Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides.

Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
M BarentsM J L de Jongste

Abstract

Without knowing the exact CHF prevalence, chronic heart failure (CHF) occurs frequently in elderly people both inside and outside nursing homes. For a diagnosis we have to rely on physical examination and additional tests. We therefore run the risk of missing CHF diagnoses or of diagnosing CHF when we should not. Natriuretic peptide assays have emerged as a diagnostic test but their use in nursing home residents is limited. We examined the number of misdiagnoses, the CHF prevalence and the role of natriuretic peptide. Residents in one centre without aphasia, cognitive impairments or metastatic cancer were screened for CHF; the natriuretic peptide levels were measured separately. Of the 150 residents, 103 (64%) were included (79+/-11 years). The diagnosis of CHF was established in 24 of these 103 residents with NTproBNP 1871 (IQR 539 to 4262) and BNP 194 (IQR 92 to 460) pg/ml. A striking result was that of the 24 residents found to have CHF after the screening, 15 (66%) had previously been undetected: NT-proBNP 1146 (interquartile range (IQR) 228 to 3341) and BNP 200 (IQR 107 to 433) pg/ml. Moreover, in 13 out of 22 residents (62%) who had previously been thought to have CHF, the diagnosis was rejected: NT-proBNP 388 (IQR 174 to...Continue Reading

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Citations

Apr 30, 2010·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·I C C van der HorstD J van Veldhuisen
Mar 15, 2012·BMC Research Notes·Helen C HancockJerry J Murphy
Mar 6, 2012·European Journal of Epidemiology·Maarten J G LeeningJacqueline C M Witteman
Nov 6, 2013·BMC Geriatrics·Beata Borgström BolmsjöPatrik Midlöv
Jun 16, 2009·Congestive Heart Failure·Mihály TapolyaiNeville R Dossabhoy
Jan 5, 2013·European Journal of Heart Failure·Arno W Hoes
Jan 15, 2010·Scandinavian Journal of Caring Sciences·Mariëlle A M J DaamenJan P H Hamers
May 28, 2014·European Journal of Heart Failure·Evelien E S van RietFrans H Rutten
Mar 23, 2020·Heart Failure Reviews·Vesna HomarMitja Lainscak
May 29, 2021·Journal of Cardiac Failure·Chun Wai WongChun Shing Kwok

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