HeartLogic Performs as Well as NT-proBNP to Rule out Acute Heart Failure at Point of Care

Abstract

Background The ESC Guidelines recommend the measurement of N-terminal pro B-type natriuretic peptide (NT-proBNP) concentration in all patients who present to emergency rooms with acute dyspnoea and suspected acute decompensated heart failure (HF), with a decision cut-off (NT-proBNP Purpose The purpose of this analysis was to compare the diagnostic accuracy of NT-proBNP and HeartLogic to rule out ADHF in acute settings. Methods The MultiSENSE study followed 900 HF patients with implanted CRT-Ds for up to 1 year. All hospitalizations were adjudicated by an independent panel of clinicians, and classified as HF or non-HF based on the presenting cause. Optional NT-proBNP tests were conducted when patients were hospitalized. The composite HeartLogic index of the day before each of the hospitalization dates were extracted to differentiate HF and non-HF hospitalizations. By varying the HeartLogic index decision cutoff, a ROC curve was generated to assess the prediction accuracy of HeartLogic and compared to the counterpart performance of NT-proBNP using Hanley and McNeil s method. Results Of the total 603 hospitalizations, 76 hospitalizations (52 HF, 24 non-HF) had both valid NT-proBNP measures within 48 hours of admission (71 within 24 hours), and valid HeartLogic for the day before the hospitalization date. Figure 1 illustrates that the HeartLogic -based ROC was similar to the ROC of NT-proBNP (AUC of 0.809 and 0.803, respectively, p=0.932). An exclusion criterion of HeartLogic index Conclusion HeartLogic showed similar accuracy for differentiating HF and non-HF hospitalizations in the MultiSENSE dataset as NT-proBNP. HeartLogic may be used in the acute setting to exclude acute decompensated heart failure.