BNP in discrimination of cardiac [heart failure] and non-cardiac [pulmonary] dyspnea

ABSTRACT

To evaluate the utility of BNP [B-type natriuretic peptide] in discrimination of cardiac and non-cardiac [Pulmonary] dyspnea. Traditionally the diagnosis of heart failure has been made on the basis of presence of certain signs and symptoms .In case of chronic outpatients, where the physical signs are usually prominent, the diagnosis is easy, whereas in elderly who present to the emergency department with acute dyspnea it is sometimes challenging and often difficult particularly when associated chronic pulmonary diseases are also present. Elevated plasma B-type natriuretic peptide [BNP] has been demonstrated to be a powerful marker for diagnosis and discrimination of dyspnea in the setting of heart failure from a non-cardiac dyspnea. We studied 105 subjects [mean age 51.57 +/- 5.11 yr], 35 presenting to the emergency department with dyspnea due to HF [New York Heart Association [NYHA] class IIIJ, 35 presenting to the emergency department with dyspnea due to pulmonary causes and 35 normal controls, in Dr. HMI Institute of Pharmacology and Herbal Sciences in collaboration with Arif Medical complex Karachi From June 2004 to Dec 2004. Results: Baseline characteristics of the two groups were similar. Their serum levels of BNP were estimated and compared. Levels of serum BNP in patients with HF were found to be significantly high as compared to the non-cardiac dyspneic patients and control subjects [680 +/- 45.20,375.2I +/- 25.63 and 78.45 +/- 16.44 respectively]. BNP level can be a useful tool in differentiation of a heart failure patient from a non-cardiac patient presenting to the emergency department with dyspnea