Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology
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Comparative Study
Comparative value of BNP and NT-proBNP in diagnosis of heart failure.
Heart failure (HF) remains a major diagnostic challenge. Brain natriuretic peptide (BNP) and the N-terminal portion of proBNP (NT-proBNP) have emerged as excellent diagnostic biohumoral indicators in cardiac disease. It is not clear which of the two is superior as a diagnostic marker in HF. ⋯ Both peptides had an excellent ability to distinguish HF from non-HF subjects. NT-proBNP was more sensitive and specific. Nevertheless, neither peptide could differentiate between the SDG and the PFG by itself. NT-proBNP is a simple, highly effective diagnostic test for HF. A favorable impact on management and costs is expected from implementation of this diagnostic test in clinical practice.
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Cardiac arrest is a classic contraindication for fibrinolysis, due to possible hemorrhagic complications. Most cardiac arrests, particularly those occurring out-of-hospital, are caused by vascular thrombosis, including myocardial infarction and pulmonary embolism, in which fibrinolysis has proved to be an effective treatment. Indeed, there are several reports and clinical trials suggesting that fibrinolysis may be a safe and effective therapeutic option in patients with cardiac arrest of presumed cardiovascular cause. Based on a case of successful fibrinolytic treatment of a pulmonary embolism patient with cardiac arrest, these questions are reviewed.
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The authors studied the effect of volume status modification on cardiac Doppler features, with negative fluid balance and corresponding central venous pressure change. This was carried out in 64 patients admitted to the Intensive Care Unit, 24 of whom were under mechanical ventilation. ⋯ No significant correlation was observed between the parameters studied and volume changes, or between central venous pressure and fluid balance. Volume changes in critical care patients modify certain features of Doppler echocardiography, but the magnitude of such variations is unpredictable.