Diagnostic value of NT-BroBNP in HF patients admitted with dyspnea in Emergency Department

ABSTRACT

Considering the increasing prevalence of patients with dyspnea and the possibility of heart disease, as well as unavailability of echocardiography specially in primary care situations and unreliability of echocardiography findings in some diseases and finding NTProBNP as a diagnostic factor in heart failure in these patients, this study was done to determine the accuracy of NTProBNP in comparison to echocardiography in the diagnosis of heart failure in Modarress Hospital, in Tehran, between 2006 and 2007. This study, with a clinical trial diagnostic design, was performed on patients with chief complaint of dyspnea. The NTProBNP marker of serum was determined by Elecsys and patients were categorized according to age adjusted reference book values into two groups of with and without heart failure. Then, the patients underwent Simpson Echocardiography and Tissue Doppler; and the positive and negative predictive value for NTProBNP in relation to the echocardiography was determined and analyzed by statistical tests. One hundred patients were analyzed. Mean age was 59 +/- 11.8 years and 70% were male. PPV was 84%, NPV was 70.4%, false positive was 16%, while false negative was 29.5%. Sensitivity was 78%, specificity 77%, and accuracy was equal to 78%. It seems that NTProBNP marker is a good test for screening patients with dyspnea and besides clinical criteria it has an acceptable diagnostic value. It would be good to perform other studies, using more precise laboratory methods and reevaluation of cut point especially for Iranian patients considering factors other than age to obtain a rapid, easy, and costeffective test in primary care