학술논문
Diagnostic value of pleural fluid N-terminal pro-brain natriuretic peptide levels in patients with cardiovascular diseases
Document Type
Report
Author abstract
Author abstract
Source
Respirology. Jan, 2008, Vol. 13 Issue 1, p53, 5 p.
Subject
Language
English
ISSN
1323-7799
Abstract
To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1440-1843.2007.01191.x Byline: Huai LIAO (1,2,3), Moon Jun NA (2,3), Oner DIKENSOY (2,3), Kirk B. LANE (3), Barnette RANDAL (2,3), Richard W. LIGHT (2,3) Keywords: brain natriuretic peptide; diagnosis; pleural effusion Abstract: Background and objective: The diagnosis of the cause of pleural effusions caused by cardiovascular diseases such as congestive heart failure (CHF) and acute pulmonary embolism is sometimes difficult. The purpose of the present study was to evaluate the utility of pleural fluid levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) in differentiating pleural effusions due to CHF, pulmonary embolism and post-coronary artery bypass graft (CABG) surgery. Methods: The levels of pleural fluid NT-proBNP were measured by ELISA in a total of 40 patients: 10 with CHF, 10 with pulmonary embolism, 10 post-CABG and 10 with carcinoma. Results: The median level of NT-proBNP in the pleural fluid of patients with CHF was 5390 pg/mL (25th to 75th percentiles, 4566 to 8158 pg/mL), which was significantly higher than that in patients with post-CABG effusions (424 pg/mL, 352 to 873), with pulmonary embolism (311 pg/mL, 212 to 1159), or with carcinoma (302 pg/mL, 208 to 626) (P < 0.001, CHF group vs all other groups). In receiver-operating curve analysis, an NT-proBNP level of [greater than or equal to]2220 pg/mL demonstrated a sensitivity of 100% and a specificity of 96.7% for the identification of CHF. Conclusions: Measurement of the NT-proBNP level in pleural fluid is accurate in diagnosing the etiology of the effusion as CHF. Pleural fluid levels above 2220 pg/mL are essentially diagnostic that the pleural effusion is due to CHF. Author Affiliation: (1)Department of Pulmonary Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China, (2)Department of Pulmonary Medicine, St Thomas Hospital, London, UK, and (3)Department of Pulmonary Medicine, Vanderbilt University, Nashville, Tennessee, USA Article History: Received 20 December 2006; invited to revise 2 February 2007; revised 2 May 2007; accepted 29 May 2007 (Associate Editor: Gary Lee). Article note: Huai Liao, Department of Pulmonary Medicine, The First Affiliated Hospital of Sun Yat-sen University, #58 Zhongshan 2nd Road, Guangzhou, Guangdong 510080, China. Email: liaohuai1208@hotmail.com