Aim: Congestive heart failure (CHF) is a severe cardiovascular disorder seen in the Emergency Department (ED). B-type Natriuretic Peptide (BNP) is usually ordered to evaluate the CHF severity. However, it is difficult...Aim: Congestive heart failure (CHF) is a severe cardiovascular disorder seen in the Emergency Department (ED). B-type Natriuretic Peptide (BNP) is usually ordered to evaluate the CHF severity. However, it is difficult to interpret serum BNP level when different clinical entities existed. The aim of this study is to illustrate the correlation between serum BNP level and relevant clinical variables and further determine the role of serum BNP in different CHF patients. Methods: Univariate comparisons between 26 clinical variables and serum BNP level were analyzed. In order to avoid confounding factors, potential independent clinical variables were analyzed together using multivariate regression. Results: 529 CHF patients were reviewed and divided into different groups by 26 clinical variables. Serum BNP levels were found statistically significant different by univariate compareson between groups divided by 8 clinical variables that included obesity, diastolic/systolic heart failure (HF), serum blood urea nitrogen (BUN) level, serum creatinine (Cr) level, serum sodium (Na) level, patients taking loop diuretics, history of cerebrovascular accident (CVA), and history of dementia. Among all 8 clinical variables, obesity, serum BUN, Cr level, and diastolic/systolic HF had weak-to-moderate correlation effects with serum BNP level by correlation coefficient analysis. However, only obesity and dia- stolic/systolic HF were two moderately stronger clini- cal variables that can affect the serum BNP levels by multivariate regression. Analyzing CHF patients separately by obesity and diastolic/systolic HF subsets showed longer hospitalization in diastolic HF patients with relatively higher serum Cr level. In addition, poor correlation was found between serum BNP level and length of hospitalization (LOH) as well. Conclusion: High variability of serum BNP levels exists in CHF patients with weak-to-moderate correlation effects particularly on obesity and diastolic/systolic HF.It is recommended that physicians should be cautious on interpreting BNP in different CHF populations.展开更多
PROFESSIONAL ballerina Yu Chuanya sets high standards for herself. After a recent long haul flight from Beijing to Johannesburg, the 25-year-old went straight into intensive rehearsals soon after landing, ignoring the...PROFESSIONAL ballerina Yu Chuanya sets high standards for herself. After a recent long haul flight from Beijing to Johannesburg, the 25-year-old went straight into intensive rehearsals soon after landing, ignoring the effects of jet lag in pursuit of her craft. What drove her passion was the unique collaboration on the ballet classic Swan Lake, iointly presented by Joburg Ballet of South Africa and Liaoning Ballet of China.展开更多
Hydrostatic pulmonary edema is as an abnormal in-crease in extravascular water secondary to elevatedpressure in the pulmonary circulation, due to conges-tive heart failure or intravascular volume overload.Diagnosis of...Hydrostatic pulmonary edema is as an abnormal in-crease in extravascular water secondary to elevatedpressure in the pulmonary circulation, due to conges-tive heart failure or intravascular volume overload.Diagnosis of hydrostatic pulmonary edema is usuallybased on clinical signs associated to conventional ra-diography findings. Interpretation of radiologic signsof cardiogenic pulmonary edema are often question-able and subject. For a bedside prompt evaluation,lung ultrasound(LUS) may assess pulmonary conges-tion through the evaluation of vertical reverberationartifacts, known as B-lines. These artifacts are relatedto multiple minimal acoustic interfaces between smallwater-rich structures and alveolar air, as it happens incase of thickened interlobular septa due to increase of extravascular lung water. The number, diffusion and in-tensity of B lines correlates with both the radiologic andinvasive estimate of extravascular lung water. The inte-gration of conventional chest radiograph with LUS canbe very helpful to obtain the correct diagnosis. Com-puted tomography(CT) is of limited use in the work upof cardiogenic pulmonary edema, due to its high cost,little use in the emergencies and radiation exposure.However, a deep knowledge of CT signs of pulmonaryedema is crucial when other similar pulmonary condi-tions may occasionally be in the differential diagnosis.展开更多
文摘Aim: Congestive heart failure (CHF) is a severe cardiovascular disorder seen in the Emergency Department (ED). B-type Natriuretic Peptide (BNP) is usually ordered to evaluate the CHF severity. However, it is difficult to interpret serum BNP level when different clinical entities existed. The aim of this study is to illustrate the correlation between serum BNP level and relevant clinical variables and further determine the role of serum BNP in different CHF patients. Methods: Univariate comparisons between 26 clinical variables and serum BNP level were analyzed. In order to avoid confounding factors, potential independent clinical variables were analyzed together using multivariate regression. Results: 529 CHF patients were reviewed and divided into different groups by 26 clinical variables. Serum BNP levels were found statistically significant different by univariate compareson between groups divided by 8 clinical variables that included obesity, diastolic/systolic heart failure (HF), serum blood urea nitrogen (BUN) level, serum creatinine (Cr) level, serum sodium (Na) level, patients taking loop diuretics, history of cerebrovascular accident (CVA), and history of dementia. Among all 8 clinical variables, obesity, serum BUN, Cr level, and diastolic/systolic HF had weak-to-moderate correlation effects with serum BNP level by correlation coefficient analysis. However, only obesity and dia- stolic/systolic HF were two moderately stronger clini- cal variables that can affect the serum BNP levels by multivariate regression. Analyzing CHF patients separately by obesity and diastolic/systolic HF subsets showed longer hospitalization in diastolic HF patients with relatively higher serum Cr level. In addition, poor correlation was found between serum BNP level and length of hospitalization (LOH) as well. Conclusion: High variability of serum BNP levels exists in CHF patients with weak-to-moderate correlation effects particularly on obesity and diastolic/systolic HF.It is recommended that physicians should be cautious on interpreting BNP in different CHF populations.
文摘PROFESSIONAL ballerina Yu Chuanya sets high standards for herself. After a recent long haul flight from Beijing to Johannesburg, the 25-year-old went straight into intensive rehearsals soon after landing, ignoring the effects of jet lag in pursuit of her craft. What drove her passion was the unique collaboration on the ballet classic Swan Lake, iointly presented by Joburg Ballet of South Africa and Liaoning Ballet of China.
文摘Hydrostatic pulmonary edema is as an abnormal in-crease in extravascular water secondary to elevatedpressure in the pulmonary circulation, due to conges-tive heart failure or intravascular volume overload.Diagnosis of hydrostatic pulmonary edema is usuallybased on clinical signs associated to conventional ra-diography findings. Interpretation of radiologic signsof cardiogenic pulmonary edema are often question-able and subject. For a bedside prompt evaluation,lung ultrasound(LUS) may assess pulmonary conges-tion through the evaluation of vertical reverberationartifacts, known as B-lines. These artifacts are relatedto multiple minimal acoustic interfaces between smallwater-rich structures and alveolar air, as it happens incase of thickened interlobular septa due to increase of extravascular lung water. The number, diffusion and in-tensity of B lines correlates with both the radiologic andinvasive estimate of extravascular lung water. The inte-gration of conventional chest radiograph with LUS canbe very helpful to obtain the correct diagnosis. Com-puted tomography(CT) is of limited use in the work upof cardiogenic pulmonary edema, due to its high cost,little use in the emergencies and radiation exposure.However, a deep knowledge of CT signs of pulmonaryedema is crucial when other similar pulmonary condi-tions may occasionally be in the differential diagnosis.
