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Table 2 Plasma BNP, lung ultrasound alone or combined with BNP, cardiac findings, and the LCI integrated ultrasound for diagnosis of AHFS

From: Rapid evaluation by lung-cardiac-inferior vena cava (LCI) integrated ultrasound for differentiating heart failure from pulmonary disease as the cause of acute dyspnea in the emergency setting

  Sensitivity (%) Specificity (%) NPV (%) PPV (%) Accuracy (%)
BNP ≥100 pg/ml 92.4 35.1 76.4 67.1 68.8
Framingham criteria* 79.2 56.7 65.6 64.6 70.0
Lung ultrasound alone 96.2 54.0 90.9 75.0 78.8
Both Lung ultrasound and BNP (≥100 pg/ml) 88.6 67.6 80.6 79.8 80.0
Reduced EF (LVEF <40%) 26.4 86.5 45.1 73.7 51.1
MR or TR ≥ moderate 92.4 81.0 88.2 87.5 87.7
IVC collapsibility <50% 83.0 81.1 76.9 86.3 82.2
Both preserved EF and MR ≥ moderate 56.7 100.0 61.6 100.0 67.0
Both reduced EF and either MR or TR ≥ moderate 30.1 94.5 48.6 88.9 56.7
Lung-cardiac-inferior vena cava (LCI) integrated ultrasound 94.3 91.9 91.9 94.3 93.3
  1. * Two major or one major and two minor criteria. BNP = brain natriuretic peptide; LCI = lung-cardiac-inferior vena cava; AHFS = acute heart failure syndromes; NPV = negative predictive value; PPV = positive predictive value; LVEF = left ventricular ejection fraction; IVC = inferior vena cava; MR = mitral regurgitation; TR = tricuspid regurgitation.