Tissue Doppler echocardiography for the diagnosis of new-onset heart failure with normal ejection fraction: influence of serum protein concentration on clinical interpretation in elderly patients.

Introduction: According to Starling's law, low serum colloid osmotic pressure related to hypoproteinaemia is likely to modulate the pulmonary capillary hydrostatic pressure threshold of pulmonary oedema formation. We therefore examined the clinical relevance of bedside tissue Doppler echocardiography in the emergency diagnosis of new-onset heart failure with normal ejection fraction (HFnlEF) according to serum protein concentration.

Methods: A total of 105 consecutive elderly patients presenting with acute severe dyspnoea were prospectively enrolled.

Comparison of B-type natriuretic peptide with left atrial enlargement by echocardiography for the diagnosis of new-onset congestive heart failure with a preserved left ventricular systolic function in the setting of longstanding hypertension.

The present study attempted to determine the accuracy of B-type natriuretic peptide (BNP) compared with left atrial enlargement at echocardiography in the emergency diagnosis of new-onset heart failure with preserved systolic function (HFPSF) related to longstanding hypertension. The study comprised 57 patients in sinus rhythm hospitalized for acute dyspnea, 30 with hypertensive HFPSF and 27 with noncardiac cause. By stepwise logistic regression analysis, BNP provided independent and incremental diagnostic information over the score of Boston criteria.

[Usefulness of B-type natriuretic peptide (BNP) for the diagnosis of new-onset heart failure with a preserved left ventricular systolic function in longstanding hypertensive patients with acute dyspnea].

Background: B-type natriuretic peptide (BNP) has been largely validated in the etiologic diagnosis of acute dyspnea. Nevertheless, its reliability in the setting of a preserved left ventricular systolic function (ejection fraction >50%) has not been adequately established.

Objective: the study addressed the usefulness of BNP in the diagnosis of new-onset heart failure with a preserved systolic function in hypertensive patients hospitalized for acute dyspnea.

Usefulness of bedside tissue Doppler echocardiography and B-type natriuretic peptide (BNP) in differentiating congestive heart failure from noncardiac cause of acute dyspnea in elderly patients with a normal left ventricular ejection fraction and permanent, nonvalvular atrial fibrillation: insights from a prospective, monocenter study.

Background: The incremental role of bedside tissue Doppler echocardiography and B-type natriuretic peptide (BNP) over the clinical judgment has been recently reported in the emergency diagnosis of congestive heart failure with a normal left ventricular ejection fraction (HFNEF). However, how well does this diagnostic strategy be applicable in the setting of atrial fibrillation is unknown.

Objective: To investigate the usefulness of bedside tissue Doppler echocardiography and BNP in the emergency diagnosis of HFNEF in elderly patients with permanent, nonvalvular atrial fibrillation.

Accuracy of the isovolumic relaxation time in the emergency diagnosis of new-onset congestive heart failure with preserved left ventricular systolic function in the setting of B-type natriuretic peptide levels in the mid-range.

Despite the fact that B-type natriuretic peptide (BNP) is a useful diagnostic complement to clinical and radiographic data in the emergency diagnosis of acute congestive heart failure, levels of BNP in the mid-range (100-500 pg/ml) are acknowledged to be inconclusive for the diagnosis. We assessed the diagnostic value of the pulsed Doppler-derived isovolumic relaxation time (IVRT) by bedside Doppler echocardiography in the emergency diagnosis of new-onset congestive heart failure with preserved systolic function in 43 patients presenting with acute severe dyspnea and inconclusive BNP levels. A short IVRT <50 ms was a good predictor of acute congestive heart failure in this clinical setting, with a positive predictive value of 94%.