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. 2023 Nov 5;15(11):e48306.
doi: 10.7759/cureus.48306. eCollection 2023 Nov.

Rapid N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) Kit as a Differentiating Tool for Acute Dyspnea in a Resource-Limited Setting

Sweta Sahu  1 , Devarsh N Shah  2 , Roopeessh Vempati  3   4 , Pallavi Roy Kandhi  5 , Mihirkumar P Parmar  6 , Sanjay Bethanabotla  7 , Shardool Gadgil  8 , Prerna Chandra  9 , Sangamesh N Malipatil  10 , Yash Patel  6 , Balaganesh Natarajan  11 , Thrilok Chander Bingi  12
Affiliations

Rapid N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) Kit as a Differentiating Tool for Acute Dyspnea in a Resource-Limited Setting

Sweta Sahu et al. Cureus. .

Abstract

Introduction Dyspnea is among the most prevalent symptoms experienced by patients presenting as an emergency. The underlying etiology is often a cardiovascular or pulmonary condition, of which heart failure is recognized as a major contributor. The differentials are primarily established based on the patient's clinical presentation and physical examinations but are not conclusive. Of the various investigations undertaken to determine the cause of dyspnea, the biomarker N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) was found to be significantly associated with heart failure. Its level has been proven to be in direct correlation with the severity of the disease. This study demonstrates the usability of an economical rapid test kit in measuring NT-ProBNP levels to help differentiate the cause of dyspnea in the presenting patient in a resource-limited setting. Methodology We studied 115 participants from a tertiary care center in India, which included 70 males and 45 females aged ≤30 to ≥75 years, presenting with shortness of breath. Rapid NT-ProBNP tests were conducted alongside recording their symptoms, vitals, examination findings, and other parameters. They were also classified according to New York Heart Association (NYHA) Classification, and further investigated. Results The study elucidated the efficacy and accuracy of the rapid kits in determining NT-ProBNP levels, and its relation with the severity and prognosis of heart failure. The kits utilized had a sensitivity of greater than 93% for ruling out heart failure as a cause of dyspnea, and a sensitivity of greater than 96% for ruling out elevated NT-ProBNP levels in general. Other parameters such as presenting symptoms and vitals were also analyzed, establishing a correlation with NT-ProBNP levels. Conclusion This study guided us in understanding the effective utilization of the rapid testing kits for emergency care, minimizing the burden on other limited resources. The lower cost and ease of use would serve as a quick means of reaching a conclusive diagnosis, especially in an emergency, which in turn would aid in receiving timely and specific treatment. These kits could act as a stepping stone in creating a sustainable and efficient healthcare system for patients as well as healthcare workers.

Keywords: acute heart faiure; cardiopulmonary diseases; nt-probnp; resource limited setting; severe dyspnea.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Rapid NT-proBNP kit used in the study
*Mytest® NT-proBNP; Biofootprints Healthcare Pvt Ltd, New Delhi, India
Figure 2
Figure 2. Symptoms experienced by the patients
Figure 3
Figure 3. Age and gender distribution of participants
Figure 4
Figure 4. Etiologies of dyspnea presentation
HF: Heart failure
Figure 5
Figure 5. Onset of dyspnea among participants
Figure 6
Figure 6. Duration of dyspnea among research participants
Figure 7
Figure 7. Comparison of severity of NYHA with increasing NT-ProBNP levels
NYHA: New York Heart Association; NT-ProBNP: N-Terminal Pro-B-Type Natriuretic Peptide
See this image and copyright information in PMC

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