Natriuretic peptides in the diagnosis and management of heart failure

Felker, G. Michael; Petersen, John W.; Mark, Daniel B.

doi:10.1503/cmaj.060236

Cited by 96 publications

(92 citation statements)

References 48 publications

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“…NTproBNP is synthesized in myocytes from the ventricles in relation to the severity of ventricular dysfunction and promotes the renal excretion of sodium (natriuresis) and water (diuresis), causes vasodilatation by relaxing vascular smooth muscle cells, improves diastolic relaxation (lusitropy) and decreases myocardial fibrosis. 13 According to previous reports, our study shows that in patients with pneumonia hospitalized in an internal medicine ward there is a good and moderate correlation between NT-proBNP and the illness score PSI and CURB-6. These scores have demonstrated to be able to evaluate the severity and prognosis of patients with pneumonia and are suggested by the guidelines as tool to take into consideration, also to decide the setting where to treat the patients affected by pneumonia.…”

Section: Discussionsupporting

confidence: 66%

NT-proBNP correlates with the illness scores pneumonia severity index and CURB-65 in patients with pneumonia

et al. 2017

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Pneumonia severity index (PSI) and urea, respiratory rate, blood pressure, age ≥65) are used to estimate the severity and prognosis of patients with pneumonia. NT-proBNP is a marker of myocardial stress and of sepsis-induced myocardial depression and might be used to predict short and long-term survival in patients with pneumonia. Twenty-three patients [age 79±15 standard deviation (SD); M/F 8/15, CURB-65 2.2±0.9 SD, PSI 118±38 SD, procalcitonin 3.9±5 SD] with pneumonia hospitalized in our Internal Medicine Unit were retrospectively evaluated. NT-proBNP was measured in the first 72 h of hospitalization. CURB-65 and PSI were calculated and correlation with biomarkers investigated. NT-proBNP showed a moderate statistically significant correlation with both PSI and CURB-65 (NT-proBNP vs PSI, r=0.42, P<0.05, NT-proBNP vs CURB-65, r=0.46, P<0.05). These correlations were confirmed also when patients with a diagnosis of heart failure where excluded from the analysis, even if the correlation did not reach the statistical significance. NT-proBNP seems to well correlate with the illness scores PSI and CURB-65 and might be a reliable predictor of severity and survival in patients with pneumonia.

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Section: Discussionsupporting

confidence: 66%

NT-proBNP correlates with the illness scores pneumonia severity index and CURB-65 in patients with pneumonia

et al. 2017

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“…another reason for this discrepancy may be that BNP reaction to physiological stimuli is very fast; on the other hand TsH level normalization is delayed up to months. This delay can also explain the lack of correlation between these parameters in our study [13].…”

Section: Methodsmentioning

confidence: 60%

Decreasing Brain Natriuretic Peptide Levels after Treatment for Hyperthyroidism

et al. 2009

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Brain natriuretic peptide (BNP) belongs to the family of natriuretic peptides which counterbalances the renin-angiotensin-aldosterone system. BNP are produced in ventricular cardiomyocytes, and secreted in response to volume expansion or pressure overload. The BNP test can be used to detect preclinical heart disease or to confirm the cardiac etiology in symptomatic patients. Brain natriuretic peptide was investigated in several extra-cardiac conditions such as rheumatic diseases, pulmonary diseases [1,2].Hyperthyroidism can manifest with overt clinical symptoms of heart failure. The increase in pulse rate and cardiac output seen in untreated hyperthyroid patients also represents a situation of increased cardiac abstract. BNP are produced in ventricular cardiomyocytes, and secreted in response to volume expansion or pressure overload. The purpose of this study was to assess BNP levels in patients with hyperthyroidism before specific treatment for hyperthyroidism and after euthyroidism was achieved. The study was performed in a prospective design. The study population consisted of 48 consecutive newly diagnosed untreated overt hyperthyroid patients who had not been treated any anti-thyroid medications before. all subjects underwent transthoracic echocardiography. levels of fT3, fT4, TsH and BNP were measured before the onset of the treatment and after euthyroidism was achieved. A significant decrease in BNP (102.5 (6.7-1769) ng/l vs. 5.0 (0.1-87.0) ng/l p< 0.001) levels were observed, after euthyroidism was achieved. The decrease in BNP levels was positively correlated with the decrease in fT3 (r=0.298; p=0.049) and fT4 (r=0.313; p=0.030).There was no correlation between BNP levels and TsH levels (p=Ns). We conclude that hyperthyroidism may cause high BNP measurements which can lead to misdiagnosis of congestive heart failure. We suggest that thyroid hormones should be checked in patients with high levels of BNP.Key words: Hyperthyroidism, BNP, echocardiography, Heart failure (Endocrine Journal 56: [1043][1044][1045][1046][1047][1048] 2009) stretch, which theoretically could influence the secretion of BNP [3]. There are only a few studies investigating the influence of thyroid dysfunction on BNP measurements [4][5][6]. However there are controversial issues in this field. The purpose of this study was to assess BNP levels in patients with hyperthyroidism before specific treatment for hyperthyroidism and after euthyroidism was achieved. MethodsThe study was performed in a prospective design. The study population consisted of 48 consecutive newly diagnosed untreated overt hyperthyroid patients who had not been treated any anti-thyroid medications before. Overt hyperthyroidism was diagnosed when patients simultaneously showed high serum concentra-

