Author
Listed:
- Terrence Nyamayaro
(University of Zimbabwe)
- Courage Mpandawana
(University of Zimbabwe)
Abstract
Background: Heart failure is a clinical syndrome caused by structural and functional defects in the myocardium resulting in impairment of ventricular filling and/ or the ejection of blood. Natriuretic peptides have emerged as important tools for diagnosis, risk stratification and therapeutic decision making for patients with heart failure. Relative changes in the amino-terminal pro B-type natriuretic peptide (NT-proBNP) levels may assist in the assessment of the risk of congestive heart failure (CHF). However, whether the levels can enable the prediction of outcomes with acute exacerbation at the time of admission remains unknown. This study seeks to determine the diagnostic and therapeutic potential of NT-proBNP in the diagnosis of CHF at Parirenyatwa Group of Hospitals. The study will also determine the correlation between NT-proBNP measurement and the gold standard method for the diagnosis of CHF. Methods: Patients suspected to have CHF who were admitted at Parirenyatwa Group of Hospitals’ medical wards and urgent care unit who had requests for echocardiogram were enrolled into the present cross-sectional study. All patients had dyspnoea of differing severity. The mean age of the participants was 71±7 years old. Demographic data was collected using a pretested interviewer-based questionnaire. Four millilitres of blood sample were collected from each participant into sodium citrate tubes and sent to GoPath Clinical Laboratories. Plasma levels of NT-proBNP were immediately measured, and other risk factors, symptoms and clinical data were also investigated. The sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value of the NT-proBNP assay amongst patients suspected to have CHF was determined. The performance of the assay was also evaluated against the gold standard method. Results: Of the 110 patients, 74 (67.3%) had CHF. The remaining 36 (32.7%) presented with dyspnoea of non-cardiac origin. Plasma NT-proBNP levels were higher in patients with CHF (492.5, IQR= 300.0 – 709.0 vs 49.5, IQR = 34.5 – 69.5; P
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