Key result
Severe left ventricular systolic dysfunction (EF <31%) was associated with significantly higher B-type natriuretic peptide levels compared to normal ejection fraction (mean difference 682.96 pg/mL) in adults with acute dyspnea.
Why the study?
The study was designed to evaluate the role of B-type natriuretic peptide in patients presenting with acute dyspnea admitted to emergency services.
Do B-type natriuretic peptide (BNP) levels correlate with cardiac dysfunction and clinical outcomes in adults presenting to the emergency department with acute dyspnea?
Observational (n=100)
No
Do B-type natriuretic peptide (BNP) levels correlate with cardiac dysfunction and clinical outcomes in adults presenting to the emergency department with acute dyspnea?
Mean Difference: 682.96
Absolute Event Rate: 1464.63% vs 781.67%
p-value: p=0.004
High BNP levels on emergency admission for acute dyspnea correlate with left ventricular dysfunction and prolonged hospital stay, supporting its use as a screening tool.
BNP associated with lower EF and longer stays in acute dyspnea; hypothesis-generating for ED screening, needs prospective validation before practice change.
Objective: The aim of the study was to evaluate the role of B-type natriuretic peptide (BNP) in patients presenting with acute dyspnea admitted in emergency services. Materials and Methods: A prospective observational study was conducted on 100 patients presenting to the emergency of Dayanand Medical College and Hospital and Hero DMC Heart Institute with acute dyspnea of <48 h duration, in which BNP levels were done on arrival to emergency. Results: BNP levels were significantly higher in patients having left ventricular dysfunction, both systolic and diastolic. Patients with systolic dysfunction had slightly higher BNP (1251.50 ±950.14 pg/mL) compared to patients with diastolic dysfunction (905.62±618.10 pg/mL) though statistically insignificant (P = 0.055). BNP levels were also inversely related to ejection fraction. Mean BNP levels in patients with EF <31%, 31%–45%, 46%–59%, and ≥60% were 1464.63 ± 1058.29, 968.24 ± 751.59, 841.64 ± 503.41 and 781.67 ± 504.21 (P = 0.009), respectively. Patients having higher BNP levels had significantly prolonged duration of stay compared to patients with lower BNP. Patients who expired had slightly higher levels of BNP though statistically nonsignificant. BNP had no significant statistical relation with age, heart rate, creatine phosphokinase-MB, Trop-T levels, systolic blood pressure. Conclusion: We conclude that high BNP levels are a marker of cardiac dysfunction and increased duration of hospital stay in patients presenting to the emergency with acute dyspnea. Hence, BNP can be used as a screening test for the evaluation and management of dyspnea.
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Kashyap et al. (2020) conducted an observational in Acute dyspnea (n=100). Left ventricular systolic dysfunction (EF <31%) vs. Normal ejection fraction (≥60%) was evaluated on Mean B-type natriuretic peptide (BNP) levels (MD 682.96, p=0.004). Severe left ventricular systolic dysfunction (EF <31%) was associated with significantly higher B-type natriuretic peptide levels compared to normal ejection fraction (mean difference 682.96 pg/mL) in adults with acute dyspnea.
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