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“…Once validated, proposed biomarkers can be involved in achieving an earlier diagnosis, differentiating between disease types with greater accuracy, and assessing response to treatment. Prominent examples of biomarkers include proteins that are associated with a variety of cancers, [1][2][3][4] as well as heart, 5,6 renal, 7,8 andAlzheimer's 9,10 diseases.Most biomarker studies reported to date have focused on serum-, plasmaand urine-based samples. A number of other possibilities include saliva, tears, breath condensates, cerebrospinal fluid and tissue lysates extracted from biopsy samples.…”

Section: Introductionmentioning

confidence: 99%

Microarray methods for protein biomarker detection

Lee

Wark

Corn

2008

Analyst

137

108

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The application of protein biomarkers as an aid for the detection and treatment of diseases has been subject to intensified interest in recent years. The quantitative assaying of protein biomarkers in easily obtainable biological fluids such as serum and urine offers the opportunity to improve patient care via earlier and more accurate diagnoses in a convenient, non-invasive manner as well as providing a potential route towards more individually targeted treatment. Essential to achieving progress in biomarker technology is the ability to screen large numbers of proteins simultaneously in a single experiment with high sensitivity and selectivity. In this article, we highlight recent progress in the use of microarrays for high-throughput biomarker profiling and discuss some of the challenges associated with these efforts. I IntroductionThe discovery of protein biomarkers whose change in expression level or state correlates with the progression of a disease is becoming increasingly important. Once validated, proposed biomarkers can be involved in achieving an earlier diagnosis, differentiating between disease types with greater accuracy, and assessing response to treatment. Prominent examples of biomarkers include proteins that are associated with a variety of cancers, 1-4 as well as heart, 5,6 renal, 7,8 andAlzheimer's 9,10 diseases.Most biomarker studies reported to date have focused on serum-, plasmaand urine-based samples. A number of other possibilities include saliva, tears, breath condensates, cerebrospinal fluid and tissue lysates extracted from biopsy samples. There are several excellent reviews detailing biomarker discovery and validation. [11][12][13][14][15] The potential benefits of biomarkers have greatly motivated both academic and industry researchers to apply new proteomic technologies for biomarker discovery and to develop quantitative analytical methodologies for rapid and sensitive biomarker detection. Many clinically relevant biomarkers reside in blood at picomolar concentrations and lower, which is five to seven orders of magnitude lower than the most abundant plasma proteins. Therefore, protein detection with high specificity and sensitivity is required; unfortunately, no universal ultrasensitive enzymatic amplification method (such as PCR for the case of nucleic acid detection) exists for proteins. Additionally, it is desirable to screen multiple proteins simultaneously in a single sample. Multiplexed measurements are attractive not only for economic reasons but also for identifying characteristic signal patterns associated with the relative changes in entire sets of proteins as this will provide much more insight and diagnostic accuracy than individual biomarker measurements.hyejinlee@knu.ac.kr. 14,19,[24][25][26][27][28][29][30] Although microarray methods are wellestablished for high-throughput nucleic acid studies, their application for protein detection has been limited by issues such as the surface immobilization of protein capture probes without loss in bioactivity as well a...

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Natriuretic peptides in the diagnosis and management of heart failure

Cited by 96 publications

References 48 publications

NT-proBNP correlates with the illness scores pneumonia severity index and CURB-65 in patients with pneumonia

NT-proBNP correlates with the illness scores pneumonia severity index and CURB-65 in patients with pneumonia

Decreasing Brain Natriuretic Peptide Levels after Treatment for Hyperthyroidism

Microarray methods for protein biomarker detection

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