[Importance of surfactant proteins B and D for the differential diagnosis of acute dyspnea].
OBJECTIVE
The basis for an optimal therapy of cardiopulmonary diseases is the assessment of an early diagnosis. This implies an evaluation of possible differential diagnoses of acute dyspnea. In numerous studies, natriuretic peptides were characterized as additional, meaningful parameters for the assessment of left ventricular function. Current studies could demonstrate that surfactant proteins B (SP-B) and D (SP-D) are of importance for the differentiation of patients with acute dyspnea. The aim of this study was to compare the values of NT-proBNP (N-terminal brain natriuretic peptide) and surfactant proteins for the assessment of a final diagnosis in patients with acute dyspnea.


METHODS
NT-proBNP, SP-B and SP-D were measured in 81 patients with acute dyspnea in the emergency room and were correlated with clinical and echocardiographic parameters with respect to the final diagnosis. For this, patients were classified with respect to clinical and echocardiographic parameters in different subgroups concerning the final diagnosis of acute dyspnea.


RESULTS
In patients with a cardiac origin of acute dyspnea, plasma levels of NT-proBNP were significantly higher as compared to patients with a noncardiac diagnosis (p = 0.04). SP-D was highest in patients with a cardiac origin of acute dyspnea, but after performing regression analysis it seems to be of less importance for the differential diagnosis of acute dyspnea as compared to NT-proBNP. SP-B plasma levels were not different between the four subgroups.


CONCLUSIONS
NT-proBNP is of importance for the differential diagnosis of acute dyspnea. Although SP-D shows similar changes of plasma levels between the four subgroups, it seems to be of less importance for the differential diagnosis of acute dysnea. SP-B occurs to be of no relevance for the differentiation between cardiac and noncardiac origin of acute dyspnea.
Lüers
Claus
C
Abteilung Innere Medizin - Kardiologie, Philipps-Universität Marburg, Marburg, Germany. lueersc@med.uni-marburg.de
Hagenah
Gerrit
G
Wachter
Rolf
R
Kleta
Sibylle
S
Schaumberg
Jens
J
Riedel
Sebastian
S
Binder
Lutz
L
Jung
Klaus
K
Schmidt
Albrecht
A
Pieske
Burkert
B
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology* / Q000503:physiopathology; D004636:Emergency Service, Hospital; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000175:diagnosis; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D008171:Lung Diseases / Q000097:blood / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D037662:Pulmonary Surfactant-Associated Protein A / Q000097:blood*; D037701:Pulmonary Surfactant-Associated Protein B / Q000097:blood*; D012016:Reference Values
D010446:Peptide Fragments; D037662:Pulmonary Surfactant-Associated Protein A; D037701:Pulmonary Surfactant-Associated Protein B; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain