[Usefulness of natriuretic peptide testing and Doppler echocardiography at bedside in the diagnosis of acute heart failure].
Acute heart failure is a common condition that leads to hospital admission, with important mortality and readmission rates. A prompt and accurate diagnosis of this condition by hospitalists is essential for an early and tailored medical management. The use of natriuretic peptide testing (BNP and NT-proBNP) through a two cut-point strategy is currently recommended as the first-line diagnostic complement to the initial clinical evaluation in the acute care setting. Transthoracic Doppler echocardiography is an other noninvasive method that can be used at bedside, especially in patients with intermediate, inconclusive natriuretic peptides levels. In this regard, left ventricular ejection fraction and several simple Doppler indexes (restrictive mitral filling pattern, spectral tissue Doppler E/e' ratio), have been validated in the emergency diagnosis of acute heart failure. The aim of the present review is to overview the respective contribution of natriuretic peptides and Doppler echocardiography at bedside to the diagnosis of acute heart failure in the acute care setting.
Service de cardiologie, centre hospitalier Édmond-Garcin, avenue des Sœurs-Gastine, 13400 Aubagne, France. Electronic address: sarques@ch-aubagne.fr.
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Service de cardiologie, centre hospitalier Édmond-Garcin, avenue des Sœurs-Gastine, 13400 Aubagne, France.
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D000208:Acute Disease; D015150:Echocardiography, Doppler; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005602:France; D006333:Heart Failure / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010348:Patient Care Team / Q000458:organization & administration; D000067716:Point-of-Care Testing / Q000458:organization & administration*; D011237:Predictive Value of Tests; D018570:Risk Assessment / Q000458:organization & administration; D013318:Stroke Volume / Q000502:physiology
D020097:Natriuretic Peptide, Brain
Acute heart failure; BNP; Doppler tissulaire; Fraction d’éjection; Insuffisance cardiaque aiguë; Left ventricular ejection fraction; Tissue Doppler imaging; Transthoracic Doppler echocardiography; Échocardiographie Doppler transthoracique