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Previous Volume 347:1976-1978 December 12, 2002 Number 24 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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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 . . . [Full Text of this Article]

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