ACC: Biomarker May Help Distinguish Cardiac and Pulmonary Dyspnea

March 29, 2007

NEW ORLEANS -- Office-based use of the biomarker pro-B-type natriuretic peptide (proBNP) to help diagnose the cause of dyspnea in the general population may be feasible, Danish researchers said here.

NEW ORLEANS, March 29 -- Office-based use of the biomarker pro-B-type natriuretic peptide (proBNP) to help diagnose the cause of dyspnea in the general population may be feasible, Danish researchers said here.

The blood test has only been used in emergency care and for care of patients with established heart conditions, in part because of a lack of an algorithm to interpret the results in the general population.

But in a study of nearly 3,000 unselected individuals in the general population, proBNP was able to distinguish between heart failure or other cardiac causes of shortness of breath and lung-related dyspnea.

So found Rasmus Mogelvang, M.D., of Gentofte University Hospital in Hellerup, and colleagues, who reported at the American College of Cardiology meeting on an algorithm for diagnosis they devised.

ProBNP is not FDA approved for point-of-care testing and would require further study before adoption for widespread use in general practice. However, determining the etiology of dyspnea from office-based blood test results might, for instance, eliminate the need for ultrasound scans.

"The search for a biomarker to examine an entire population to distinguish the cause of dyspnea has been quite elusive so far," commented Mandeep R. Mehra, M.D., of the University of Maryland in Baltimore, who was a discussant at the presentation.

It could allow physicians to skip echocardiography in many cases, Dr. Mogelvang said.

The 2,929 participants in the community-based Copenhagen City Heart Study were evaluated for dyspnea using spirometry, oxygen saturation, echocardiography and pro-BNP.

A high proportion of them had dyspnea (959), though the majority had mild dyspnea (726).

The proBNP level findings included:

  • Those who had dyspnea had significantly higher proBNP levels than those who did not (17.8 versus 10.6 pmol/L, P

Likewise, Dr. Mogelvang said that with further study proBNP might be useful as a screening tool for heart disease in both emergency and non-emergency settings.