Use of Amino-Terminal Pro–B-Type Natriuretic Peptide to Guide Outpatient Therapy of Patients With Chronic Left Ventricular Systolic Dysfunction

Januzzi, James L.; Rehman, Shafiq; Mohammed, Asim; Bhardwaj, Anju; Barajas, Linda; Barajas, Justine; Kim, Han Na; Baggish, Aaron L.; Weiner, Rory B.; Chen‐Tournoux, Annabel; Marshall, Jane E.; Moore, Stephanie; Carlson, William D.; Lewis, Gregory D.; Shin, Jordan T.; Sullivan, Dorothy; Parks, Kimberly A.; Wang, Thomas J.; Gregory, Shawn A.; Uthamalingam, Shanmugam; Semigran, Marc J.

doi:10.1016/j.jacc.2011.03.072

Cited by 330 publications

(269 citation statements)

References 34 publications

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“…In some studies, a prespecified treatment escalation algorithm was followed21, 22 while in other studies the attending clinician was instructed to escalate treatment according to their individual clinical judgment 23, 24, 25. Our study used an empirical prespecified treatment escalation strategy that, included increasing existing doses of furosemide followed by introduction of thiazide diuretics and spironolactone, similar to the algorithms described in the aforementioned human studies.…”

Section: Discussionmentioning

confidence: 99%

Effect of prespecified therapy escalation on plasma NT‐proBNP concentrations in dogs with stable congestive heart failure due to myxomatous mitral valve disease

Hezzell

Block

Laughlin

et al. 2018

Veterinary Internal Medicne

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BackgroundTreatment targeted to achieve reduction in N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) improves outcomes in human congestive heart failure (CHF) patients.HypothesisA pre‐specified therapeutic algorithm that increased diuretic or pimobendan usage will reduce plasma NT‐proBNP concentrations in dogs with CHF secondary to myxomatous mitral valve disease (MMVD).AnimalsTwenty‐six dogs with clinically stable CHF secondary to MMVD.MethodsProspective, controlled before‐and‐after study. Dogs were examined up to 3 times over 21 days. Treatment was prescribed based on NT‐proBNP as follows: <1500 pmol/L at baseline, no treatment adjustment at any point during the study (group 1); ≥1500 pmol/L and creatinine ≤3.0 mg/dL at baseline or SC visits, treatment escalated according to the algorithm (group 2); ≥1500 pmol/L at baseline, no treatment adjustment (group 3).ResultsN‐terminal pro‐B‐type natriuretic peptide decreased significantly in group 2 (mean change = −1736 pmol/L (95% CI, −804 to −2668), P < .001) but not in groups 1 or 3 (623 pmol/L [–631 to 1877 pmol/L], P = .14 and 685 pmol/L [–304 to 1068 pmol/L], P = .46, respectively). Serum BUN and creatinine did not change significantly between visit 0 and visit 2 in group 1 (median = 23 mg/dL [range 13‐32] versus 19 mg/dL [12‐38], P = .72 and 1.15 mg/dL [0.70‐1.40] versus 0.95 mg/dL [0.70‐1.10], P = .10, respectively) or group 2 (28 mg/dL [18‐87] versus 43.5 mg/dL [21‐160], P = .092 and 1.10 mg/dL [0.90‐2.50] versus 1.55 mg/dL [0.90‐3.30], P = .062, respectively).Conclusions and Clinical ImportanceUse of this treatment escalation algorithm allows effective targeting of treatment for CHF in dogs against an objective criterion.

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Section: Discussionmentioning

confidence: 99%

Effect of prespecified therapy escalation on plasma NT‐proBNP concentrations in dogs with stable congestive heart failure due to myxomatous mitral valve disease

Hezzell

Block

Laughlin

et al. 2018

Veterinary Internal Medicne

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“…1 In a prospective study addressing the function of Nterminal pro-B-type natriuretic peptide (NT-proBNP) in guiding the treatment options for cases with impaired left ventricle (LV) systolic function, NT-proBNP-guided therapy was associated with lower event rates, improved living conditions, and superior LVEF (left ventricular ejection fraction) compared to standard therapies, independent on the age of the subjects (p = 0.03). 2 The Atherosclerosis Risk in Communities (ARIC) Study, recruiting 12,230 patients with a body mass index (BMI) of ≥18.5 kg/m 2 and no history of HF at baseline, followed-up their evolution for a median of 20.6 years, and showed that NT-proBNP represents a valuable biomarker that offers significant prognostic information regarding the risk of developing HF. 3 …”

Section: Natriuretic Peptidesmentioning

confidence: 99%

Recent Advances in Biomarker Discovery — from Serum to Imaging-based Biomarkers for a Complex Assessment of Heart Failure Patients

