Intérêt diagnostique du dosage rapide du peptide natriurétique de type B (BNP) sur sang total dans un service de cardiologie

Abstract

Diagnostic value in the cardiology department of rapid whole blood B-type natriuretic peptide (BNP) testing. BNP, or B-Type natriuretic peptide, is a “cardiac hormone” released into the blood in response to left ventricular stretch. Its concentration increases with heart failure severity. A new quantitative rapid test, which may be used in an emergency setting, delivers results within 15 minutes using whole blood samples. We have used it to determine its diagnostic value in a population of patients admitted to the hospital in the cardiology department. It has allowed us to rule-out or confirm heart failure for 56 patients presenting with acute dyspnea and therefore to avoid more expensive cardiological investigations. BNP is systematically increased (mean of 1,648 pg/mL) for patients presenting with a typical clinical picture of heart failure. The level is proportional to the severity of the cardiopathy as determined by left ventricular ejection fraction. Inversely, a normal BNP level allows to rule-out heart failure. Patients with chronic cardiopathy have moderately elevated BNP levels (223 pg/mL). Knowing the level of BNP during the stability phase of chronically ill heart failure patients can be of significant help in linking the symptoms to a new decompensation event when a patient is readmitted. Levels of BNP have also been measured in patients with acute coronary syndrome. However the values where too heterogenic to be able to draw any conclusions and warrant further studies.