Usefulness of brain natriuretic peptide as a marker for separating cardiac and noncardiac causes of syncope

We retrospectively evaluated the feasibility of measuring brain natriuretic peptide to identify cardiac syncope in 148 consecutive patients with syncope. Sixty-one patients with cardiac syncope were identified. A cut-off value of 40 pg/ml was used to determine the cardiac causes of syncope; the sensitivity and specificity for identification of cardiac syncope were 82% and 92%, respectively. Thus, measurement of brain natriuretic peptide concentrations may help confirm cardiac causes of syncope, and merits consideration for incorporation into the algorithm used to diagnose syncope.