Blood Test For Heart Failure - - The News for South Mississippi

Blood Test For Heart Failure

A 15-minute blood test lets emergency room doctors accurately judge whether patients with severe shortness of breath are suffering from congestive heart failure. The test ``is the most significant improvement in the diagnosis of heart failure in the past 20 years,'' said Dr. Alan Maisel, director of the coronary unit at the San Diego Veterans Affairs Medical Center.

Tens of millions of people go to the emergency room each year because of trouble breathing. Heart failure is one of the worst and most common causes but far from the only one. Until recently, there was no simple test for heart failure, and doctors often confuse it with other diseases.

A major study released Tuesday shows that a $20 test that measures a protein released by stressed heart muscle can quickly sort out whose bad breathing is caused by heart failure, which occurs when the heart cannot pump forcefully enough. Maisel directed the study, which was partially financed by the test's maker, Biosite Inc. of San Diego. He presented the results in Atlanta at the annual meeting of the American College of Cardiology.

The test, called Triage, is already used by about 500 U.S. hospitals, Maisel said. It measures levels of a protein called B-type natriuretic peptide, which is often greatly elevated during heart failure. Ordinarily, doctors diagnose heart disease by taking a history of symptoms, a physical exam, an electrocardiogram, an ultrasound scan and blood tests to rule out other causes, such as kidney disease. Even with all this, they are often wrong. Dr. Margaret Redfield of the Mayo Clinic said other studies show doctors miss about 20 percent of cases and about half of all those they initially call heart failure are actually something else. Maisel's study found that the test alone is 83 percent accurate in diagnosing heart failure in people with unexplained breathing difficulty.

It was conducted on 1,586 men and women at seven hospitals in the United States and Europe. In 43 percent of the cases, doctors felt unsure based on the usual criteria whether patients' breathing problems were caused by heart failure. The test results reduced this uncertainty to 11 percent. Usually, he said, the test readings for people with heart disease are many times higher than for victims of other breathing disorders, such as asthma. ``Most of these cases were no-brainers,'' Maisel said.

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