Comparison of the diagnostic values of MR-proANP (mid-regional pro-atrial natriuretic peptide) and cardiopulmonary USG in the diagnosis of heart failure in patients admitted to emergency service with dyspnea

Introduction and Aim: The main complaint of patients with acute heart failure in emergency service is shortness of breath. This study aimed to investigate the diagnostic value of the use of MR-proANP and cardiopulmonary ultrasonography in patients with shortness of breath and heart failure in the emergency department. Materials and Methods: The demographic data, physical examination and vital signs, MR-proANP levels, blood gas results, and bedside ultrasonography findings of adult patients with shortness of breath were statistically compared according to the diagnosis. Results: 45.8% of the patients who applied with shortness of breath had decompensated heart failure. Apart from that, the most common causes were COPD exacerbation, pulmonary embolism, and pneumonia (bacterial and Covid -19). The most common physical examination findings were rales, jugular fullness, and pretibial edema. In bedside ECHO, while EF was below 45% in 36.1% of patients, MR-proANP levels did not differ between patients with EF below and above 45%. MR-proANP values were similar between groups with and without decompensated heart failure. In the patient group with decompensated heart failure, the frequency of patients with EF<45% and diastolic insufficiency was significantly higher than the other patient group. The combined use of different combinations of lung ultrasound and echocardiogram parameters (B, PLAPS profiles, EF, diastolic failure) was more successful in recognizing decompensated heart failure in all cases. MR-proANP alone was not competent enough to diagnose or rule out decompensated heart failure. Diastolic insufficiency and B profile parameters alone did not have the power to diagnose or rule out heart failure. Discussion and Conclusion: Cardiopulmonary ultrasonography was capable of diagnosing heart failure in patients admitted to the emergency department with shortness of breath, but MR-proANP was not capable of diagnosing heart failure and when its levels were evaluated according to cardiopulmonary ultrasonography findings, no significant difference was found. Keywords: Shortness of breath, Decompensated heart failure, Diastolic failure, Cardiopulmonary ultrasonography, MR-proANP