20.500.12556/DKUM-66511 Combination of lung ultrasound (a comet-tail sign) and N-terminal pro-brain natriuretic peptide in differentiating acute heart failure from chronic obstructive pulmonary disease and asthma as cause of acute dyspnea in prehospital emergency setting Introduction: We studied the diagnostic accuracy of bedside lung ultrasound (the presence of a comet tail sign), N-terminal pro-brain natriuretic peptide (NT-proBNP), and clinical assessment (modified Boston criteria) in differentiating heart failure (HF)- related acute dyspnea from pulmonary (COPD/asthma) related acute dyspnea in the prehospital setting. Methods: Prospective study was performed at the Center for Emergency Medicine Maribor, Slovenia, between July 2007 and April 2010. Two groups of patients were compared: HF-related acute dyspnea group (n = 129) vs pulmonary-related (asthma/COPD) acute dyspnea group (n = 89). All patients underwent lung ultrasound examination, along with basic laboratory, rapid NT-proBNP testing and chest X-ray. Results: Ultrasound comet tail sign has 100% sensitivity, 95% specificity, 100% negative predictive value (NPV) and 96% positive predictive value (PPV) for the diagnosis of HF. NT-proBNP (cut-off point 1000 pg/ml) has 92% sensitivity, 89% specificity, 86% NPV and 90% PPV. Boston modified criteria have 85% sensitivity, 86% specificity, 80% NPV and 90% PPV. Comparing the three methods, we found significant differences between ultrasound sign vs NT-proBNP (P<0.05) and Boston modified criteria (P<0.05). Combination of ultrasound sign and NT-proBNP has 100% sensitivity, 100% specificity, 100% NPV and 100% PPV. With ultrasound we can exclude HF in patients with pulmonary related dyspnea who have positive NT-proBNP (> 1000 pg/ml) and previous history of HF. Conclusions: Ultrasound comet tail sign alone or in combination with NT-proBNP has a high diagnostic accuracy in differentiating between acute HF and COPD/asthma causes of acute dyspnea in prehospital emergency setting. lungs ultrasound N-terminal pro-brain natriuretic peptide acute heart failure chronic obstructive pulmonary disease asthma acute dyspnea pljuča ultrazvok N-terminalni možganski natriuretični peptid akutno srčno popuščanje kronična obstruktivna pljučna bolezen astma akutna dispneja true false true Angleški jezik Slovenski jezik Znanstveno delo 2017-06-29 09:40:32 2017-06-29 09:41:30 2022-07-11 03:07:24 2019-07-11 15:49:57 2011 0 0 str. 1-9 Letn. 15 2011 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 1466-609X 616.24-008.4-083.98 1137983 3911231 10.1186/cc10140 1466-609X URN:SI:UM:DK:KXEEWJ6W Critical_Care_2011_Prosen_et_al._Combination_of_lung_ultrasound_(a_comet-tail_sign)_and_N-terminal_pro-brain_natriuretic_peptide_in_diff.pdf Critical_Care_2011_Prosen_et_al._Combination_of_lung_ultrasound_(a_comet-tail_sign)_and_N-terminal_pro-brain_natriuretic_peptide_in_diff.pdf 1 A9152657A06A7BF9CB630E7278001024 2d2dc60778a23a2f6a705d2104dcd45c56fec3b61b33320a504f634866cdcd21 51ea6112-7c0e-11eb-bb7a-00155d0001ca https://dk.um.si/Dokument.php?lang=slv&id=113321 http://ccforum.biomedcentral.com/articles/10.1186/cc10140 1 https://dk.um.si/Dokument.php?lang=slv&id=113320 Medicinska fakulteta 0 0 0