Cardiac ultrasound helps for differentiating the causes of acute dyspnea with available B-type natriuretic peptide tests

Introduction: The aim of this study was to evaluate the role of cardiac ultrasound in diagnosing acute heart failure (AHF) in patients with acute dyspnea with available plasma B-type natriuretic peptide (BNP) level. Methods: Patients with acute dyspnea presenting to the emergency department (ED) of a tertiary medical center were prospectively enrolled. The enrolled 84 patients received both BNP tests and cardiac ultrasound studies and were classified into AHF and non heart failure groups. Results: Plasma BNP levels were higher in the AHF group (1236 +/- 1123 vs 354 +/- 410 pg/mL; P < .001). The AHF group had larger left ventricular end-diastolic dimension (LVEDD; 32 +/- 7 vs 27 +/- 4 mm/m(2); P <.001) and worse left ventricular ejection fraction (52% +/- 18% vs 64% +/- 15%; P = .003). Multiple logistic regression analysis showed that both BNP levels more than 100 pg/mL and LVEDD were independent predictors for AHF. In patients with plasma BNP levels within gray zone of 100 to 500 pg/mL, LVEDD was larger in the Al-IF group than that in the non heart failure group (29 +/- 4 vs 26 +/- 4 mm/m(2); P = .044). Conclusion: Both LVEDD by cardiac ultrasound and BNP levels can help emergency physicians independently diagnose AHF in the ED. In patients with plasma BNP levels within 100 to 500 pg/mL, cardiac ultrasound can help differentiate heart failure or not. (C) 2010 Elsevier Inc. All rights reserved.