title: Correlation between chest x-ray and B-type natriuretic peptide in congestive heart failure.
abstract: BACKGROUND
  B-Type natriuretic peptide (BNP) values greater than 400 pg/mL have high positive likelihood ratio (>10) for the diagnosis of clinical congestive heart failure (CHF). However, in patients with CHF, it is not known what correlation, if any, exists for the BNP levels above 400 pg/mL and the findings on the initial chest x-ray (CXR).
  
  
  METHODS
  Retrospective review of emergency department patients with CHF and initial BNP greater than 400 pg/mL. Descriptive statistics were analyzed and logistic regression was performed.
  
  
  RESULTS
  Fifty-four patients mean age of 81.7 (SD, 8.2), 64.8% women. The mean BNP was 1493 pg/mL (SD, 1106). Only 68.5% had a finding of CHF on CXR. Logistic regression showed no correlation (Wald P = .568; R 2 = 0.8%).
  
  
  CONCLUSIONS
  In patients with clinical CHF, there is no correlation between very high BNP levels (>400 pg/mL) and CXR readings. Clinicians should not be surprised to find patients with very high BNP levels but negative CXR.
authors: Resurrection Emergency Medicine Residency Program, Resurrection Medical Center, Chicago, IL 60631, USA.
authors: Chad
authors: C
authors: Aleman
authors: Shu B
authors: SB
authors: Chan
authors: Mary Frances
authors: MF
authors: Kordick
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004635:Emergency Medicine / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D011654:Pulmonary Edema / Q000209:etiology / Q000378:metabolism; D011859:Radiography; D012189:Retrospective Studies
chemical_list: D020097:Natriuretic Peptide, Brain