The Role of B-Type Natriuretic Peptide in the Diagnosis of Congestive Heart Failure in Patients Presenting to an Emergency Department with Dyspnea

Villacorta, Humberto; Duarte, Adriana; Duarte, Neison Marques; Carrano, Angela; Mesquita, Evandro Tinoco; Hj, Dohmann; Ferreira, Francisco Eduardo G

doi:10.1590/s0066-782x2002001500002

Cited by 44 publications

(36 citation statements)

References 16 publications

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“…5,6) It has been reported that BNP levels can be used as a tool to monitor the treatment of patients with CHF as well as for the differential diagnosis of dyspnea. [7][8][9][10] This means that BNP is not only of diagnostic value, but is also important for prognostic purposes and the evaluation of therapy. [11][12][13][14] In recent years, BNP assay has been applied in cardiac pacing.…”

Section: Discussionmentioning

confidence: 99%

<b>Blood B-Type Natriuretic Peptide Changes in Different Periods and Different Cardiac Pacing Modes</b>

Wang

Wen-ping

et al. 2005

Int. Heart J.

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SUMMARYTo observe blood B-type natriuretic peptide (BNP) level changes and the clinical implications in different periods and different cardiac pacing modes, the BNP levels of 105 patients with permanent cardiac pacing were assayed before pacemaker implantation and 1 day, 1 week, 1 month, 3 months, 6 months, and 9 months postoperatively. BNP level changes were compared in different periods and during different pacing modes. DDD(R) pacing mode was performed in 32 patients for 9 months and then changed to AAI(R) and VVI(R) pacing modes for 2 months, respectively. BNP levels were assayed during three different pacing modes.BNP levels did not change at any time with any pacing mode in patients with New York Heart Association (NYHA) heart functional class I to II before pacemaker implantation, however, BNP levels did change significantly with physiologic pacing mode and nonphysiologic pacing mode in patients with NYHA heart functional class III to IV before pacemaker implantation. BNP levels during physiologic pacing mode decreased significantly while it increased during nonphysiologic pacing mode. BNP levels were the lowest in AAI(R) pacing and the highest in VVI(R) pacing among the three pacing modes. The BNP level in DDD(R) pacing was between that for AAI(R) pacing and VVI(R) pacing.The results indicate that physiologic pacing should first be chosen in patients with bradycardia and congestive heart failure (CHF), and that AAI(R) was the best pacing mode if atrioventricular conduction function was normal. (Int Heart J 2005; 46: 1015-1022 Key words: B-type natriuretic peptide, Pacing mode, Congestive heart failure, Physiologic pacing, Nonphysiologic pacing IN recent years, the indications of cardiac pacing have expanded continuously with the rapid development of pacing techniques. Pacemaker treatment is not only limited to arrhythmias of bradycardia and the number of pacemaker treatments has increased year by year. However, more and more cases of new congesFrom the

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Section: Discussionmentioning

confidence: 99%

<b>Blood B-Type Natriuretic Peptide Changes in Different Periods and Different Cardiac Pacing Modes</b>

Wang

Wen-ping

et al. 2005

Int. Heart J.

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“…Of note, the nucleic acid sequence of the BNP gene contains the destabilizing sequence "tatttat", which suggests that the turnover of BNP messenger RNA is high and that BNP is synthesized in bursts, differently from atrial natriuretic peptide, which is synthesized and stored in granules within the atria (Nakagawa et al 1995, Villacorta et al 2002. For the latter reasons, BNP has a short half-life, around 22 min , and its determination represents a more dynamic parameter of cardiac function.…”

Section: Discussionmentioning

confidence: 99%

Brain natriuretic peptide and left ventricular dysfunction in chagasic cardiomyopathy

Talvani

Rocha

Cogan³

et al. 2004

Mem. Inst. Oswaldo Cruz

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“…Using tests for BNP or NT-proBNP improves diagnosis of HF in patients presenting with acute dyspnea in the ED as demonstrated in several seminal studies (Tables 1 & 2) [12,[34][35][36][37][38][39][40][41]. The use of optimal cutoff values allows physicians to quickly rule out or rule in HF as a cause of patient symptoms.…”

Section: Differential Diagnosis In Patients With Acute Dyspneamentioning

confidence: 99%

“…Multiple single center studies demonstrated the usefulness of BNP as a diagnostic tool in the ED [12,[34][35][36][37][38][39][40][41] and this was validated by the Breathing Not Properly (BNP) Multinational Study [42]. In this study, BNP was tested in a large (N=1586) multicenter, prospective, blinded, and adjudicated format, and it demonstrated that utilization of BNP testing lead to more accurate diagnoses than ED physician judgment based on patient history, physical findings, chest xray, and other laboratory values [42].…”

Section: Differential Diagnosis In Patients With Acute Dyspneamentioning

confidence: 99%

Comprehensive Review of the Relative Clinical Utility of B-Type Natriuretic Peptide and N-Terminal Pro-B-Type Natriuretic Peptide Assays in Cardiovascular Disease

McCullough¹,

Neyou²

2009

TOHFJ

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Measurable B-type natriuretic peptides, which are largely produced by the left ventricle, include B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). These proteins are released by cardiomyocytes in response to wall-tension and neurohumoral signals. In this review the literature is summarized to date with respect to the approved indications for testing which include the diagnostic evaluation and prognosis of heart failure. PubMed in 2009 was searched and 5496 references were reduced to 242 studies that reported on either diagnosis, prognosis, screening, or monitoring of heart failure. In head-to-head diagnostic comparisons, 58 studies measured both assays, and 11 studies in adults that included at least 100 patients compared commercially available tests. We performed the analogous search in acute coronary syndromes (ACS) and found 82 articles of which 11 papers focused on the study of BNP and NT-proBNP in either stable angina, non-ST-segment elevation myocardial infarction or ST-segment elevation myocardial infarction. For heart failure diagnosis, BNP and NT-proBNP had similar decision statistics; however, while optimal diagnostic cutpoints for both markers varied depended on age and degree of renal dysfunction, and the clinical application; NT-proBNP had a much more widely variable optimal cutpoint than did BNP. Sufficient evidence for clinical utility of both tests exists for other applications of prognosis, screening, and monitoring of heart failure. In addition, both tests have a role in the risk stratification of all forms of ACS. Future trials of clinical strategies are warranted using these tools in advancing both inpatient and outpatient management of heart failure and ACS.

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The Role of B-Type Natriuretic Peptide in the Diagnosis of Congestive Heart Failure in Patients Presenting to an Emergency Department with Dyspnea

Abstract: BNP measurement is a useful tool in the diagnosis of CHF in patients presenting to the ED with dyspnea.

Cited by 44 publications

References 16 publications

<b>Blood B-Type Natriuretic Peptide Changes in Different Periods and Different Cardiac Pacing Modes</b>

<b>Blood B-Type Natriuretic Peptide Changes in Different Periods and Different Cardiac Pacing Modes</b>

Brain natriuretic peptide and left ventricular dysfunction in chagasic cardiomyopathy

Comprehensive Review of the Relative Clinical Utility of B-Type Natriuretic Peptide and N-Terminal Pro-B-Type Natriuretic Peptide Assays in Cardiovascular Disease

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