The Role of Brain Natriuretic Peptide in the Patients with Acute Dyspnea in the Emergency Department

2007 ◽  
Vol 37 (10) ◽  
pp. 464 ◽  
Author(s):  
Ji Yong Choi
Keyword(s):  
Emergency Department ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Acute Dyspnea

scholarly journals LO55: Role of n-terminal pro brain natriuretic peptide (NT Pro-BNP) in emergency department syncope risk stratification: a multicenter study

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S26-S26
Author(s):  
V. Thiruganasambandamoorthy ◽  
M. L.A. Sivilotti ◽  
A. D. McRae ◽  
I. G. Stiell ◽  
M. Mukarram ◽  
...  
Keyword(s):  
Emergency Department ◽  
Adverse Events ◽  
Risk Stratification ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Multicenter Study ◽  
Structural Heart Disease ◽  
Significant Independent Predictor ◽  
Serious Adverse Events

Introduction: Two published studies reported natriuretic peptides can aid in risk-stratification of Emergency Department (ED) syncope. We sought to assess the role of N-Terminal pro Brain Natriuretic Peptide (NT pro-BNP) to identify syncope patients at risk for serious adverse events (SAE) within 30 days of the ED visit, and its value above that of the Canadian Syncope Risk Score (CSRS). Methods: We conducted a multicenter prospective cohort study at 6 large Canadian EDs from Nov 2011 to Feb 2015. We enrolled adults who presented within 24-hours of syncope and excluded those with persistent altered mentation, obvious seizure, and intoxication. We collected patient characteristics, nine CSRS predictors (includes troponin), ED management and NT pro-BNP levels. Adjudicated serious adverse events (SAE) included death, cardiac SAE (arrhythmias, myocardial infarction, serious structural heart disease) and non-cardiac SAE (pulmonary embolism, severe hemorrhage and procedural interventions within 30-days). We used two tailed t-test and logistic regression analysis. Results: Of the 1359 patients (mean age 57.2 years, 54.7% females, 13.3% hospitalized) enrolled, 148 patients (10.9%; 0.7% deaths, 7.9% cardiac SAE including 6.1% arrhythmia) suffered SAE within 30-days. The mean NT pro-BNP values, when compared to the patients with no SAE (499.8ng/L) was significantly higher among the 56 patients who suffered SAE after ED disposition (3147ng/L, p=0.001), and among the 35 patients with cardiac SAE after ED disposition (2016.2ng/L, p=0.02). While there was a trend to higher levels among patients who suffered arrhythmia after the ED visit, it was not statistically significant (1776.4ng/L, p=0.07). In a model with CSRS predictors, the adjusted odds ratio for NT pro-BNP was 8.0 (95%CI 1.8, 35.9) and troponin was 3.8 (95%CI 1.7, 8.8). The addition of NT pro-BNP did not significantly improve the classification performance (p=0.76) with areas under the curves for CSRS was 0.91 (95%CI 0.88, 0.95) and CSRS with NT pro-BNP was 0.92 (95%CI 0.88, 0.95). Conclusion: In this multicenter study, mean NT pro-BNP levels were significantly higher among ED syncope patients who suffered SAE including cardiac SAE after ED disposition. Though NT pro-BNP was a significant independent predictor of SAE after ED disposition, it did not improve accuracy in ED syncope risk-stratification when compared to CSRS. Hence, we do not recommend NT pro-BNP measurement for ED syncope management.

C-Reactive Protein, Interleukin 6, and N-Terminal Pro-Brain Natriuretic Peptide Following Cardioversion of Atrial Fibrillation: Is There a Role of Biomarkers in Arrhythmia Recurrence?

Angiology ◽  
2010 ◽  
Vol 62 (4) ◽  
pp. 310-316 ◽  
Author(s):  
Stavroula N. Psychari ◽  
Dionyssios Chatzopoulos ◽  
Efstathios K. Iliodromitis ◽  
Thomas S. Apostolou ◽  
Dimitrios T. Kremastinos
Keyword(s):  
Atrial Fibrillation ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Interleukin 6 ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Role of Brain Natriuretic Peptide assay in identifying children with pneumonia complicated by congestive cardiac failure

2018 ◽  
Vol 4 (2) ◽  
pp. 182-188
Author(s):  
Wilson E. Sadoh ◽  
Wilson O. Osarogiagbon
Keyword(s):  
Developing Countries ◽  
Respiratory Distress ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Cardiac Failure ◽  
Congestive Cardiac Failure ◽  
Morbidity And Mortality

Background: Pneumonia in children is a leading cause of morbidity and mortality in developing countries. It is often complicated by Congestive Cardiac Failure (CCF), with some of the symptoms similar to those of pneumonia. Brain Natriuretic Peptide (BNP) assay can differentiate cardiac from respiratory-related causes of respiratory distress. Objective: To determine the role of BNP in differentiating isolated pneumonia from pneumonia complicated by CCF. Methods: Over a 12-month period, consecutive children with radiologically-confirmed pneumonia were recruited for the study. Those with complicating CCF were noted. All the children had blood BNP assay done by ELISA, prior to treatment. Biodata was obtained and the children were grouped into those with isolated pneumonia and those with pneumonia complicated by CCF. Results: Fifty children were recruited; of these 26 (52.0%) had isolated pneumonia while 24 (48.0%) had pneumonia with CCF. The median age of the children was 6 months. The median BNP values for the isolated pneumonia group (229.4 ng/l), was significantly lower than that of pneumonia complicated by CCF group (917.3 ng/l); (p = 0.007). ROC showed that a BNP value >550ng/l could identify children with pneumonia complicated with CCF from those with isolated pneumonia with a sensitivity of 70.4% and specificity of 63.4%. Conclusion: A BNP assay prior to treatment of >550ng/l can differentiate children with pneumonia complicated with CCF from those without CCF.

