Assessment of the impact of different N terminal pro brain natriuretic peptide thresholds on echocardiography services.

N terminal pro brain natriuretic peptide thresholds recommended by ESC and NICE result in large numbers of patients with suspected chronic heart failure being referred for echocardiography. Raising the NT-proBNP threshold would improve access to echocardiography with minimal negative impact on the clinical performance of this cardiac biomarker.