Abstract
INTRODUCTION
The most frequent cause of a pleural effusion is heart failure. The diagnosis is based on clinical findings and biochemical parameters.
RATIONALE
The existence of a specific heart biomarker could avoid unnecessary studies for the diagnosis of cardiac origin of pleural fluids.
OBJECTIVE
The purpose of our study was to evaluate the diagnostic accuracy of pleural fluid aminoterminal fragment N-terminal pro-brain natriurético peptide (NTpro-BNP) for pleural effusions of cardiac origin compared with Framingham criteria.
MATERIAL AND METHODS
We studied 32 consecutive patients admitted at the work site. Pleural and blood samples were simultaneously obtained
NTpro-BNP was measured in blood and pleural fluids (Bio Merieux® Enzyme-Linked Fluorescent Assay). Light criteria and serum-pleural albumin gradient was used to discriminate transudates from exudates.
RESULTS
The cut-off value of pleural fluid NTpro-BNP level to discriminate between pleural effusions due to heart failure was ≥1.791 pg/mL. The sensitivity and specificity was 75.0%(95%CI 47.6-92.6) and 81.2%(95%CI 54.4-95.7) respectively; with a positive predictive value of 80.0%(95%CI 51.9-96.0), negative predictive value 81.8%(95%CI 50.1-93.2), positive likelihood ratio 4.0(95%CI 20.8-5.8) and negative likelihood ratio 0.3(95%CI 0.1-1.2).
CONCLUSIONS
Pleural fluid NTpro-BNP is a very useful biomarker with high diagnostic accuracy for distinguishing pleural effusions of cardiac origin.
- © 2012 ERS