Chiotoroiu

Buicu

Neagu

et al. 2016

Journal of Interdisciplinary Medicine

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Over the last years, a vast majority of serum biomarkers and imaging techniques have been used alone or combined in the diagnosis, management and prognosis of numerous pathologies. This review provides a brief insight into the novelties from the last 6 years (2010-2016) regarding serum and imaging markers in heart failure (HF). New information about natriuretic peptides (NPs), soluble ST2 (Sst2), growth differentiation factor 15 (GDF-15), myeloperoxidase (MPO), C-reactive protein (CRP), procalcitonin (PCT), troponins (Tns), myoglobin (Mb), galectin-3 (Gal-3), micro ribonucleic acids (microRNAs) and long non-coding ribonucleic acids (IncRNAs), copectin and cardiac magnetic resonance (CMR) measurements were summarized in this review in order to guide the practitioner.

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“…Az elmúlt évtizedben számos, nagyon heterogén vizsgálat értékelte a natriureticus peptidek szerepét a króni-kus szívelégtelenség kezelésének irányításában [39,40,41,42,43,44,45,46,47,48]. Bár a legtöbb vizsgálat-ban az értékelt biomarker alkalmas volt a betegek és a betegség súlyosságának követésére, a vizsgálatok egy részében ez nem járt együtt a morbiditás és a mortalitás csökkenésével.…”

Section: A Natriureticus Peptidek Szerepe a Krónikus Szívelégtelenségunclassified

Natriureticus peptidek mérése szívelégtelen betegekben: a helyes laboratóriumi és klinikai gyakorlat

et al. 2015

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A szíveredetű natriureticus peptidek (B típusú natriureticus peptid, pre-prohormon B típusú natriureticus peptid) fontos szerepet játszanak a cardiovascularis homeostasisban, többek között vasodilatatiós, natriureticus, diuretikus és antiproliferatív hatásaik által. A natriureticus peptidek szakszerű mérésével dyspnoe esetén eldönthető, hogy respirá-ciós vagy cardialis eredetű, lehetséges a szívelégtelenség korai diagnózisa, a szívbetegség súlyosságának elbírálása (prognózis) és a kezelés hatékonyságának monitorozása. Sok országban mérése nagyon elterjedt akár a szakvizsgálat első lépcsőjeként a szív érintettségének eldöntésére. Eddigi elméleti és klinikai vizsgálatok nemcsak megerősítették, hogy a natriureticus peptideknek helye van a mindennapi betegellátásban, hanem napjainkra nemzetközi ajánlások is rendelkezésre állnak ezen biomarkerek gyakorlati alkalmazásáról. A szerzők a dolgozatban áttekintik a natriureticus peptidek hazai mérésének problémakörét, beleértve a laboratóriumi, kardiológiai és egészség-gazdaságtani vonatkozásokat. Orv. Hetil., 2015, 156(31), 1235-1245. Kulcsszavak: BNP, NT-proBNP, szívelégtelenség, nehézlégzés, diagnózis Measurement of natriuretic peptides in heart failure: the good laboratory and clinical practiceCardiac natriuretic peptides (BNP, NT-proBNP) play a pivotal role in cardiovascular homeostasis, mainly due to their roles in vasodilatation, natriuresis, diuresis and due to their antiproliferative properties. Proper measurement of the natriuretic peptide levels may help differentiate between respiratory and cardiac forms of dyspnea, diagnose early forms of heart failure, evaluate severity of heart failure (prognosis) and monitor the effi cacy of therapy. In many countries natriuretic peptide levels are being used as one of the earliest diagnostics tools to evaluate the involvement of the heart. Current theoretical and clinical data confi rm the importance of natriuretic peptides in routine healthcare. These roles are clearly described in international recommendations and guidelines. In the current review the authors discuss the problems of the measurement of natriuretic peptides in Hungary, including several aspects related to laboratory medicine, cardiology and health economy.

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Use of Amino-Terminal Pro–B-Type Natriuretic Peptide to Guide Outpatient Therapy of Patients With Chronic Left Ventricular Systolic Dysfunction

Cited by 330 publications

References 34 publications

Effect of prespecified therapy escalation on plasma NT‐proBNP concentrations in dogs with stable congestive heart failure due to myxomatous mitral valve disease

Effect of prespecified therapy escalation on plasma NT‐proBNP concentrations in dogs with stable congestive heart failure due to myxomatous mitral valve disease

Recent Advances in Biomarker Discovery — from Serum to Imaging-based Biomarkers for a Complex Assessment of Heart Failure Patients

Natriureticus peptidek mérése szívelégtelen betegekben: a helyes laboratóriumi és klinikai gyakorlat

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