scholarly journals Brain natriuretic peptide: Diagnostic potential in dogs

2009 ◽  
Vol 63 (5-6) ◽  
pp. 381-392
Author(s):  
Ljubica Spasojevic-Kosic
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Natriuretic Peptides ◽  
Arterial Disease ◽  
Cardiac Insufficiency ◽  
Everyday Clinical Practice ◽  
Coronary Arterial Disease ◽  
Diagnostic Potential ◽  
Adequate Method

The endocrine role of the heart is evident in the secretion of noradrenaline and natriuretic peptides. The secretion of natriuretic peptides presents a useful mechanism for different conditions of cardiac dysfunction. Brain natriuretic peptide (BNP) has been accepted in human cardiology as a biomarker for cardiac insufficiency and coronary arterial disease. The specificity of the BNP structure is specie-specific, so that the testing of diagnostic and prognostic potential in dogs requires the existence of a test that is a homologue for that animal specie. The existence of an adequate method for measuring BNP concentration makes possible its implementation as a screening test in everyday clinical practice. .

scholarly journals Acute cardiac dyspnea in the emergency department: diagnostic value of N-terminal prohormone of brain natriuretic peptide and galectin-3

2018 ◽  
Vol 47 (1) ◽  
pp. 159-172 ◽  
Author(s):  
Alexandra Stoica ◽  
Victoriţa Şorodoc ◽  
Cătălina Lionte ◽  
Irina M. Jaba ◽  
Irina Costache ◽  
...  
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Clinical Manifestations ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Diagnostic Methods ◽  
Left Ventricular Ejection ◽  
Galectin 3

Objective This study was performed to determine whether a dual-biomarker approach using N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and galectin-3 optimizes the diagnosis and risk stratification of acute cardiac dyspnea. Atypical clinical manifestations and overlapping pathologies require objective and effective diagnostic methods to avoid treatment delays. Methods This prospective observational study included 208 patients who presented to the emergency department for acute dyspnea. NT-proBNP and galectin-3 were measured upon admission. The patients were divided into two groups according to the etiology of their clinical manifestations: cardiac and non-cardiac dyspnea. The patients’ New York Heart Association functional class, left ventricular ejection fraction, and discharge status were assessed. Results Diagnostic criteria for acute heart failure were fulfilled in 61.1% of the patients. NT-proBNP and galectin-3 were strongly and significantly correlated. Receiver operating characteristic analysis revealed similar areas under the curve for both markers in the entire group of patients as well as in the high-risk subsets of patients. Conclusions The diagnostic performance of NT-proBNP and galectin-3 is comparable for both the total population and high-risk subsets. Galectin-3 adds diagnostic value to the conventional NT-proBNP in patients with acute cardiac dyspnea, and its utility is of major interest in uncertain clinical situations.

How to use N-terminal pro-brain natriuretic peptide (NT-proBNP) in assessing disease severity in bronchiolitis

2019 ◽  
Vol 105 (5) ◽  
pp. 282-288 ◽  
Author(s):  
Keir Dan Edwards ◽  
Mark Peter Tighe
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Cardiac Failure ◽  
Cardiac Disease ◽  
Respiratory Compromise ◽  
Conflicting Evidence ◽  
Congenital Cardiac Disease ◽  
Viral Illness ◽  
Respiratory Causes

Bronchiolitis is a common viral illness which can lead to severe respiratory compromise and can coexist with or mask cardiac failure. Brain natriuretic peptide (BNP) and the inactive portion of its pro-hormone: N-terminal pro-BNP (NT-proBNP) are excreted in response to cardiomyocyte stretching and are established biomarkers in cardiac failure. Here, we discuss the technicalities of NT-proBNP testing and review available evidence regarding NT-proBNP testing in bronchiolitis. We identified and appraised seven studies assessing the role of BNP or NT-proBNP as biomarkers of bronchiolitis severity, in children with and without underlying congenital cardiac disease. One study of 76 children with dyspnoea showed that the median NT-proBNP level in children with cardiac failure was 7321 pg/mL vs 241 pg/mL in children with a respiratory cause of dyspnoea vs 87.21 pg/mL in healthy controls (p<0.05). A cut-off of 726 pg/mL could aid differentiation between cardiac and respiratory causes of respiratory distress. Other evidence showed a positive correlation between BNP levels and bronchiolitis severity, and that raised BNP can predict acute heart failure in children with congenital cardiac disease presenting with bronchiolitis. However, most studies consisted of small cohorts with conflicting evidence between them. Furthermore, several studies assessed BNP rather than NT-proBNP directly. BNP has a shorter half-life, which may affect analysis. In conclusion, NT-proBNP is a rapid and inexpensive test with the potential to be a useful biomarker in severe bronchiolitis and cases complicated by acute cardiac failure. However, studies with larger cohorts are required to better establish this role.

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