A new blood test that measures a particular marker of cardiac distress can markedly improve the ability to diagnose or exclude congestive heart failure in patients with shortness of breath who come to hospital emergency departments. The report from researchers at Massachusetts General Hospital (MGH) finds that measuring levels of a protein called NT-proBNP was significantly better at identifying heart failure than was standard clinical evaluation. The report will appear in the April 15 issue of the American Journal of Cardiology and has been released online prior to print publication.
"We found that testing with the NT-proBNP assay was an extremely accurate way to identify or exclude heart failure in patients with shortness of breath," says James Januzzi Jr., MD, of the MGH Cardiology Division, the paper's lead author. "Importantly, we also found that the very best results came from combining the results of this very sensitive and specific blood test with the logic and wisdom of a good emergency physician, which gave the optimal balance between biologic data and clinical judgement."
Congestive heart failure, which occurs when an impaired heart muscle cannot pump blood efficiently, is a growing health problem and major cause of cardiac death. The diagnosis of heart failure may be difficult to make because its typical symptoms can overlap with those of other conditions. Missing a heart failure diagnosis can put patients at high risk of serious problems, including death, but overdiagnosis may lead patients to receive unnecessary treatment.
"To date, the way physicians have traditionally evaluated potential heart failure patients has been rather random, with some receiving a physical examination and medical history while others also get expensive and time-consuming procedures," Januzzi says. "Having a widely-available, accurate, and cost-effective diagnostic method would be of extraordinary value."
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Contact: Sue McGreevey
Massachusetts General Hospital
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