August 7, 2007 – After using a portable echocardiography to test the potential of B-type natriuretic peptide (BNP) assay in diagnosing heart failure among patients registered as having heart failure in a single primary care practice, researchers determined that BNP level is not useful for validating a primary care register diagnosis of heart failure, according to a report in the July 30th BMC Cardiovascular Disorders.
"This study was designed to see if BNP testing would be of use in validation," said lead researcher, Russell C. Davis, M.D., Sandwell & West Birmingham Hospitals NHS Trust, West Bromwich, UK.
In the study, just 70 of 112 patients with a record of previous heart failure investigations had echocardiography reports consistent with heart failure. Twenty-four per cent of 56 patients who underwent the ECG had left ventricular systolic dysfunction and an another 8 had normal systolic function with another ECG diagnosis consistent with a diagnosis of heart failure with preserved systolic function.
Only 5 patients with an echocardiographic diagnosis of heart failure
had normal cardiograms, resulting in a positive predictive value of 0.68 for an abnormal ECG and a negative predictive value of 0.69 for a normal ECG.
The report found BNP level to be a poor discriminator between patients with and without left ventricular systolic dysfunction, the researchers note, even though BNP was significantly higher in patients with echocardiographic features consistent with heart failure.
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