Brain Natriuretic Peptide Blood Levels in the Differential Diagnosis of Dyspnea
In dyspneic patients without left ventricular enlargement, it may be difficult to differentiate between obstructive lung disease and diastolic heart failure. Determination of plasma brain natriuretic peptide (BNP) levels, known to increase with ventricular stretch, may be of clinical relevance in th...
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| Veröffentlicht in: | Chest 2001-12, Vol.120 (6), p.2047-2050 |
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| creator | Cabanes, Laure Richaud-Thiriez, Bénédicte Fulla, Yvonne Heloire, Franćois Vuillemard, Catherine Weber, Simon Dusser, Daniel |
| description | In dyspneic patients without left ventricular enlargement, it may be difficult to differentiate between obstructive lung disease and diastolic heart failure. Determination of plasma brain natriuretic peptide (BNP) levels, known to increase with ventricular stretch, may be of clinical relevance in this situation. We compared the discriminant power of BNP blood levels and of echocardiography in patients with either chronic obstructive lung disease or diastolic heart failure.
Twenty-six New York Heart Association class III dyspneic patients with normal left ventricular systolic function were enrolled: 17 patients with chronic obstructive lung disease and 9 patients with unequivocal diastolic heart failure.
Echocardiographic data were unable to accurately differentiate between the two groups, whereas BNP levels were significantly and markedly higher in patients with diastolic heart failure when compared to those with obstructive lung disease (224 ± 240 pg/mL vs 14 ± 12 pg/mL, p < 0.0001).
These preliminary results warrant a prospective, large-scale evaluation of the value of BNP assay for determining diastolic dysfunction, a common cause of dyspnea in elderly patients, and differentiating it from other diagnoses such as obstructive lung disease. |
| doi_str_mv | 10.1378/chest.120.6.2047 |
| format | Article |
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Twenty-six New York Heart Association class III dyspneic patients with normal left ventricular systolic function were enrolled: 17 patients with chronic obstructive lung disease and 9 patients with unequivocal diastolic heart failure.
Echocardiographic data were unable to accurately differentiate between the two groups, whereas BNP levels were significantly and markedly higher in patients with diastolic heart failure when compared to those with obstructive lung disease (224 ± 240 pg/mL vs 14 ± 12 pg/mL, p < 0.0001).
These preliminary results warrant a prospective, large-scale evaluation of the value of BNP assay for determining diastolic dysfunction, a common cause of dyspnea in elderly patients, and differentiating it from other diagnoses such as obstructive lung disease.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1378/chest.120.6.2047</identifier><identifier>PMID: 11742939</identifier><identifier>CODEN: CHETBF</identifier><language>eng</language><publisher>Northbrook, IL: Elsevier Inc</publisher><subject>Aged ; Biological and medical sciences ; brain natriuretic peptide ; Cardiac arrhythmia ; Cardiovascular system ; chronic airways obstruction ; congestive heart failure ; Diagnosis, Differential ; Diastole - physiology ; diastolic failure ; Doppler effect ; Dyspnea ; Dyspnea - blood ; Dyspnea - etiology ; Edema ; Ejection fraction ; Female ; Heart failure ; Heart Failure - blood ; Heart Failure - diagnosis ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Lung diseases ; Male ; Medical sciences ; Middle Aged ; Natriuretic Peptide, Brain - blood ; Patients ; Peptides ; Predictive Value of Tests ; Pulmonary arteries ; Pulmonary Disease, Chronic Obstructive - blood ; Pulmonary Disease, Chronic Obstructive - diagnosis ; Ultrasonic investigative techniques ; Velocity</subject><ispartof>Chest, 2001-12, Vol.120 (6), p.2047-2050</ispartof><rights>2001 The American College of Chest Physicians</rights><rights>2002 INIST-CNRS</rights><rights>Copyright American College of Chest Physicians Dec 2001</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c510t-466ddcb7184fb4ed0750fe6e13c9461e735c0469e442dbc740bf39b3707fca1b3</citedby><cites>FETCH-LOGICAL-c510t-466ddcb7184fb4ed0750fe6e13c9461e735c0469e442dbc740bf39b3707fca1b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13379659$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11742939$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cabanes, Laure</creatorcontrib><creatorcontrib>Richaud-Thiriez, Bénédicte</creatorcontrib><creatorcontrib>Fulla, Yvonne</creatorcontrib><creatorcontrib>Heloire, Franćois</creatorcontrib><creatorcontrib>Vuillemard, Catherine</creatorcontrib><creatorcontrib>Weber, Simon</creatorcontrib><creatorcontrib>Dusser, Daniel</creatorcontrib><title>Brain Natriuretic Peptide Blood Levels in the Differential Diagnosis of Dyspnea</title><title>Chest</title><addtitle>Chest</addtitle><description>In dyspneic patients without left ventricular enlargement, it may be difficult to differentiate between obstructive lung disease and diastolic heart failure. Determination of plasma brain natriuretic peptide (BNP) levels, known to increase with ventricular stretch, may be of clinical relevance in this situation. We compared the discriminant power of BNP blood levels and of echocardiography in patients with either chronic obstructive lung disease or diastolic heart failure.
