Clinical Considerations and Applications in Cardiac Diseases

Clerico, Aldo; Passino, Claudio; Emdin, Michele

doi:10.1007/88-470-0498-5_5

Cited by 2 publications

(3 citation statements)

References 256 publications

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“…In fact, although it is necessary to establish whether a plausible biological explanation exists for the observed statistical relationship between gene variants and pathological phenotypes, generally ANP levels are not measured. To overcome this limitation in the present study, we measured concentrations of not only ANP but also BNP and NT-proBNP, which are also increased in HF (10 ). Thus, although the relatively low number of study participants may represent a limitation, the importance of our results is reinforced by strict criteria used to select our population, homogeneity of pharmacologic treatment, and strengthened by the clinical phenotype and circulating NP correlates.…”

Section: Discussionmentioning

confidence: 99%

Influence of ScaI and Natriuretic Peptide (NP) Clearance Receptor Polymorphisms of the NP System on NP Concentration in Chronic Heart Failure

et al. 2007

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Results: ScaI polymorphism had no effect on NP concentration in the NYHA I-II subgroup. Conversely, in severe HF, A1 carriers had higher ANP (P <0.05), BNP (P <0.01), and NT-proBNP (P <0.01) than A2A2 patients. After multivariate adjustment, A1 presence remained an independent predictor for increased NP. Regarding NPRC polymorphism in mild HF, higher ANP (P <0.05) and BNP (P <0.05) were observed in CC than A allele carriers. After multivariate adjustment, however, this association did not remain significant. In severe HF, the NPRC polymorphism had no effect on NP.

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Section: Discussionmentioning

confidence: 99%

Influence of ScaI and Natriuretic Peptide (NP) Clearance Receptor Polymorphisms of the NP System on NP Concentration in Chronic Heart Failure

et al. 2007

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“…The low percentage of reliable eHFLs at levels 0 -3 (the " gray zone " of diagnostic outcomes) likely depends on the cardiac and/or extra-cardiac BNP conditioning factors, such as arrhythmias, coronary ischemia, valvular dysfunctions, age, gender, disease prevalence, renal failure, pulmonary or systemic hypertension, anemia, and body mass index [ 5 ]. These first-order conditioning HeFs can be more exhaustively explored trough a large, multicenter follow-up study or an individual patient meta-analysis [ 79 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the use of physiological descriptors such as " diastolic HF " has declined, and the more descriptive term " heart failure with normal ejection fraction (HFNEF) " has been adopted [ 2 ]. The differential diagnosis between HF-associated acute dyspnea and other cardiac or non-cardiac dyspneas cannot be easily or quickly made at the point-of-care or in an emergency department [ 5 ]. For HF diagnosis in emergency departments, echocardiography is challenging because it generally requires a longer turn-around time and advanced operator skills, which are disadvantages compared with the BNP test.…”

Section: Introductionmentioning

confidence: 99%

The diagnostic utility of brain natriuretic peptide in heart failure patients presenting with acute dyspnea: a meta-analysis

Mastandrea

2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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Heart failure with normal ejection fraction (HFNEF) accounts for approximately 50% of heart failure (HF) cases. To establish the utility of brain natriuretic peptide (BNP) in differentiating HF-related severe dyspnea from non-HF-related acute dyspnea, we used an estimation formula (eF) that was obtained from a series of three meta-regressions. We selected 60 out of 2721 case-control and follow-up studies that were published from 1998 to 2010. The heart failure levels (HFLs) were assessed using the New York Heart Association (NYHA) criteria. Random-effects meta-regression analyses of the natural logarithm (ln) of the BNP odds ratio (OR) were performed on the HFLs. The ln of the median BNP values (lnmBNP) was meta-regressed over the laboratory method (LM). A third meta-regression was performed on the HFLs to account for only the lnmBNP in the homogeneous LM subgroups. To determine the eF, the data from the diseased and control subjects were combined. The Bland-Altman method was used to detect eF bias. The overall BNP(OR) in the subgroup with severe HF was 35. The lnmBNP analysis showed that LM was a significant heterogeneity factor in the meta-regression (slope − 0.38; CI − 0.59 to − 0.16). The meta-regression of lnmBNP on the HFL resulted in the following calculation for eF: estimated HFL (eHFL) = (lnmBNP -3.157)/0.886. The Bland-Altman test revealed no significant difference (0.0997; 95% CI − 2.84 to 3.06) between HFL and eHFL. The severe eHFL showed a 78% accuracy. Based on the eF obtained from this meta-analysis, the BNP outcomes were shown to reliably diagnose severe dyspnea in HF and differentiate this condition from non-HF acute dyspnea.

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Clinical Considerations and Applications in Cardiac Diseases

Cited by 2 publications

References 256 publications

Influence of ScaI and Natriuretic Peptide (NP) Clearance Receptor Polymorphisms of the NP System on NP Concentration in Chronic Heart Failure

Influence of ScaI and Natriuretic Peptide (NP) Clearance Receptor Polymorphisms of the NP System on NP Concentration in Chronic Heart Failure

The diagnostic utility of brain natriuretic peptide in heart failure patients presenting with acute dyspnea: a meta-analysis

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