title: Cardiac ultrasound helps for differentiating the causes of acute dyspnea with available B-type natriuretic peptide tests.
abstract: BACKGROUND
  The aim of this study was to evaluate the role of cardiac ultrasound in diagnosing acute heart failure (AHF) in patients with acute dyspnea with available plasma B-type natriuretic peptide (BNP) level.
  
  
  METHODS
  Patients with acute dyspnea presenting to the emergency department (ED) of a tertiary medical center were prospectively enrolled. The enrolled 84 patients received both BNP tests and cardiac ultrasound studies and were classified into AHF and non-heart failure groups.
  
  
  RESULTS
  Plasma BNP levels were higher in the AHF group (1236 ± 1123 vs 354 ± 410 pg/mL; P < .001). The AHF group had larger left ventricular end-diastolic dimension (LVEDD; 32 ± 7 vs 27 ± 4 mm/m(2); P < .001) and worse left ventricular ejection fraction (52% ± 18% vs 64% ± 15%; P = .003). Multiple logistic regression analysis showed that both BNP levels more than 100 pg/mL and LVEDD were independent predictors for AHF. In patients with plasma BNP levels within gray zone of 100 to 500 pg/mL, LVEDD was larger in the AHF group than that in the non-heart failure group (29 ± 4 vs 26 ± 4 mm/m(2); P = .044).
  
  
  CONCLUSIONS
  Both LVEDD by cardiac ultrasound and BNP levels can help emergency physicians independently diagnose AHF in the ED. In patients with plasma BNP levels within 100 to 500 pg/mL, cardiac ultrasound can help differentiate heart failure or not.
authors.affiliation: Department of Emergency Medicine, Min-Sheng Hospital, Taoyuan City 330, Taiwan.
authors.forename: Hsien-Kuo
authors.initials: HK
authors.lastname: Wang
authors.forename: Min-Shan
authors.initials: MS
authors.lastname: Tsai
authors.forename: Jia-How
authors.initials: JH
authors.lastname: Chang
authors.forename: Tzung-Dau
authors.initials: TD
authors.lastname: Wang
authors.forename: Wen-Jone
authors.initials: WJ
authors.lastname: Chen
authors.forename: Chien-Hua
authors.initials: CH
authors.lastname: Huang
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D004452:Echocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011446:Prospective Studies; D012372:ROC Curve; D013318:Stroke Volume / Q000502:physiology
chemical_list: D020097:Natriuretic Peptide, Brain