Diagnostic Utility Of NT-proBrain Natriuretic Peptide In Patients With Pleural Effusions From Congestive Heart Failure

objective To examine whether the N-terminal pro-brain Natriuretic peptide (NT-proBNP)in pleural fluid or blood serum is a very effective diagnostic tool for determining the pleural effusion resulting from the congestive heart failur.Methods 106 among 123 patients with the diagnostic thoracentesis were selected by the clinical diagnosis and exclusion criteria.We measured pleural fluid and serum NT-proBNP levels in a consecutive series of 30 patients with congestive heart failure and in 76 patients with other causes including 20 tuberculousis,15 pneumonia,16 carcinoma,14 renal failure,11 hepaticcirrhosis by means of the ELISA.Results The median pleural fluid or serum NT-proBNP levels:the congestive heart failur patients (3730.07±1667.27pg/ml,4496.70±1657.22pg/ml) w-ere significantly higher than the others(TB 356.15±144.88pg/ml,442.45±191.08pg/m 1.Ca 706.81±210.83pg/ml,942.00±255.00pg/ml.PPE 426.33±117.56pg/ml,595.07±200 .43pg/ml.HC 581.82±132.86pg/m,873.72±386.78pg/ml.CRF 826.36±372.57pg/ml,1 110.44±577.70pg/ml).At a cut-off point of blood serum NT-proBNP≥2209.5pg/ml or pleural fluid NT-proBNP>1552.5pg/ml, the test had a sensitivity of 96.7% or 98.7%, a specificity of 98.7% or 100% for the diagnosis of pleural fluid from congestive heart failure(p<0.05). Pleural fluid NT-proBNP levels were correlated with serum NT-proBNP levels (R=0.972, p<0.05).Conclusion Pleural fluid or blood serum NT-proBNP may be useful in the diagnosis of pleural effusion resulting from the congestive heart failur.