The Role of B-Type Natriuretic Peptide in the Diagnosis of Congestive Heart Failure in Patients Presenting to an Emergency Department with Dyspnea

OBJECTIVE: To determine the utility of B-type natriuretic peptide (BNP) in the diagnosis of congestive heart failure (CHF) in patients presenting with dyspnea to an emergency department (ED). METHODS: Seventy patients presenting with dyspnea to an ED from April to July 2001 were included in the study. Mean age was 72±16 years and 33 (47%) were male. BNP was measured in all patients at the moment of admission to the ED. Emergency-care physicians, blinded to BNP values, were required to assign a probable initial diagnosis. A cardiologist retrospectively reviewed the data (blinded to BNP measurements) and assigned a definite diagnosis, which was considered the gold standard for assessing the diagnostic performance of BNP. RESULTS: The mean BNP concentration was higher in patients with CHF (n=36) than in those with other diagnoses (990±550 vs 80±67 pg/mL, p<0.0001). Patients with systolic dysfunction had higher BNP levels than those with preserved systolic function (1,180±641 vs 753±437 pg/mL, p=0.03). At a blood concentration of 200 pg/mL, BNP showed a sensitivity of 100%, specificity of 97.1%, positive predictive value of 97.3%, and negative predictive value of 100%. The application of BNP could have potentially corrected all 16 cases in which the diagnosis was missed by the emergency department physician. CONCLUSION: BNP measurement is a useful tool in the diagnosis of CHF in patients presenting to the ED with dyspnea.

GIS analysis of change in an agricultural landscape in Central Finland

Selostus: Keskisuomalaisen maatalousmaiseman muutosten GIS-analyysi

Universally primed polymerase chain reaction analysis of Fusarium avenaceum isolated from wheat and barley in Finland

Selostus: Vehnästä ja ohrasta eristettyjen F. avenaceum -punahomekantojen analysointi UP-PCR-menetelmällä

Seasonal occurrence of Lygus bugs on field crops in Finland

Selostus: Niittyluteiden esiintyminen viljelykasveissa kasvukauden eri aikoina

First report of Diuraphis (Holcaphis) frequens as a pest of wheat in Finland

Selostus: Diuraphis frequens -kirva vehnässä

Effect of fertilization on soil phosphorus in a long-term field experiment in southern Finland

Selostus: Maan fosforitilan muutos pitkäaikaisessa kenttäkokeessa hietamaalla

Reforms of the Common Agricultural Policy and agriculture in Finland

Selostus: Euroopan unionin yhteisen maatalouspolitiikan uudistaminen ja Suomen maatalous

Assessing the risks and uncertainties of regional crop potential under changing climate in Finland

Selostus: Arviointi Suomen kasvintuotantopotentiaalin alueellisista riskeistä ja epävarmuuksista ilmaston muuttuessa

Pest status and incidence of the honey bee tracheal mite in Finland

Selostus: Mehiläisen sisuspunkin aiheuttamat tuhot ja esiintyminen Suomessa

Arrangement of experiments for simulating the effects of elevated temperatures and elevated CO2 levels on field-sown crops in Finland

Selostus: Koejärjestelyt kohonneen lämpötilan ja CO2-tason vaikutusten simuloimiseksi peltokasveilla Suomessa

Salt content labelling of foods in supermarkets in Finland

Selostus: Suolamerkinnät valintamyymälöiden pakatuissa elintarvikkeissa

Seed production characters and germination performance of reed canary grass in Finland

Selostus: Ruokohelven siementuotanto-ominaisuudet ja itävyys Suomessa

Soils in a young landscape on the coast of southern Finland

Selostus: Nuoria maita Viikin pelloilla