Importance and Interpretation of Intermediate (Gray Zone) Amino-Terminal Pro–B-Type Natriuretic Peptide Concentrations - 08/08/11
Address for reprints: James L. Januzzi, Jr., MD, Cardiology Division, Massachusetts General Hospital, 55 Fruit Street, Yawkey 5984, Boston, Massachusetts 02114.Résumé |
Amino-terminal pro–B-type natriuretic peptide (NT-proBNP) values between the cut point of 300 ng/L for “ruling out” acute heart failure (HF) and the consensus-recommended age-adjusted cut points for “ruling in” acute HF are referred to as intermediate or gray zone values, which may be seen in approximately 20% of patients with dyspnea in the emergency department. Knowledge of the differential diagnosis of the causes of a gray zone NT-proBNP finding is useful to ascertain the correct diagnosis. Possible causes include cardiac ischemia, atrial fibrillation, and infectious/inflammatory pulmonary diseases. Importantly, a gray zone NT-proBNP result is not associated with a benign prognosis. Regardless of the cause, it should not be ignored because it is a “negative” result. Patients with a gray zone NT-proBNP value are at higher risk for hazard compared with those with a negative NT-proBNP result.
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Vol 101 - N° 3S
P. S39-S42 - février 2008 Retour au numéro
Article précédent
- Amino-Terminal Pro–B-Type Natriuretic Peptide Testing for the Diagnosis or Exclusion of Heart Failure in Patients with Acute Symptoms
- James L. Januzzi, Annabel A. Chen-Tournoux, Gordon Moe
- The Differential Diagnosis of an Elevated Amino-Terminal Pro–B-Type Natriuretic Peptide Level
- Aaron L. Baggish, Roland R.J. van Kimmenade, James L. Januzzi
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