Value of Brain Natriuretic Peptide Assay for the Etiologic Diagnosis and Its Correlation with Doppler Echocardiography in Patients of Acute Onset Dyspnoea

To evaluate the role of the Brain/B-type natriuretic peptide (BNP) assay and Doppler echocardiography in patients with acute dyspnoea to diagnose decompensated left-heart failure (ADHF). Also to compare the values of BNP levels with that of different cardiac Doppler and echocardiographic findings.

BNP and Doppler echocardiography are considered as important tools to diagnose heart failure.

A total of 100 patients were enrolled for the present study, the one who presented to the emergency room/ICU/Wards from March 2016 to June 2017 with acute onset dyspnoea. BNP estimation and echocardiography were performed in all 100 patients. The accuracy of both for etiologic diagnosis was compared on the basis of the final diagnoses made by physicians. Moreover, values of both were also compared.

The final etiologic diagnosis was CHF in 86 patients. Twenty-four patients (24%) were misdiagnosed at admission. The BNP concentration was 954.99 ± 965.2 ng/ml in the CHF subgroup and 61.97 ± 40.06 ng/ml in the other patients (p = 0.002). A BNP cut-off of 100 ng/ml correctly classified 94% of the patients (p = 0.0001), but a high negative predictive value (76.9%) was only obtained when the cut-off was lowered to 80 pg/ml. Among 100 patients, BNP values were also correlated with Doppler findings and were found to correlate significantly with the degree of systolic/diastolic dysfunction.

Measurement of Brain Natriuretic Peptide (BNP) levels and Doppler echocardiography are both important for establishing the cause of acute dyspnoea. BNP can predict and can give an estimate about degree of dysfunction which can be confirmed by echocardiography later on.