The use of B‐type natriuretic peptide in the management of elderly patients with acute dyspnoea ( J Intern Med 2005;258:77–85)

Abstract

Dear Sir, The findings of the above study [1] would have been more readily applicable to routine clinical practice if the radiographic stigmata of acute left ventricular failure (LVF) had also been documented, using parameters which have not only been found to be positively correlated with B-type atrial natriuretic factor, but have also proved to be highly predictive of LVF itself [2]. Coupled with a categorization of the patients into those with subnormal left ventricular ejection fraction (LVEF) and those with intact LVEF, the inclusion of radiographic stigmata as well as the radiographic response to antifailure therapy would have considerably enhanced our understanding of left ventricular diastolic failure in addition to validating the therapeutic trial as an alternative diagnostic tool in the evaluation of the acutely breathless patient with normal LVEF. No conflict of interest was declared.