Arif Hussain, Irfan Amjad Lutfi, Faisal Iqbal Afridi.
Diagnostic Cut-Off Levels of Plasma Brain Natriuretic Peptide to Distinguish Left Ventricular Failure in Emergency Setting.
J Coll Physicians Surg Pak Jan ;24(5):304-7.

Objective: To determine the diagnostic cut-off values of brain natriuretic (BNP) peptide to establish left ventricular failure in patients presenting with dyspnoea in emergency department. Study Design: Descriptive study. Place and Duration of Study: Ziauddin University Hospital, Karachi, from July to December 2011. Methodology: BNP estimation was done on Axysm analyzer with kit provided by Abbott diagnostics, while the Doppler echocardiography was done on Toshiba istyle (UICW-660A) using 2.5 MHz and 5.0 MHz probes. Log transformation was done to normalize the original BNP values. A receiver operating curve was plotted to determine the diagnostic cut-off value of BNP which can be used to distinguish CHF from other causes of dyspnoea. Statistical analysis was performed by SPSS version 17. Results: A total of 92 patients presenting with dyspnoea in the emergency department were studied. There were 38/92 (41.3%) males and 54/92 (58.7%) females, and the average age of the study population was 64 ± 14.1 years. These patients had BNP levels and Doppler echocardiography done. The average BNP was found to be 1117.78 ± 1445.74 pg/ml. In log transformation, the average was found to be 2.72 ± 0.58. BNP value of 531 pg/ml was found to be the cut off to distinguish between cardiogenic and non-cardiogenic causes of dyspnoea. Conclusion: BNP value of 531 pg/ml can distinguish CHF from other conditions as a cause of dyspnoea in emergency.

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