Twenty-six New York Heart Association class III dyspneic patients with normal left ventricular systolic function were enrolled: 17 patients with chronic obstructive lung disease and 9 patients with unequivocal diastolic heart failure.
Echocardiographic data were unable to accurately differentiate between the two groups, whereas BNP levels were significantly and markedly higher in patients with diastolic heart failure when compared to those with obstructive lung disease (224 ± 240 pg/mL vs 14 ± 12 pg/mL, p < 0.0001).
These preliminary results warrant a prospective, large-scale evaluation of the value of BNP assay for determining diastolic dysfunction, a common cause of dyspnea in elderly patients, and differentiating it from other diagnoses such as obstructive lung disease.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>brain natriuretic peptide</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular system</subject><subject>chronic airways obstruction</subject><subject>congestive heart failure</subject><subject>Diagnosis, Differential</subject><subject>Diastole - physiology</subject><subject>diastolic failure</subject><subject>Doppler effect</subject><subject>Dyspnea</subject><subject>Dyspnea - blood</subject><subject>Dyspnea - etiology</subject><subject>Edema</subject><subject>Ejection fraction</subject><subject>Female</subject><subject>Heart failure</subject><subject>Heart Failure - blood</subject><subject>Heart Failure - diagnosis</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Lung diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Patients</subject><subject>Peptides</subject><subject>Predictive Value of Tests</subject><subject>Pulmonary arteries</subject><subject>Pulmonary Disease, Chronic Obstructive - blood</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnosis</subject><subject>Ultrasonic investigative techniques</subject><subject>Velocity</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kUtr3DAUhUVoSaZp9lkFE2h3nuplKcouj75gaLpo10KWrjIKGmsi2Sn591U6hqGFrsSF7zw4QuiU4CVh8uKDXUMZl4TipVhSzOUBWhDFSMs6zl6hBcaEtkwoeoTelPKA602UOERHhEhOFVMLdHedTRiab2bMYcowBtt8h-0YHDTXMSXXrOAJYmkqM66huQ3eQ4ZhDCbWw9wPqYTSJN_cPpftAOYteu1NLHAyv8fo56ePP26-tKu7z19vrlat7QgeWy6Ec7aX5IL7noPDssMeBBBmFRcEJOss5kIB59T1VnLce6Z6JrH01pCeHaP3O99tTo9TXUFvQrEQoxkgTUVLyjpCsKrg-T_gQ5ryULtpijFXTFBWIbyDbE6lZPB6m8PG5GdNsH5ZWv9ZWteltdAvS1fJ2ew79Rtwe8E8bQXezYAp1kSfzWBD2XOMSSU6tc9eh_v1r5BBl42JsdqyXerc96_sy52k_gw8Bci62ACDBVfldtQuhf8X_w37R6tk</recordid><startdate>20011201</startdate><enddate>20011201</enddate><creator>Cabanes, Laure</creator><creator>Richaud-Thiriez, Bénédicte</creator><creator>Fulla, Yvonne</creator><creator>Heloire, Franćois</creator><creator>Vuillemard, Catherine</creator><creator>Weber, Simon</creator><creator>Dusser, Daniel</creator><general>Elsevier Inc</general><general>American College of Chest Physicians</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20011201</creationdate><title>Brain Natriuretic Peptide Blood Levels in the Differential Diagnosis of Dyspnea</title><author>Cabanes, Laure ; Richaud-Thiriez, Bénédicte ; Fulla, Yvonne ; Heloire, Franćois ; Vuillemard, Catherine ; Weber, Simon ; Dusser, Daniel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c510t-466ddcb7184fb4ed0750fe6e13c9461e735c0469e442dbc740bf39b3707fca1b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>brain natriuretic peptide</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular system</topic><topic>chronic airways obstruction</topic><topic>congestive heart failure</topic><topic>Diagnosis, Differential</topic><topic>Diastole - physiology</topic><topic>diastolic failure</topic><topic>Doppler effect</topic><topic>Dyspnea</topic><topic>Dyspnea - blood</topic><topic>Dyspnea - etiology</topic><topic>Edema</topic><topic>Ejection fraction</topic><topic>Female</topic><topic>Heart