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Purpose: To examine accuracy of Emergency Department (ED) physicians and N-terminal (NT) proBNP levels for diagnosing heart failure (HF) in a contemporary cohort of patients hospitalised with acute dyspnoea. Methods: We included 314 consecutive patients with dyspnoea and collected the probability of HF (0-100%) from the ED physicians prior to NT-proBNP measurements. HF was adjudicated according to guidelines by two independent senior physicians. Among non-HF related hospitalisations we also assessed whether there was coexisting myocardial dysfunction, e.g. patient with HF hospitalised due to pneumonia. Results: Mean age was 70±1 y and 143 patients (46%) were diagnosed with HF as the cause of the hospitalisation, of whom 52 patients (36%) had left ventricular ejection fraction≥50%. Several variables previously reported to be predictive of HF were independently associated with a diagnosis of HF in our patients, including NT-proBNP levels. The area under the curve (AUC) for ED physician to differentiate HF patients from the other patients was 0.864 (95% CI 0.821-0.900) compared to AUC=0.859 (0.816-0.896) for NT-proBNP levels, p=0.84. Excluding the patients with non-HF related hospitalisation but coexisting myocardial dysfunction (n=55) improved the AUC for both ED physicians and NT-proBNP levels: 0.898 (0.854-0.932) vs. 0.926 (0.887-0.955), respectively, p=0.17. Conclusion:The accuracy of ED physicians and NT-proBNP for diagnosing HF were sub-optimal in this cohort of elderly subjects hospitalised for acute dyspnoea compared to previous studies, which primarily was caused by a high proportion of coexisting myocardial dysfunction also in the group of patients with non-HF aetiology of the index hospitalisation. P669 | BEDSIDE Repeated echocardiography after first ever ST segment elevation myocardial infarction treated with primary percutaneous coronary intervention, is it necessaryH. Soeholm, J. Loenborg, M.J. Andersen, N. Vejlstrup, T. Engstroem, J.E. Moller, C. Hassager. Rigshospitalet -Copenhagen University Hospital, Heart Centre, Department of Cardiology, Copenhagen, Denmark Purpose: Current guidelines recommend early echocardiography in patients suffering from ST-segment elevation myocardial infarction (STEMI) and routinely left ventricular (LV) function is reassessed after 3 months. However, most studies have been performed in the pre-thrombolysis or thrombolysis era. We sought to assess changes in LV size/function using echocardiography and cardiac magnetic resonance imaging (CMRI) in a contemporary STEMI-population treated with primary percutaneous coronary intervention (pPCI). Method: In a prospective study, 128 patients (age 61±11 years) with first ever STEMI were treated with pPCI and examined with 2D echocardiography and CMRI at baseline (<72hrs) and at follow-up after 3 months. Results: Using 2D echocardiography 44 patients (34%) were found to have preserved LVEF (>50%), 70 patients (55%) to have mild/moderate systolic dysfunction (35-50%) and 14 patients (11%) to have severe systolic dysfunction (<35%) ...

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