Brain natriuretic peptide (BNP) in differential diagnosis of dyspnea.

BACKGROUND: The differentiation of congestive heart failure from pulmonary cause of dyspnea is of extreme importance in patients presenting with acute shortness of breath. It seems that the use of B-type natriuretic peptide (BNP) can speed up the diagnostic process significantly. MATERIAL AND METHODS: 79 patients (46 men - 58.2%, average 71.9, range 43-92; 33 women - 41.8%, average 75.5, range 51-93). In each of them we measured BNP concentrations by means of rapid fluorescent immunoassay. RESULTS: We divided the patients according to BNP results into two groups: BNP positive and BNP negative. There were 28 BNP negative patients -35.40% (13 men, 15 women). BNP positive patients (51) were divided into NYHA I-IV groups in accordance with BNP results. CONCLUSION: The rapid, highly sensitive and specific measurement of BNP concentrations in the patients with dyspnea can significantly help to differentiate the cardiac and pulmonary causes of dyspnea (Tab. 1, Fig. 1, Ref. 24).

[Occurrence of carcinoid syndrome in patients with carcinoid tumors]. / Výskyt karcinoidného syndrómu u pacientov s karcinoidom.

BACKGROUND: Carcinoid syndrome occurs in about 10% of patients with carcinoid tumors. OBJECTIVES: The main objective of the present study was to determine the presence of the carcinoid syndrome in the group of patients with the carcinoid tumor. SUBJECTS AND METHODS: 43 pts. (22 w/21 m) with carcinoid tumors (M group--26 pts. with metastatic disease, B group--17 pts. after resection of the primary tumor without known metastases at the time of the investigation) were included in the study. We estimated the presence of the carcinoid syndrome in all patients. The urinary excretion of 5-HIAA was performed and echocardiography were done. RESULTS: The amount of the 5-hydroxyindolacetate acid in urine in pts. with metastatic carcinoid was statistically significant higher than in the pts. without metastases (p < 0.001). The carcinoid syndrome in metastatic group we found in 10 patients. Flush had 9, diarhoe 7 pts., and cardiac involvement with endocardial fibrosis had 3 pts. During the treatment with lanreotide the amount of 5-HIAA in urine decreased from 1155 (207.6-1406) to 471 (96.6-1000) mumol/24 h (p < 0.05). During the follow up period 3 patients with carcinoid syndrome died.