PURPOSE: To investigate the contribution of NT-ProBNP in the differential diagnosis and classification of indefinite pleural effusion and transudate in dyspnea patients (pts).
METHODS: Twenty-four dyspnea pts with indefinite pleural effusion or transudate and fourty controls (mean age 66,43±14,99 and 61,17±15,47 years respectively)underwent also: 1) echocardiography and 2) NT-ProBNP evaluation of serum and pleural levels with the ECL method.
RESULTS: 1)Bilateral (85%) and unilateral (15%) pleural effusion 2)12,5% pts showed EF<45% with NT-ProBNP in serum >900pg/ml 3)87,5% pts had EF>45% with NT-ProBNP in serum >150pg/ml 4)Mean NT-ProBNP in serum of pts and controls: 4.468,91±1.166 pg/ml and 90,87±66,51 pg/ml respectively (p<0,001) 5)Mean NT-ProBNP values in pleural: 5.020±728 pg/ml(p<0,001) 6)58,2% pts with EF>45%, LAD>4cm and NT-ProBNP in serum 500-900 pg/ml 7)70% of indefinite pleural effusion pts had RVSP>35mmHg.
CONCLUSION: 1)A significant statistical difference in serum NT-ProBNP values between pts and controls (p<0,001) 2)Significant statistical correlation of NT-ProBNP serum and pleural levels of pts studied (p<0,001, r=0,883) 3)All pts were finally found to have pleural transudate 4)Relying on NT-ProBNP values>500pg/ml, LAD>4cm and RVSP>35mmHg, we confirmed that 70% of pts with pleural transudate was due to congestive heart failure, while 30% pts had pleural transudate of other, non cardiac, origin 5)12,5% of pts suffered from systolic heart failure and 58,2% had heart failure with preserved systolic function.
CLINICAL IMPLICATIONS: Further investigation is needed to clarify the diagnostic contribution of NT-ProBNP, Echo LA and RV performance and pathophysiology of diastolic dysfunction and/or failure on pleural transudate.
DISCLOSURE: Ioannis Angomachalelis, No Financial Disclosure Information; No Product/Research Disclosure Information