The Clinical Value Of EVLW And BNP To Diagnose Cardiac Dyspnea From Non-cardiac Dyspnea

OBJECTIVE: We explored the clinical value of EVLW and BNP to diagnose cardiac dyspnea from non-cardiac dyspnea, through comparing EVLW and BNP in patients with cardiac dyspnea and those in patients with non-cardiac dyspnea.METHODS: According to the clinical symptoms and CVP, 21 patients with dyspnea were divided into two groups: cardiac dyspnes's group ( â…  group) and non-cardiac group ( â…¡ group). When all patients were hospitalized in ICU, CO,CI, CVP, EVLW, ITBV and GEDV were gotten by PICCO in the first 24 hours. At the same time septum BNP were measured immediately. Then the differences of EVLW and BNP concentrations between two groups were analyzed.RESULTS: 1. There had no differences in age, gender, ALP and score of APHCHEII between two groups. 2. CO and CI in patients with cardiac dyspnea were significantly lower than in patients with non-cardiac dyspnea. 3. CVP, EVLW, ITBV, GEDV and BNP concentrations in I group were significantly higher than in II group;but no difference in PBI between two groups.4. The level of EVLW positively correlated with CVP in I group. But neither EVLW nor BNP concentrations did correlate with age, ALP,score of APHCHEII, CO, CI GEDV, and BNP.CONCLUSION: 1.Patients with cardiac dyspnea had significantly high level of EVLW and BNP concentration. 2.Because there had positively correspond between the level of EVLW and CVP in patients with cardiac dyspnea,no correspond between the level of EVLW and Alb, EVLW and BNP also.lt was concluded that high venous-pressure edema is a pathophysical change of cardiac pulmonary edema ;but it suggested that cardiac pulmonary edema should be a combined edema because patients with cardiac dyspnea had an increased PBI.3.EVLW may be used to diagnose the type of pulmonary edema. Low level or normal EVLW may be used to excluded the relation of dyspnea and lung edema, and left heart failure, while high level of EVLW has less specialty in identifying left heart failure. In conclusion, low level of EVLW is an important negative clinic value to evaluate left heart function. 4.No doubt ,PiCCO is a simple> easy and prospective method, but it can't reflect the left ventricular pressure ,an invasive method also. BNP examined immediately may be used a complement tool to diagnose heart failure ,and it is a non-invasive , powerful and independent factor that can identify cardiac dyspnea from non-cardiac dyspnea,has more value than EVLW in clinic.