E-resources
Peer reviewed
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Colli, Agostino; Fraquelli, Mirella; Conte, Dario
The New England journal of medicine, 12/2002, Volume: 347, Issue: 24Journal Article
To the Editor: Maisel et al. (July 18 issue) 1 suggest the usefulness of measurement of B-type natriuretic peptide in the diagnosis of left ventricular dysfunction in patients with acute dyspnea, but their conclusions must be challenged. With a cutoff level of 50 pg per milliliter for B-type natriuretic peptide, the negative likelihood ratio was 0.04, allowing them to rule out the diagnosis. Conversely, the specificity (83 percent) and the positive likelihood ratio (5.1) obtained with a cutoff level of 150 pg per milliliter seem too low to confirm the diagnosis definitely, because the post-test probability of symptomatic left ventricular dysfunction . . .
