Abstract:
OBJECTIVES:The goal of this study was to evaluate the utility of a rapid "bedside" technique for measurement of B-type natriuretic peptide (BNP) in the diagnosis of congestive heart failure (CHF) in an urgent-care setting. BACKGROUND:B-type natriuretic peptide is a protein secreted from the cardiac ventricles in response to pressure overload. One potential application of measurements of BNP in blood is distinguishing dyspnea due to CHF from other causes. METHODS:B-type natriuretic peptide concentrations were measured in a convenience sample of 250 predominantly male (94%) patients presenting to urgent-care and emergency departments of an academic Veteran's Affairs hospital with dyspnea. Results were withheld from clinicians. Two cardiologists retrospectively reviewed clinical data (blinded to BNP measurements) and reached a consensus opinion on the cause of the patient's symptoms. This gold standard was used to evaluate the diagnostic performance of the BNP test. RESULTS:The mean BNP concentration in the blood of patients with CHF (n = 97) was higher than it was in patients without (1,076 +/- 138 pg/ml vs. 38 +/- 4 pg/ml, p < 0.001). At a blood concentration of 80 pg/ml, BNP was an accurate predictor of the presence of CHF (95%); measurements less than this had a high negative predictive value (98%). The overall C-statistic was 0.97. In multivariate analysis, BNP measurements added significant, independent explanatory power to other clinical variables in models predicting which patients had CHF. The availability of BNP measurements could have potentially corrected 29 of the 30 diagnoses missed by urgent-care physicians. CONCLUSIONS:B-type natriuretic peptide blood concentration measurement appears to be a sensitive and specific test to diagnose CHF in urgent-care settings.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Dao Q,Krishnaswamy P,Kazanegra R,Harrison A,Amirnovin R,Lenert L,Clopton P,Alberto J,Hlavin P,Maisel ASdoi
10.1016/s0735-1097(00)01156-6subject
Has Abstractpub_date
2001-02-01 00:00:00pages
379-85issue
2eissn
0735-1097issn
1558-3597pii
S0735-1097(00)01156-6journal_volume
37pub_type
杂志文章abstract:OBJECTIVES:We investigated whether the serum markers of collagen turnover differed in various forms of atrial fibrillation (AF) and in sinus rhythm (SR) in humans. BACKGROUND:Structural alterations and fibrosis have been implicated in the generation and perpetuation of AF. METHODS:Serum C-terminal propeptide of colla...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2008.03.045
更新日期:2008-07-15 00:00:00
abstract:OBJECTIVES:The aim of the study was to screen 36 unrelated patients with hypertrophic cardiomyopathy (HCM; 16 familial and 20 sporadic cases) from a genetically homogeneous area in eastern Finland for variants in the cardiac beta-myosin heavy chain (beta-MHC) and alpha-tropomyosin (alpha-TM) genes. BACKGROUND:Mutation...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(98)00448-3
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abstract:OBJECTIVES:In this study, we assessed the utility of exercise thallium-201 scintigraphy and other clinical factors in predicting perioperative cardiac complications in patients undergoing elective vascular surgery. BACKGROUND:The risk of cardiac complications among such patients is very high. METHODS:The study group ...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(93)90307-m
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine the role of the endothelium in the vascular actions of protease-activated receptor type 1 (PAR-1) activation in vivo in man. BACKGROUND:Thrombin is central to the pathophysiology of atherothrombosis. Its cellular actions are mediated via PAR-1. Protease-activated r...
journal_title:Journal of the American College of Cardiology
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更新日期:2008-05-06 00:00:00
abstract:BACKGROUND:Treatment-related cardiac death is the primary, noncancer cause of mortality in adult survivors of childhood malignancies. Early detection of cardiac dysfunction may identify a high-risk subset of survivors for early intervention. OBJECTIVES:This study sought to determine the prevalence of cardiac dysfuncti...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2015.04.013
更新日期:2015-06-16 00:00:00
abstract:BACKGROUND:Persistent severe left ventricular (LV) systolic dysfunction after myocardial infarction (MI) is associated with increased mortality and is a class I indication for implantation of a cardioverter-defibrillator. OBJECTIVES:This study developed models and assessed independent predictors of LV recovery to >35%...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2016-03-15 00:00:00
abstract:OBJECTIVES:This study was done to assess the impact of anterior mitral leaflet reconstructive procedures on initial and long-term results of mitral valve repair. BACKGROUND:It has been suggested that involvement of the anterior leaflet in mitral valve disease adversely affects the long-term outcome of mitral valve rep...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(94)00325-k
更新日期:1995-01-01 00:00:00
abstract::To evaluate acute and follow-up changes in left ventricular diastolic performance, simultaneous digital left ventriculography and micromanometry were performed in 49 patients undergoing aortic balloon valvuloplasty. All patients improved symptomatically after valvuloplasty, and 26 returned 6.3 +/- 1.5 months later for...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80324-9
更新日期:1990-10-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2005-01-18 00:00:00
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doi:10.1016/s0735-1097(98)00144-2
更新日期:1998-06-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2005-07-19 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2006.05.080
更新日期:2006-12-19 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(91)90791-7
更新日期:1991-09-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1988-07-01 00:00:00
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更新日期:2002-07-17 00:00:00
abstract::Alterations in the blood radioactivity affect ventricular volume calculations using count-based radionuclide ventriculography. To study this phenomenon, the effect of time, posture and supine exercise on blood radioactivity, red blood cell count and splenic radioactivity was evaluated. The red blood cell count, and bl...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(84)80178-3
更新日期:1984-05-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(90)90621-u
更新日期:1990-03-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(83)80052-7
更新日期:1983-06-01 00:00:00
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更新日期:1996-08-01 00:00:00
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更新日期:2000-04-01 00:00:00
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更新日期:2017-03-21 00:00:00
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更新日期:1998-04-01 00:00:00
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更新日期:1990-10-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2007.07.081
更新日期:2007-12-11 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(85)80010-3
更新日期:1985-05-01 00:00:00
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更新日期:2017-03-28 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(96)00102-7
更新日期:1996-07-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(88)90203-3
更新日期:1988-04-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2016.10.073
更新日期:2017-01-31 00:00:00
abstract:BACKGROUND:Major disparities between women and men in the diagnosis, management, and outcomes of acute coronary syndrome are well recognized. OBJECTIVES:The aim of this study was to evaluate the impact of implementing a high-sensitivity cardiac troponin I assay with sex-specific diagnostic thresholds for myocardial in...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2019-10-22 00:00:00