Key result
ECG, BNP, and N terminal-pro BNP are more sensitive than specific for diagnosing chronic left ventricular systolic dysfunction.
Why the study?
Do ECG, BNP, and NT-pro BNP accurately diagnose chronic left ventricular systolic dysfunction in patients with suspected LVSD?
Systematic Review
Do ECG, BNP, and NT-pro BNP accurately diagnose chronic left ventricular systolic dysfunction in patients with suspected LVSD?
ECG, BNP, and NT-proBNP demonstrate higher sensitivity than specificity for the diagnosis of chronic left ventricular systolic dysfunction.
Answers are grounded in this paper and cite their sources.
High sensitivity supports ruling out chronic LVSD; confirms diagnostic profile in meta-analysis of suspected cases.
Davenport C, Cheng EY, Kwok YT, et al . Assessing the diagnostic test accuracy of natriuretic peptides and ECG in the diagnosis of left ventricular systolic dysfunction: a systematic review and meta-analysis. Br J Gen Pract 2006;56:48–56. [OpenUrl][1][Abstract/FREE Full Text][2] Q How do electrocardiography (ECG), brain natriuretic peptide (BNP), and N terminal-pro brain natriuretic peptide (NT-pro BNP) perform in diagnosing chronic left ventricular systolic dysfunction (LVSD)? Clinical impact ratings IM/Ambulatory care ★★★★★★☆ GP/FP/Primary care ★★★★★★☆ Internal medicine ★★★★★★☆ Cardiology ★★★★☆☆☆ Emergency medicine ★★★★☆☆☆ ### ![Graphic][3]Data sources Medline, EMBASE/Excerpta Medica (1980 to March 2004), Cochrane Library (Issue 4, 2003), hand searches of selected proceedings and cardiology journals, and citations from relevant studies and reviews. ### ![Graphic][4]Study selection and assessment cohort studies that compared ECG, BNP, NT-pro BNP, or combinations with a reference standard (nuclear cardiology techniques or 2 dimensional echocardiography) in patients with suspected LVSD. Trials with insufficient data to calculate sensitivity and specificity and those that studied patients with acute heart failure (HF) or suspected ventricular diastolic dysfunction or patients receiving long term treatment with angiotensin converting enzyme (ACE) inhibitors or diuretics for presumed HF were excluded. … [1]: {openurl}?query=rft.jtitle%253DBritish%2BJournal%2Bof%2BGeneral%2BPractise%26rft.stitle%253Dbjgp%26rft.issn%253D0960-1643%26rft.aulast%253DDavenport%26rft.auinit1%253DC.%26rft.volume%253D56%26rft.issue%253D522%26rft.spage%253D48%26rft.epage%253D56%26rft.atitle%253DAssessing%2Bthe%2Bdiagnostic%2Btest%2Baccuracy%2Bof%2Bnatriuretic%2Bpeptides%2Band%2BECG%2Bin%2Bthe%2Bdiagnosis%2Bof%2Bleft%2Bventricular%2Bsystolic%2Bdysfunction%253A%2Ba%2Bsystematic%2Breview%2Band%2Bmeta-analysis%26rft_id%253Dinfo%253Apmid%252F16438815%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=bjgp&resid=56/522/48&atom=%2Febmed%2F11%2F4%2F117.atom [3]: /embed/inline-graphic-1.gif [4]: /embed/inline-graphic-2.gif
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Jenny Doust (2006) conducted a systematic review in chronic left ventricular systolic dysfunction. ECG, BNP, and NT-pro BNP vs. nuclear cardiology techniques or 2 dimensional echocardiography was evaluated on diagnostic test accuracy (sensitivity and specificity). ECG, BNP, and N terminal-pro BNP are more sensitive than specific for diagnosing chronic left ventricular systolic dysfunction.
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