Utility of Point-of-Care Diagnosis of Chronic Heart Failure Using an Express Test for Semi-Quantitative Determination of NT-proBNP Levels.

IF 0.5 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Kardiologiya Pub Date : 2024-07-31 DOI:10.18087/cardio.2024.7.n2647

A V Iosifov, O A Shtegman

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Abstract

Aim: To evaluate the accuracy of a rapid test for semi-quantitative determination of NT-proBNP levels in the diagnosis of CHF in comparison with quantitative assessment; to study the strength of the association of the results of this NT-proBNP test with indicators of the CHF severity.

Material and methods: The concentration of NT-proBNP was determined in 44 patients at bedside both semi-quantitatively using an express test (BioTest, Novosibirsk) and quantitatively in a laboratory. In 11 patients, the severity of CHF was assessed with the CHF Clinical Status Scale (CSS). Echocardiography was performed in all patients.

Results: The sensitivity of the quantitative and semi-quantitative tests coincided and was 95%. The specificity of the quantitative test was 100% in our study, whereas the semi-quantitative test showed a specificity of 92%. The negative predictive value of either test was 96%. The diagnostic accuracy was 98% and 93%, respectively. In patients with significantly high NT-proBNP concentrations, the semi-quantitative test demonstrated a reduced ability to verify values above 1800 pg/ml; in patients with threshold concentrations, the semi-quantitative test showed an increased subthreshold sensitivity. Increases in the NT-proBNP concentration correlated with the severity of CHF according to the stage of the disease.

Conclusion: Due to the sufficiently high sensitivity, specificity, ease of use, and speed of obtaining results, the rapid test for semi-quantitative measuring NT-proBNP is promising for outpatient screening bedside diagnosis of CHF and in the emergency room to confirm or exclude CHF. When determining the dynamics of NT-proBNP during the treatment of CHF, the use of the semi-quantitative rapid test with visual assessment of the results may produce an error compared to the quantitative assessment, which will probably not allow tracking the effect of therapy or predicting exacerbation of the disease.

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使用半定量检测 NT-proBNP 水平的快速检验对慢性心力衰竭进行护理点诊断的实用性。

目的：与定量评估相比，评估半定量测定 NT-proBNP 水平的快速检测方法在诊断慢性心力衰竭中的准确性；研究 NT-proBNP 检测结果与慢性心力衰竭严重程度指标之间的关联强度：44名患者的NT-proBNP浓度是在床边用快速检测仪（BioTest，新西伯利亚）进行半定量检测和在实验室进行定量检测的。用 CHF 临床状态量表 (CSS) 评估了 11 名患者 CHF 的严重程度。所有患者均进行了超声心动图检查：定量检测和半定量检测的灵敏度一致，均为 95%。在我们的研究中，定量检测的特异性为 100%，而半定量检测的特异性为 92%。两种检测方法的阴性预测值均为 96%。诊断准确率分别为 98% 和 93%。在 NT-proBNP 浓度明显偏高的患者中，半定量检测验证数值超过 1800 pg/ml 的能力有所下降；而在浓度达到阈值的患者中，半定量检测对阈值以下的敏感性有所提高。根据疾病的分期，NT-proBNP 浓度的增加与 CHF 的严重程度相关：由于半定量检测 NT-proBNP 具有足够高的灵敏度、特异性、易用性和获得结果的速度，因此该快速检测方法有望用于门诊筛查床旁诊断 CHF，以及急诊室确诊或排除 CHF。在确定 CHF 治疗期间 NT-proBNP 的动态变化时，与定量评估相比，使用目测结果的半定量快速检测可能会产生误差，这很可能无法跟踪治疗效果或预测疾病的恶化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kardiologiya 医学-心血管系统

CiteScore

1.70

自引率

20.00%

发文量

审稿时长

3-8 weeks

期刊介绍： “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.