BNP Test Aids Patients With Acute Dyspnea

B-type natriuretic peptide (BNP) testing for patients with congestive heart failure resulted in more effective clinical management of patients with acute dyspnea, a new study has shown.

The BNP test, which measures the level of B-type natriuretic peptide in blood, is designed to diagnose heart failure. The ventricles of the heart produce extra BNP when they are unable to pump enough blood to meet the body's needs. If the BNP level is high, it is an indication of heart failure. The higher the BNP level is at diagnosis, the worse the heart failure is likely to be.

According to the results of a study published in the May 22, 2006, issue of the Archives of Internal Medicine, BNP testing significantly reduced total treatment costs, lowered rates of hospital admission, reduced the number of days in hospital, decreased intensive care admissions, and was fully maintained after 180 days.

Dr. Christian Mueller and colleagues at the University of Basel (Basel, Switzerland) conducted a prospective randomized study of BNP for acute shortness-of-breath evaluation involving 452 patients (mean age 72) who presented at the emergency department with acute dyspnea. Two hundred and twenty-five participants were randomly assigned to a point-of-care assay of BNP levels or to conventional diagnostic evaluation and treatment without BNP assessment.

The researchers found that BNP testing was more cost-effective during the initial hospital encounter and during the next 180 days. Among the other advantages of BNP testing were an increase in diagnostic accuracy, a more rapid diagnosis and initiation of treatment, and a more favorable short-term patient outcome.

Because BNP testing is non-invasive, simple, and inexpensive, the researchers advise initiating the test while physicians collect other data. "Measuring BNP directly at presentation in all patients with acute dyspnea seems to be a reasonable strategy,” said Dr. Mueller.



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