Discriminating Between Cardiac and Pulmonary Dysfunction in the General Population With Dyspnea by Plasma Pro-B-Type Natriuretic Peptide

Discriminating Between Cardiac and Pulmonary Dysfunction in the General Population With Dyspnea by Plasma Pro-B-Type Natriuretic Peptide Rasmus Mogelvang, Jens P. Goetze, Peter Schnohr, Peter Lange, Peter Sogaard, Jens F. Rehfeld, Jan S. Jensen In the Copenhagen City Heart Study, dyspnea was evaluated in the general population with spirometry, oxygen saturation, echocardiography, and plasma pro-B-type natriuretic peptide (proBNP). Cardiac dysfunction was associated with a 2.6-fold increase in plasma proBNP concentration (p < 0.001), whereas pulmonary dysfunction was not (p = 0.66). We establish a model to estimate the expected concentration of plasma proBNP based on age and gender: an actual proBNP concentration below one-half of the expected value rules out left ventricular systolic and diastolic dysfunction. In the general population with dyspnea, proBNP concentrations are increased in left ventricular dilatation, hypertrophy, systolic dysfunction, or diastolic dysfunction, but are unaffected by pulmonary dysfunction.