Diagnostic accuracy of plasma brain natriuretic peptide for evaluation of dyspnea NYHA-III and NYHA-IV in emergency department of tertiary care hospital.

Abstract

To determine the diagnostic accuracy of breathing not properly (BNP) for evaluation of dyspnea NYHA III and IV due to systolic heart failure in emergency department patients keeping echocardiography as the gold standard. Cross-sectional validation study. Setting: Department of Accident and Emergency Duration of Study: 25 July 2022-25 January 2023. A total of 115 of both sexes presenting with acute onset of dyspnea and having NYHA Class III and IV were included. Emergency nursing staff had immediately taken a single venous blood sample for BNP and creatinine levels and a 2D echo was performed. Ejection fraction was recorded, and the diagnosis of systolic heart failure on the basis of an ejection fraction, that is less than or equal to 45% was documented. The age range in this study was from 18 to 65 years, with a mean age of 49.147±8.73 years. Mean BNP levels were 139.452±84.04pg/ml. Patients with NYHA class III was 67.8 and 32.2% belongs to NYHA class IV. BNP levels greater than or equal to 100pg/ml diagnosed 76 (66.1%) and echocardiography has diagnosed 68 (59.1%) patients with heart failure. BNP levels greater than or equal to 100pg/ml had shown sensitivity 94.1%, specificity 74.5%, and diagnostic accuracy 86%, positive predictive value 84.21%, negative prediction value 89.74%, likelihood positive ratio 3.68 and likelihood negative ratio was 0.08 in diagnosis of heart failure. BNP estimation is a sensible and particular procedure for diagnosing CHF in patients who present to the emergency department with acute dyspnea and may add extra advantages to the administration of patients with congestive heart failure (CHF) in our population.