failure</topic><topic>Heart Failure - blood</topic><topic>Heart Failure - diagnosis</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Lung diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Patients</topic><topic>Peptides</topic><topic>Predictive Value of Tests</topic><topic>Pulmonary arteries</topic><topic>Pulmonary Disease, Chronic Obstructive - blood</topic><topic>Pulmonary Disease, Chronic Obstructive - diagnosis</topic><topic>Ultrasonic investigative techniques</topic><topic>Velocity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cabanes, Laure</creatorcontrib><creatorcontrib>Richaud-Thiriez, Bénédicte</creatorcontrib><creatorcontrib>Fulla, Yvonne</creatorcontrib><creatorcontrib>Heloire, Franćois</creatorcontrib><creatorcontrib>Vuillemard, Catherine</creatorcontrib><creatorcontrib>Weber, Simon</creatorcontrib><creatorcontrib>Dusser, Daniel</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cabanes, Laure</au><au>Richaud-Thiriez, Bénédicte</au><au>Fulla, Yvonne</au><au>Heloire, Franćois</au><au>Vuillemard, Catherine</au><au>Weber, Simon</au><au>Dusser, Daniel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brain Natriuretic Peptide Blood Levels in the Differential Diagnosis of Dyspnea</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>2001-12-01</date><risdate>2001</risdate><volume>120</volume><issue>6</issue><spage>2047</spage><epage>2050</epage><pages>2047-2050</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><coden>CHETBF</coden><abstract>In dyspneic patients without left ventricular enlargement, it may be difficult to differentiate between obstructive lung disease and diastolic heart failure. Determination of plasma brain natriuretic peptide (BNP) levels, known to increase with ventricular stretch, may be of clinical relevance in this situation. We compared the discriminant power of BNP blood levels and of echocardiography in patients with either chronic obstructive lung disease or diastolic heart failure.
Twenty-six New York Heart Association class III dyspneic patients with normal left ventricular systolic function were enrolled: 17 patients with chronic obstructive lung disease and 9 patients with unequivocal diastolic heart failure.
Echocardiographic data were unable to accurately differentiate between the two groups, whereas BNP levels were significantly and markedly higher in patients with diastolic heart failure when compared to those with obstructive lung disease (224 ± 240 pg/mL vs 14 ± 12 pg/mL, p < 0.0001).
These preliminary results warrant a prospective, large-scale evaluation of the value of BNP assay for determining diastolic dysfunction, a common cause of dyspnea in elderly patients, and differentiating it from other diagnoses such as obstructive lung disease.</abstract><cop>Northbrook, IL</cop><pub>Elsevier Inc</pub><pmid>11742939</pmid><doi>10.1378/chest.120.6.2047</doi><tpages>4</tpages></addata></record> |
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| subjects | Aged Biological and medical sciences brain natriuretic peptide Cardiac arrhythmia Cardiovascular system chronic airways obstruction congestive heart failure Diagnosis, Differential Diastole - physiology diastolic failure Doppler effect Dyspnea Dyspnea - blood Dyspnea - etiology Edema Ejection fraction Female Heart failure Heart Failure - blood Heart Failure - diagnosis Humans Investigative techniques, diagnostic techniques (general aspects) Lung diseases Male Medical sciences Middle Aged Natriuretic Peptide, Brain - blood Patients Peptides Predictive Value of Tests Pulmonary arteries Pulmonary Disease, Chronic Obstructive - blood Pulmonary Disease, Chronic Obstructive - diagnosis Ultrasonic investigative techniques Velocity |
| title | Brain Natriuretic Peptide Blood Levels in the Differential Diagnosis of Dyspnea |
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