[Diagnosis of heart failure in general medicine: role of cerebral natriuretic peptide. Results of a pilot study of a population sample from Calabria].
BACKGROUND
The aim of this study was to evaluate the usefulness of brain natriuretic peptide (BNP) in diagnosing congestive heart failure (CHF), in an unselected population.


METHODS
Eighty-three patients (47 men, 36 women, mean age 70 +/- 10 years) were referred to our hospital ambulatory from their general practitioners, with a diagnosis of CHF.


RESULTS
Clinical-instrumental evaluation confirmed diagnosis in 45 patients (54%) (group A), and excluded it in the remaining 38 (46%) (group B). There were no differences between groups regarding age, weight, height, heart rate, blood pressure. Statistically significant differences between groups were found regarding ejection fraction (44 +/- 10% group A vs 60 +/- 7% group B, p < 0.01), and BNP blood concentration (162 +/- 226 pg/ml group A vs 73 +/- 23 pg/ml group B, p < 0.01). Forty-two patients in group A (93%) and 25 in group B (65%) had a BNP value > 20 pg/ml (p < 0.05). Using this cut-off value, sensitivity was 93%, specificity 34%, negative predictive value 81% and positive predictive value 62%. Forty-two patients in group A (93%) and 14 in group B (36%) had an "abnormal" electrocardiogram (p < 0.01). The presence of electrocardiographic abnormalities showed a sensitivity for the diagnosis of CHF of 93%, specificity of 63%, negative predictive value of 89% and positive predictive value of 77%.


CONCLUSIONS
In our population BNP dosage confirms the high negative predictive value reported in the literature and may be useful to exclude diagnosis of CHF in patients with suspect signs and symptoms.
Misuraca
Gianfranco
G
Divisione di Cardiologia, Ospedale dell'Annunziata, Cosenza. g.misuraca@tin.it
Serafini
Oscar
O
Caporale
Roberto
R
Battista
Federico
F
Plastina
Franco
F
D000368:Aged; D005194:Family Practice; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D007558:Italy; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010865:Pilot Projects
D020097:Natriuretic Peptide, Brain