Meta‐analysis of B type natriuretic peptide and N‐terminal pro B natriuretic peptide in the diagnosis of clinical heart failure and population screening for left ventricular systolic dysfunction

Ewald, Ben; Ewald, Dominik; Thakkinstian, A; Attia, John

doi:10.1111/j.1445-5994.2007.01454.x

Cited by 108 publications

(89 citation statements)

References 63 publications

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“…Numerous studies have addressed this issue, and 2 large meta-analyses have summarized the available data. 65,66 These data convincingly demonstrate that natriuretic peptide levels improve diagnostic performance in several settings, including in patients with asymptomatic LV dysfunction, 67,68 in patients presenting with dyspnea and fatigue, [69][70][71][72] and in those presenting to the emergency department (ED) with acute dyspnea.…”

Section: Other Biomarkersmentioning

confidence: 79%

Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association

Chow¹,

Maisel²,

et al. 2017

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Background and Purpose: Natriuretic peptides have led the way as a diagnostic and prognostic tool for the diagnosis and management of heart failure (HF). More recent evidence suggests that natriuretic peptides along with the next generation of biomarkers may provide added value to medical management, which could potentially lower risk of mortality and readmissions. The purpose of this scientific statement is to summarize the existing literature and to provide guidance for the utility of currently available biomarkers. Methods: The writing group used systematic literature reviews, published translational and clinical studies, clinical practice guidelines, and expert opinion/statements to summarize existing evidence and to identify areas of inadequacy requiring future research. The panel reviewed the most relevant adult medical literature excluding routine laboratory tests using MEDLINE, EMBASE, and Web of Science through December 2016. The document is organized and classified according to the American Heart Association to provide specific suggestions, considerations, or contemporary clinical practice recommendations. Results: A number of biomarkers associated with HF are well recognized, and measuring their concentrations in circulation can be a convenient and noninvasive approach to provide important information about disease severity and helps in the detection, diagnosis, prognosis, and management of HF. These include natriuretic peptides, soluble suppressor of tumorgenicity 2, highly sensitive troponin, galectin-3, midregional proadrenomedullin, cystatin-C, interleukin-6, procalcitonin, and others. There is a need to further evaluate existing and novel markers for guiding therapy and to summarize their data in a standardized format to improve communication among researchers and practitioners. Conclusions: HF is a complex syndrome involving diverse pathways and pathological processes that can manifest in circulation as biomarkers. A number of such biomarkers are now clinically available, and monitoring their concentrations in blood not only can provide the clinician information about the diagnosis and severity of HF but also can improve prognostication and treatment strategies.

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Section: Other Biomarkersmentioning

confidence: 79%

Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association

Chow¹,

Maisel²,

et al. 2017

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“…Specifically, there have been significant correlations between elevated FGF23 and elevated BNP plasma levels in patients with left ventricular hypertrophy (19,43). BNP in particular is used as a diagnostic indicator for heart failure (12), suggesting that FGF23 may directly promote the progression of heart failure.…”

Section: Discussionmentioning

confidence: 99%

FGF23 is a novel regulator of intracellular calcium and cardiac contractility in addition to cardiac hypertrophy

Touchberry

Green

Tchikrizov

et al. 2013

American Journal of Physiology-Endocrinology and Metabolism

164

155

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Recent observational studies in humans suggest that circulating FGF23 is independently associated with cardiac hypertrophy and increased mortality, but it is unknown whether FGF23 can directly alter cardiac function. We found that FGF23 significantly increased cardiomyocyte cell size in vitro, the expression of gene markers of cardiac hypertrophy, and total protein content of cardiac muscle. In addition, FGFR1 and FGFR3 mRNA were the most abundantly expressed FGF receptors in cardiomyocytes, and the coreceptor ␣-klotho was expressed at very low levels. We tested an animal model of chronic kidney disease (Col4a3 Ϫ/Ϫ mice) that has elevated serum FGF23. We found elevations in common hypertrophy gene markers in Col4a3 Ϫ/Ϫ hearts compared with wild type but did not observe changes in wall thickness or cell size by week 10. However, the Col4a3 Ϫ/Ϫ hearts did show reduced fractional shortening (Ϫ17%) and ejection fraction (Ϫ11%). Acute exposure of primary cardiomyocytes to FGF23 resulted in elevated intracellular Ca 2ϩ ([Ca 2ϩ ]i; F/Fo ϩ 86%) which was blocked by verapamil pretreatment. FGF23 also increased ventricular muscle strip contractility (67%), which was inhibited by FGF receptor antagonism. We hypothesize that although FGF23 can acutely increase [Ca 2ϩ ]i, chronically this may lead to decreases in contractile function or stimulate cardiac hypertrophy, as observed with other stress hormones. In conclusion, FGF23 is a novel bone/heart endocrine factor and may be an important mediator of cardiac Ca 2ϩ regulation and contractile function during chronic kidney disease. fibroblast growth factor 23; pathological cardiac hypertrophy; chronic kidney disease; Col4a3; cardiac function; ␣-klotho FIBROBLAST GROWTH FACTOR 23 (FGF23) is a hormone released primarily by osteocytes (2, 4, 14, 38) that functions to regulate phosphate and vitamin D homeostasis through direct actions on the kidney and parathyroid (2). Although an endocrine axis has been established between bone and kidney, a new paradigm is emerging in which FGF23 could be important in establishing an endocrine axis between bone and heart. Circulating levels of FGF23 are markedly elevated 100-to 1,000-fold in patients with chronic kidney disease (CKD) (24, 31) and are independently associated with cardiovascular morbidity and mortality (8,22,26,34,35,48,52). Specifically, an association between left ventricular (LV) hypertrophy and serum FGF23 levels has been established in CKD patients (20,36,52).Nevertheless, despite strong associations between FGF23 and adverse outcomes, it remains relatively unknown whether FGF23 is simply a marker of cardiac disease risk or a direct mediator of cardiac pathology and cardiac performance. Only one study to date has analyzed the direct effects of FGF23 on the heart both in vitro and in vivo (13). This important work by Faul et al. (13) shows that FGF23 can directly induce hypertrophy in isolated neonatal cardiomyocytes as well as with intramyocardial FGF23 injections. These authors also demonstrated that a FGF receptor (FGF...

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“…Kiedy nie stwierdza się żadnych nieprawidłowości w powyższych badaniach, HF jest bardzo mało prawdopodobna i należy rozważyć inną diagnozę. W przypadku stwierdzenia odchyleń przynajmniej w jednym badaniu, należy ocenić (o ile to możliwe) stężenia NP w celu zidentyfikowania tych osób, u których konieczne jest badanie echokardiograficzne (echokardiografia jest wskazana u pacjentów z NP powyżej punktu odcięcia lub jeśli badanie NP jest niedostępne) [55][56][57][58][59][60][75][76][77][78].…”

Section: Algorytm Diagnostyczny Niewydolności Serca W Przypadku Nieosunclassified

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Ponikowski

Voors

Anker³

et al. 2016

Kardiol Pol

451

446

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Meta‐analysis of B type natriuretic peptide and N‐terminal pro B natriuretic peptide in the diagnosis of clinical heart failure and population screening for left ventricular systolic dysfunction

Abstract: Tests for BNP are helpful in the diagnosis of clinical HF or in screening for left ventricular systolic dysfunction and are superior to NTproBNP. In the clinical setting, test performance declined with increasing patient age.

Cited by 108 publications

References 63 publications

Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association

Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement From the American Heart Association

FGF23 is a novel regulator of intracellular calcium and cardiac contractility in addition to cardiac hypertrophy

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

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