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April 1, 2000BMJOpen Access

Biochemical diagnosis of ventricular dysfunction in elderly patients in general practice: observational study

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Why the study?

Does measuring plasma B type natriuretic peptide accurately diagnose left ventricular systolic dysfunction in elderly patients in general practice?

Population

155 unselected elderly patients aged 70 to 84 years from four general practice centres in Poole, Dorset.

Comparison

Measurement of plasma B type natriuretic peptide… vs Echocardiography

Design

Cross-sectional

Authors

HSHelen SmithUniversity of York

Discussion

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Implication

May support BNP as sensitive rule-out for LV dysfunction in elderly primary care; leaves open prospective validation before routine use.

Key Points

  • To assess the effectiveness of plasma B type natriuretic peptide in diagnosing left ventricular systolic dysfunction in elderly patients.
  • Performed an observational study involving 155 elderly participants aged 70 to 84 years.
  • Measured plasma B type natriuretic peptide levels using radioimmunoassay.
  • Diagnosed left ventricular systolic dysfunction via echocardiography.
  • Median plasma concentration of B type natriuretic peptide: 39.3 pmol/l (dysfunction) vs. 15.8 pmol/l (normal).
  • Sensitivity of the test at a 18.7 pmol/l cut-off was 92% with a predictive value of 18%.
  • Receiver operating characteristic area was 0.85, indicating strong diagnostic potential.

Structured PICO

Does measuring plasma B type natriuretic peptide accurately diagnose left ventricular systolic dysfunction in elderly patients in general practice?

P
Population
155 unselected elderly patients aged 70 to 84 years from four general practice centres in Poole, Dorset.
I
Intervention
Measurement of plasma B type natriuretic peptide (BNP) by radioimmunoassay
C
Comparator
Echocardiography (reference standard for assessing left ventricular systolic dysfunction)
O
Outcome
Diagnostic characteristics of plasma B type natriuretic peptide as a test for left ventricular systolic dysfunctionsurrogate

Plasma BNP is a highly sensitive initial screening test for ruling out left ventricular systolic dysfunction in elderly primary care patients, though echocardiography remains essential for confirmation.

Cite This Study

Helen Smith (2000) studied this question.

synapsesocial.com/papers/6a736274644e61a44f4e5959https://doi.org/10.1136/bmj.320.7239.906

Topics

Echocardiography
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prevalence and clinical characteristics of left ventricular dysfunction among elderly patients in general practice setting: cross sectional survey1999 · 180 citations
  2. 2Fortnightly Review: Ten years of natriuretic peptide research: a new dawn for their diagnostic and therapeutic use?1994 · 76 citations
  3. 3Validity of clinical diagnosis of heart failure in primary health care1991 · 539 citations