Abstract:
BACKGROUND:Heart failure due to left ventricular systolic dysfunction (LVSD) has a high prevalence in the adult population but is difficult to diagnose accurately on clinical grounds in the community. Early diagnosis is important as effective treatments are available to reduce morbidity and mortality. Echocardiography is widely used to assess heart failure; however, this technology is relatively expensive and of limited availability. A potential diagnostic aid in primary care is the measurement of plasma brain natriuretic peptide (BNP). OBJECTIVE:This study was performed to assess the value of BNP measurement as a selective pre-screen for breathless patients referred for open access echocardiography. METHODS:BNP was measured by radioimmunoassay with prior extraction in 83 breathless subjects (age range 37-87 years, mean 72). Standard echocardiography was performed and left ventricular systolic function was assessed. RESULTS:The prevalence of LVSD was 31% in this group. At cut-off values chosen to give negative predictive values for LVSD of >98% (BNP = 19 pg/ml), the sensitivity, specificity and positive predictive value for BNP were 100, 49.1 and 46.9%. Using this BNP threshold as a pre-screen for echocardiography would make a net saving of pound 964.20 without compromising the diagnostic accuracy. CONCLUSION:BNP measurement appears to have a significant cost-effective benefit for the selection of patients for echocardiography.
journal_name
Fam Practjournal_title
Family practiceauthors
Sim V,Hampton D,Phillips C,Lo SN,Vasishta S,Davies J,Penney Mdoi
10.1093/fampra/cmg513subject
Has Abstractpub_date
2003-10-01 00:00:00pages
570-4issue
5eissn
0263-2136issn
1460-2229journal_volume
20pub_type
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