A clinical and biochemical critical pathway for the evaluation of patients with suspected acute congestive heart failure: The ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) algorithm.

Dyspnea is a primary clinical manifestation of acute congestive heart failure (CHF) among patients presenting to the emergency department (ED). Unfortunately, other critical illnesses, including acute coronary syndromes, pulmonary embolism, chronic obstructive pulmonary disease, and pneumonia, may present with clinical symptoms and signs similar to acute CHF. N-terminal pro-brain natriuretic peptide (NT-proBNP) has proven to be a powerful tool in the diagnostic assessment of dyspnea as a result of its ability to confirm or exclude the presence of acute CHF.

Measurement of the interleukin family member ST2 in patients with acute dyspnea: results from the PRIDE (Pro-Brain Natriuretic Peptide Investigation of Dyspnea in the Emergency Department) study.

Objectives: The aim of this study was to examine the value of measurement of the interleukin-1 receptor family member ST2 in patients with dyspnea.

Background: Concentrations of ST2 have been reported to be elevated in patients with heart failure (HF).

Methods: Five hundred ninety-three dyspneic patients with and without acute destabilized HF presenting to an urban emergency department were evaluated with measurements of ST2 concentrations.

Echocardiographic measures of acute haemodynamic response after cardiac resynchronization therapy predict long-term clinical outcome.

Aims: Although acute haemodynamic improvement in response to cardiac resynchronization therapy (CRT) is reflective of a favourable cardiac contractile response, there is limited information regarding not only its ability to predict long-term clinical outcome but also cardiac-substrate-specific differences in the prognostic value of this measure.

Methods And Results: Fifty-three heart failure patients (69 +/- 11 years) with low left ventricle ejection fraction (LVEF) (22 +/- 6%), wide QRS (169 +/- 31 ms), and indications for CRT were included. There were no significant differences in age, New York Heart Association (NYHA) class, medications, QRS width, or LVEF between ischaemic (n = 37) and non-ischaemic (n = 16) groups.

Combination of D-dimer and amino-terminal pro-B-type natriuretic Peptide testing for the evaluation of dyspneic patients with and without acute pulmonary embolism.

Context: D-dimer concentration can be used to exclude a diagnosis of acute pulmonary embolism. However, clinicians frequently order unnecessary supplemental testing in patients with low concentrations of D-dimer. Elevations in natriuretic peptides have also been described in the setting of pulmonary embolism.

Neither race nor gender influences the usefulness of amino-terminal pro-brain natriuretic peptide testing in dyspneic subjects: a ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) substudy.

Background: Amino-terminal pro-brain natriuretic peptide (NT-proBNP) is useful for the diagnosis and exclusion of congestive heart failure (HF). Little is known about the effect of race on NT-proBNP concentrations. Also, NT-proBNP levels may be higher in apparently well women, but the effect of gender on NT-proBNP concentrations in dyspneic patients is not known.

NT-proBNP levels, echocardiographic findings, and outcomes in breathless patients: results from the ProBNP Investigation of Dyspnoea in the Emergency Department (PRIDE) echocardiographic substudy.

Aims: The objective of this study was to determine the integrative utility of measuring plasma NT-proBNP levels with echocardiography in the evaluation of dyspnoeic patients.

Methods And Results: Of 599 emergency department patients enrolled in a clinical study of NT-proBNP at a tertiary-care hospital, 134 (22%) had echocardiographic results available for analysis. Echocardiographic parameters correlating with NT-proBNP levels were determined using multivariable linear-regression analysis.

Acute predictors of subacute complete heart block after alcohol septal ablation for obstructive hypertrophic cardiomyopathy.

Acute and subacute complete heart block (CHB) are sequelae of alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy. Temporary pacemakers are routinely placed at the time of ASA, but there are no widely accepted guidelines for their management. This study examined acute predictors of subacute CHB in 52 consecutive ASA procedures in 48 patients without preexisting permanent pacemakers.

Combined use of amino terminal-pro-brain natriuretic peptide levels and QRS duration to predict left ventricular systolic dysfunction in patients with dyspnea.

The combination of elevated amino-terminal pro-brain natriuretic peptide levels and wide QRS duration was highly sensitive and specific for the prediction of impaired left ventricular systolic function among a group of patients presenting with dyspnea to the emergency department. This strategy can be used to predict depressed function and target more formal evaluation with echocardiography in patients with dyspnea.

The N-terminal Pro-BNP investigation of dyspnea in the emergency department (PRIDE) study.

The utility of aminoterminal pro-brain natriuretic peptide (NT-proBNP) testing in the emergency department to rule out acute congestive heart failure (CHF) and the optimal cutpoints for this use are not established. We conducted a prospective study of 600 patients who presented in the emergency department with dyspnea. The clinical diagnosis of acute CHF was determined by study physicians who were blinded to NT-proBNP results.