Value of natriuretic peptides in assessment of patients with possible new heart failure in primary care

Role of natriuretic peptides in the diagnosis and treatment of patients with carcinoid heart disease

“…2003), but is in accordance with studies performed in a population with a higher chance of cardiac dysfunction (Cowie et al, 1997;Hammerer-Lercher et al, 2001;Maisel et al, 2002). In our carcinoid population, ANP was less reliable.…”

“…Tested by a ROC curve, the diagnostic capacities of NT-proBNP were better compared to ANP, and no additional information was obtained by combining NT-proBNP with ANP. Similar to our findings, in earlier studies with a direct comparison between atrial and brain natriuretic peptides, an advantage for brain natriuretic peptides was convincingly proved with no increased predictive power by addition of ANP to BNP determination (Davidson et al, 1996;Cowie et al, 1997;McDonagh et al, 1998;Hammerer-Lercher et al, 2001). Natriuretic peptides are mainly produced and excreted in the atria of the heart in response to increased wall tension.…”

“…In this study with 32 patients, we found NT-proBNP to be a reliable marker to make this differentiation with a sensitivity of 100% and a specificity of 83%. This is comparable to the literature for diagnosis of cardiac dysfunction in the general population (McDonagh et al, 1998;Luchner et al, 2000) or in patients suspected to have heart failure (Cowie et al, 1997;Maisel et al, 2002Maisel et al, , 2003. The PPV of 69% as described in our study is relatively high compared to studies in the general population with a PPV of approximately 30% (Bay et al, Figure 3 The ROC curve shows that the accuracy to differentiate between patients with and without heart disease is the best in NT-proBNP compared to ANP levels.…”

“…In patients with the suspicion of heart failure several other studies showed natriuretic peptides to be useful indicators for the detection of heart failure (Lerman et al, 1993;Davidson et al, 1996;Cowie et al, 1997;Hammerer-Lercher et al, 2001;Maisel et al, 2002Maisel et al, , 2003. In the follow-up of patients with an acute cardiac event levels of natriuretic peptides were proved to be of prognostic value for outcome (Hall et al, 1994;Omland et al, 1996;de Lemos et al, 2001;Koglin et al, 2001;Richards et al, 2003).…”

Circulating levels of pro‐atrial natriuretic peptide in lower respiratory tract infections

“…In addition to the clinical evaluation, a novel approach to estimate the presence of an infection and to grade its severity and its treatment response is the use of biomarkers. Thereby, the MR-proANP level may mirror both, the inflammatory cytokine response correlated with the severity of pneumonia, as well as the presence of disease-relevant comorbidities, namely heart failure and renal dysfunction [7][8][9][10][11]. Therefore, we investigated MR-proANP levels in a well-defined cohort of 545 consecutive patients with lower respiratory tract infections, to evaluate its prognostic use for the severity of disease and outcome.…”