Bedside B-Type natriuretic peptide in the emergency diagnosis of heart failure with reduced or preserved ejection fraction
Results from the Breathing Not Properly Multinational Study
Alan S. Maisel, MD, FACC*,
James McCord, MD,
Richard M. Nowak, MD,
Judd E. Hollander, MD,
Alan H. B. Wu, PhD, MD, MBA,
Philippe Duc, MD,
Torbjørn Omland, MD, PhD,
Alan B. Storrow, MD,
Padma Krishnaswamy, MD,
William T. Abraham, MD, FACC,
Paul Clopton, MS,
Gabriel Steg, MD,
Marie Claude Aumont, MD,
Arne Westheim, MD, PhD, MPH,
Cathrine Wold Knudsen, MD,
Alberto Perez, MD,
Richard Kamin, MD,
Radmila Kazanegra, MD,
Howard C. Herrmann, MD, FACC,
Peter A. McCullough, MD, MPH, FACC Breathing Not Properly Multinational Study Investigators*
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Figure 1 Box plots showing median levels of B-type natriuretic peptide (BNP) measured in the emergency department in patients with dyspnea not due to heart failure, in those with an adjudicated final diagnosis of non-systolic left ventricular dysfunction, and in those with systolic left ventricular dysfunction. CHF = congestive heart failure.
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Figure 2 Number of patients in each New York Heart Association (NYHA) functional class with systolic versus non-systolic dysfunction.
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Figure 3 Box plots showing median levels of B-type natriuretic peptide (BNP) measured in men and women over 70 years of age with dyspnea not due to heart failure, and those with an adjudicated final diagnosis of heart failure, subdivided by those with systolic congestive heart failure (CHF) and those with non-systolic CHF.
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Figure 4 Receiver-operating characteristic curve for B-type natriuretic peptide (BNP) for differentiating between congestive heart failure (CHF) and non-CHF cases and between systolic versus non-systolic dysfunction (non-CHF patients excluded). Tables show decision statistics at selected cut points. AUC = area under the curve.
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