhuripanyo, Kiertijai
AU  - Bhuripanyo K
FAU - Mahanonda, Nithi
AU  - Mahanonda N
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - Thailand
TA  - J Med Assoc Thai
JT  - Journal of the Medical Association of Thailand = Chotmaihet thangphaet
JID - 7507216
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cross-Sectional Studies
MH  - Diagnosis, Differential
MH  - Female
MH  - Heart Failure/*blood/*diagnosis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Predictive Value of Tests
MH  - Sensitivity and Specificity
MH  - Thailand
EDAT- 2003/07/19 05:00
MHDA- 2003/08/23 05:00
CRDT- 2003/07/19 05:00
PHST- 2003/07/19 05:00 [pubmed]
PHST- 2003/08/23 05:00 [medline]
PHST- 2003/07/19 05:00 [entrez]
PST - ppublish
SO  - J Med Assoc Thai. 2003 May;86 Suppl 1:S87-95.