B-Type Natriuretic Peptide and Echocardiographic Determination of Ejection Fraction in the Diagnosis of Congestive Heart Failure in Patients With Acute Dyspnea

Steg, Philippe Gabriel; Joubin, Laurence; McCord, James; Abraham, William T.; Hollander, Judd E.; Omland, Torbjørn; Mentré, France; McCullough, Peter A.; Maisel, Alan S.

doi:10.1378/chest.128.1.21

Cited by 73 publications

(58 citation statements)

References 30 publications

(35 reference statements)

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“…(25,26) A BNP of > 100pg/mL has been shown to provide relatively high sensitivity (89%) and specifi city (73%) for diagnosing HF. (7,27) From a cost perspective, the unit cost of BNP is disproportionately more expensive compared to ECG but, due to differences in sensitivity and specifi city in detecting HF, BNP becomes equally cost-effective as ECG. (7) These authors report that the gold standard strategy of traditional echocardiography alone was least cost-effective for screening, supporting that the ECG (or BNP) can be used cost-effectively for screening.…”

Section: Discussionmentioning

confidence: 99%

Are ECG abnormalities common in black Africans with heart failure? Results from the Heart of Soweto study

Lee

Carrington

Sliwa³

et al. 2017

SAHJ

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Background: The "Heart of Soweto" study is currently examining the pattern of cardiovascular disease (CVD) in Soweto, South Africa. Methods: As part of a large clinical registry of CVD patients presenting to the Chris Hani Baragwanath Hospital in Soweto, a 12-lead ECG was performed on 91% of "de novo" cases in 2006. Systematic analysis of the ECGs of heart failure patients was performed using detailed Minnesota coding. Results: A total of 756 de novo patients with HF (57% women, 88% Black African and mean age of 55 ± 16 years) had a 12-lead ECG. Overall, a major ECG abnormality was detected in 91% of cases consisting of ST segment changes, T wave changes, bundle branch blocks and arrhythmias. Minor abnormalities were noted in 97% of ECGs, such as axis deviation and high amplitude R waves. Left ventricular hypertrophy was evident in 15% (22% in those with a dilated cardiomyopathy) and a bundle branch block in 8% of ECGs (11% in those with an ischemic cardiomyopathy). Conclusion: Detailed examination of 12-lead ECGs of a large group of previously undiagnosed patients with HF in the Heart of Soweto study revealed many identifi able abnormalities. In addition to reconfi rming the clinical utility of this cheap and practical diagnostic tool, these data highlight its potential role in screening for heart disease, particularly in low income communities. ABSTRACT ECG ABNORMALITIES IN HEART FAILURE5

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Section: Discussionmentioning

confidence: 99%

Are ECG abnormalities common in black Africans with heart failure? Results from the Heart of Soweto study

Lee

Carrington

Sliwa³

et al. 2017

SAHJ

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“…On the other hand, patients without systolic dysfunction but with HF may be inaccurately diagnosed as non-HF cases based on the echocardiographic findings. Steg et al (19) showed that an assessment of the BNP levels is superior to echocardiography for the diagnosis of HF on the basis of the ROC curve.…”

Section: Discussionmentioning

confidence: 99%

“…However, the cut-off values varied among these studies. One of the reasons is that different populations were studied (19). Most of the previous studies were conducted in Western countries, except for one study from Korea.…”

Section: Cut-off Values In the Previous Studiesmentioning

confidence: 99%

The Optimal Cut-off Value of Plasma BNP to Differentiate Heart Failure in the Emergency Department in Japanese Patients with Dyspnea

et al. 2015

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Objective In the emergency department, it is sometimes difficult to differentiate heart failure (HF) from other diseases (e.g., respiratory diseases) in patients who develop dyspnea. The plasma B-type natriuretic peptide (BNP) levels increase in patients with HF, and various levels are associated with specific New York Heart Association classes. Although the diagnosis of HF should not be made based only on the plasma BNP levels, the identification of a cut-off value for BNP to diagnose HF would be helpful. Methods Patients admitted to the emergency department of our hospital with dyspnea between January 2010 and December 2011 were retrospectively reviewed. The patients whose estimated glomerular filtration rate was less than 30 mL/min/1.73 m 2 were excluded. Patients were divided into two groups: those with HF (n=131) and those without HF (n=138). The cut-off value for BNP was determined by the receiver-operating characteristic curve. Results The area under the curve of this curve was 0.934. The optimal cut-off point for detection of HF was 234 pg/mL. The sensitivity and specificity were 87.0% and 85.5%, respectively. The fifth and 95th percentiles of the HF group were 132.2 and 2,420.8 pg/mL, respectively. Those of the non-HF group were 9.7 and 430.2 pg/mL, respectively. Conclusion Our study suggests that a plasma BNP level cut-off value of 234 pg/mL can be used to detect HF in the emergency department.

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“…Die präthera-peutischen BNP-Spiegel der CSA-CSR-OSA-Gruppe lagen im Vergleich zu der CSA-CSR-Gruppe durchschnittlich höher, posttherapeutisch bestand kein Unterschied. AHI, dem Desaturationsindex und der Schwere der kardialen Erkrankung [31,32]. Es wird als der zweidimensionalen Echokardiografie überlegen in der Identifikation einer Herzinsuffizienz beschrieben [31] und stellt einen sensitiven Marker nicht nur für die systolische, sondern auch für die diastolische Herzinsuffizienz dar [20 -22].…”

Section: Ein-und Ausschlusskriterienunclassified

“…AHI, dem Desaturationsindex und der Schwere der kardialen Erkrankung [31,32]. Es wird als der zweidimensionalen Echokardiografie überlegen in der Identifikation einer Herzinsuffizienz beschrieben [31] und stellt einen sensitiven Marker nicht nur für die systolische, sondern auch für die diastolische Herzinsuffizienz dar [20 -22]. Aus diesen Gründen wurde in der eigenen Untersuchung das erhöhte BNP als Marker für die Schwere der Herzinsuffizienz herangezogen.…”

Section: Ein-und Ausschlusskriterienunclassified

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Pneumologie

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B-Type Natriuretic Peptide and Echocardiographic Determination of Ejection Fraction in the Diagnosis of Congestive Heart Failure in Patients With Acute Dyspnea

Cited by 73 publications

References 30 publications

Are ECG abnormalities common in black Africans with heart failure? Results from the Heart of Soweto study

Are ECG abnormalities common in black Africans with heart failure? Results from the Heart of Soweto study

The Optimal Cut-off Value of Plasma BNP to Differentiate Heart Failure in the Emergency Department in Japanese Patients with Dyspnea

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