title: Chest computed tomography features predictive of elevated B-type natriuretic peptide independent of renal function: diagnostic implications for evaluation of congestive heart failure.
abstract: OBJECTIVE
  B-type natriuretic peptide (BNP), commonly evaluated in patients suspected of congestive heart failure, is also elevated in patients with renal insufficiency. The objective of our study was to identify chest computed tomography features that correlate with BNP levels independent of renal function.
  
  
  METHODS
  A total of 162 (of which 76 had normal BNP and 86 had elevated BNP) patients with chest computed tomography and serum BNP levels measured within 24 hours were evaluated for the presence of ground-glass opacities, interlobular septal thickening, mediastinal lymphadenopathy, mosaic perfusion, peribronchovascular thickening, pericardial effusion, and pleural effusion. Both univariate and multivariate analysis were used to correlate these features with the serum BNP. Multiple logistic regression was used to identify statistically significant correlates of BNP controlling for the glomerular filtration rate.
  
  
  RESULTS
  Ground-glass opacity, interlobular septal thickening, pericardial effusion, and left- and right-sided pleural effusion were statistically significant predictors of elevated BNP on separate logistic regression incorporating the glomerular filtration rate. After multiple logistic regression, interlobular septal thickening (odds ratio, 5.69) and pleural effusion (odds ratio, 3.88) remained significant predictors of BNP independent of the glomerular filtration rate.
  
  
  CONCLUSIONS
  Interlobular septal thickening and pleural effusion appear to be independent predictors of BNP, and this may be useful in the evaluation of patients for congestive heart failure in the setting of renal insufficiency.
authors.affiliation: From the *Harlem Hospital, New York; and †SUNY Downstate, Brooklyn, NY.
authors.forename: Haneen Abdel
authors.initials: HA
authors.lastname: Dayem
authors.forename: Arash
authors.initials: A
authors.lastname: Gohari
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Endo
authors.forename: Hyman
authors.initials: H
authors.lastname: Shwarzberg
authors.forename: Arash
authors.initials: A
authors.lastname: Afari
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Waite
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D007677:Kidney Function Tests / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D013902:Radiography, Thoracic / Q000706:statistics & numerical data*; D051437:Renal Insufficiency / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain