TY - JOUR
T1 - Ultrasound lung comets for the differential diagnosis of acute cardiogenic dyspnoea
T2 - A comparison with natriuretic peptides
AU - Gargani, L.
AU - Frassi, F.
AU - Soldati, G.
AU - Tesorio, P.
AU - Gheorghiade, M.
AU - Picano, E.
PY - 2008/1
Y1 - 2008/1
N2 - Background: Acute dyspnoea as a presenting symptom is a frequent diagnostic challenge for physicians. The main differential diagnosis is between dyspnoea of cardiac and non-cardiac origin. Natriuretic peptides have been shown to be useful in this setting. Ultrasound lung comets (ULCs) are a simple, echographic method which can be used to assess pulmonary congestion. Aim: To evaluate the accuracy of ULCs for predicting dyspnoea of cardiac origin compared to natriuretic peptides. Methods: We evaluated 149 patients admitted with acute dyspnoea. Chest sonography and NT-proBNP assessments were performed a maximum of 4 h apart and independently analyzed. ULCs were evaluated via cardiac probes placed on the anterior and lateral chest. Two independent physicians, blinded to ULCs and NT-proBNP findings, reviewed all the medical records to establish the aetiologic diagnosis of dyspnoea. Results: Cardiogenic dyspnoea was confirmed in 122 patients and ruled-out in 27 patients. The number of ULCs was significantly correlated to NT-proBNP values (r = .69, p < .0001). Receiver operating characteristic analysis, showed an area under the curve of .893 for ULCs and .978 (p = .001) for NT-proBNP, in predicting the cardiac origin of dyspnoea. Conclusions: In patients admitted with acute dyspnoea, pulmonary congestion, sonographically imaged as ULCs, is significantly correlated to NT-proBNP values. The accuracy of ULCs in predicting the cardiac origin of dyspnoea is high.
AB - Background: Acute dyspnoea as a presenting symptom is a frequent diagnostic challenge for physicians. The main differential diagnosis is between dyspnoea of cardiac and non-cardiac origin. Natriuretic peptides have been shown to be useful in this setting. Ultrasound lung comets (ULCs) are a simple, echographic method which can be used to assess pulmonary congestion. Aim: To evaluate the accuracy of ULCs for predicting dyspnoea of cardiac origin compared to natriuretic peptides. Methods: We evaluated 149 patients admitted with acute dyspnoea. Chest sonography and NT-proBNP assessments were performed a maximum of 4 h apart and independently analyzed. ULCs were evaluated via cardiac probes placed on the anterior and lateral chest. Two independent physicians, blinded to ULCs and NT-proBNP findings, reviewed all the medical records to establish the aetiologic diagnosis of dyspnoea. Results: Cardiogenic dyspnoea was confirmed in 122 patients and ruled-out in 27 patients. The number of ULCs was significantly correlated to NT-proBNP values (r = .69, p < .0001). Receiver operating characteristic analysis, showed an area under the curve of .893 for ULCs and .978 (p = .001) for NT-proBNP, in predicting the cardiac origin of dyspnoea. Conclusions: In patients admitted with acute dyspnoea, pulmonary congestion, sonographically imaged as ULCs, is significantly correlated to NT-proBNP values. The accuracy of ULCs in predicting the cardiac origin of dyspnoea is high.
KW - Differential diagnosis of dyspnoea
KW - NT-proBNP
KW - Ultrasound lung comets
UR - http://www.scopus.com/inward/record.url?scp=37649000786&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=37649000786&partnerID=8YFLogxK
U2 - 10.1016/j.ejheart.2007.10.009
DO - 10.1016/j.ejheart.2007.10.009
M3 - Article
C2 - 18077210
AN - SCOPUS:37649000786
SN - 1388-9842
VL - 10
SP - 70
EP - 77
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 1
ER -