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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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Volume 46, Issue 11 (Nov 2008)


Natriuretic peptide testing in emergency settings

Jordi Ordonez-Llanos
  • 1Servei de Bioquímica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain and Departament de Bioquímica i Biologia Molecular, Universitat Autònoma, Barcelona, Spain
/ Javier Merce-Muntanola
  • 2Servei de Bioquímica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
/ Miquel Santalo-Bel
  • 3Unitat de Semicrítics, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain


Acutely dyspneic patients are challenging, because their symptoms can be due to cardiac, pulmonary or other diseases. B-type natriuretic peptide testing offers higher diagnostic accuracy (85%–90%) than clinical assessments for identifying heart failure as the cause of dyspnea. On the other hand, the high clinical sensitivity and negative predictive value of natriuretic peptides permit to rule out heart failure with an accuracy >90%. Natriuretic peptides are the most powerful, single prognostic markers of complications associated with acute dyspnea and permit the early recognition of high-risk patients. It has been shown that systematic natriuretic peptide testing reduces the economic expenses associated with clinical management of acutely dyspneic patients. Finally, whether these biomarkers could be used to guide heart failure therapy in the acute setting remains to be elucidated.

Clin Chem Lab Med 2008;46:1543–9.

Keywords: acute heart failure; B-type natriuretic peptides; cost-benefit; diagnostic gray zone; prognosis

About the article

Corresponding author: Jordi Ordonez-Llanos, MD, PhD, Servei de Bioquímica, Hospital de la Santa Creu i Sant Pau, Avinguda Sant Antoni Maria Claret 167, 08025 Barcelona, Spain Phone: +34-93-2919451, Fax: +34-93-2919196,

Received: 2008-07-12

Accepted: 2008-09-12

Published in Print: 2008-11-01

Citation Information: Clinical Chemistry and Laboratory Medicine, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2008.298. Export Citation

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