Analysis Of Diagnostic Value Of NT-proBNP For Patients With Cardiac Effusions

Objectives: Pleural Fluid is a common clinical disease,and resultes from causes which develop too fast or absorbe too slowlead of a liquid in the pleural cavity.Amino-terminal brain natriuretic peptide precursor(NT-proBNP)is a vasoactive peptide secreted by the heart.The synthesis of this peptide is stimulated by the increased wall lension or stretching of cardiac chambers,then B-type natriuretic peptide(BNP)is cleaved to give NT-proBNP.NT-proBNP could infiltrate from the blood into the pleural cavity,leading to the high level of NT-proBNP.We therefore analysis of diagnostic value of NT-proBNP for Patients with Cardiac Effusions,in order to find an effective molecular diagnostic markers with high sensitivity,specificity and accuracy.Method: Patients with pleural effusion,admitted to our hospital from November 2014 to October 2015,were selected.According to the clinicopathological features and related inspection,The patients were divided as Cardiac effusions and Noncardiac effusions.The quantitative determination of NT-proBNP levels in serum and pleural fluid samples were performed using colloidal gold immunochromatography and were analysis by SPSS17.0.Results: Mean levels of NT-proBNP in serum and pleural fluid among patients with pleural fluid due to heart failure were significantly higher(13725pg/ml in serum,12309 pg/ml in pleural fluid)than in patients with noncardiac causes(1094 pg/ml in serum,974pg/ml in pleural fluid,P<0.001).Levels of NT-proBNP measured in serum and in pleural fluid correlated closely and spearman's coefficient of rank correlation was 0.961.Measurement of NT-proBNP levels in serum and in pleural fluid displayed high diagnostic accuracy,as shown by ROC curve analysis(area under the curve 0.97 for both).As determined by ROC curve analysis,an NT-proBNP cut-off value of4000ng/L in serum and in pleural fluid had a sensitivity of 89%(73%-96%)and 91%(74%-97%),a specificity of 92%(82%-96%)and 92%(83%-97%),a positive predictive value of 82%(65%-94%)and 81%(66%-93%)and a negative predictive value of 94%(87%-97%)and 96%(86%-99%),each with an overall diagnostic accuracy of 90%(83%-94%)and 91%(84%-96%).Conclusion: Median levels of NT-proBNP in serum and pleural fluid among patients with pleural fluid due to heart failure were significantly higher than in patients with noncardiac causes.Levels of NT-proBNP measured in serum and in pleural fluid correlated closely.Diagnostic value of NT-proBNP in pleural fluid for Patients with Cardiac Effusions show a high sensitivity and specificity.