Abstract
Study objective: The use of plasma proBNP concentrations as a diagnostic tool in differential diagnosis of dyspnea in comorbidity pulmonary patients.
Design: Observational study.
Setting: University Hospital of Lung Diseases, Tirana, Albania.
Patients: 67 patients with pleural effusions and 25 patients with dyspnea of unknown etiology were studied.
Intervention: Plasma proBNP was measured in patients with dyspnea and pleural effusion.
Measurements and results: Mean age 71±8.9 yr in patients with pleural effusions caused by CHF (n=38), 64±11.6 yr in patients with exudative effusions (n=29) [p<0.001]. The median plasma proBNP in patients with pleural effusions caused by CHF was 1108 ng/L, in patients of other etiology 110 ng/L The AUC was 0.853 for plasma proBNP level cut-off 1500ng/L. A plasma proBNP cut-off 250 ng/L had sensitivity 100%, specificity 72.4% and NPV of 100%. The plasma pro BNP with the highest YOUDEN index 0.74 (cut-off 500 ng/L)had correctly classified, 17 of 18 patients misclassified as exudates by the criteria of Light, compared with 6 patients, using serum-liquid protein gradient >3.1. proBNP plasma level cut-off of 1500 ng/L had a sensitivity of 50%, specificity of 96.5%,PPV of 94%, positive and negative likely-ratio of 14.2 and 0.07 respectively, in the diagnosis of CH.F. Mean plasma proBNP level in comorbidity pulmonary patients with dyspnea was >300 ng/L, adjusting to age, only in 3 of 18 cases aged 50-70 years it was > 900 ng/L.
Conclusions: The test of plasma proBNP may be one of the first diagnostic tools in comorbidity pulmonary patients with dyspnea and pleural effusions of unknown origin.
- © 2011 ERS