Measurement of Natriuretic Peptides in Patients with Suspected Heart Failure to Prevent Overuse of Echocardiography - a Pilot Study.

Background: European Society of Cardiology (ESC) guidelines recommend measuring natriuretic peptides (BNP or NT-proBNP) in patients with suspected heart failure (HF) as a first-line tool. HF should be ruled-out if concentrations of NT-proBNP are below 300 ng/L and 125 ng/L for acute HF and chronic HF, respectively. Methods: Patients with suspected HF referred for transthoracic echocardiography (TTE) were enrolled; NT-proBNP concentrations were obtained from medical charts (measurement < 48 hours) or prospectively measured on the day of TTE. Results: Out of 109 patients, NT-proBNP was measured by the referring department before TTE in 40 patients (36.7%), and 37.5% of these patients had NT-proBNP concentration below the rule-out threshold. NT-proBNP was measured in additional 38 patients on the day of TTE. Overall, 38.5% of the patients had a NT-proBNP concentration below the threshold value. Conclusions: Natriuretic peptides are not routinely measured in patients with suspected HF; systematic measurement would reduce unnecessary TTE by at least 38.5% [ABSTRACT FROM AUTHOR]