A Maisel

..In patients with normal systolic function, elevated BNP levels and diastolic filling abnormalities might help to reinforce the diagnosis diastolic dysfunction...

..The purpose of this study was to characterize the diagnostic and prognostic utility of short-term dynamic changes in natriuretic peptides in patients presenting with chest pain...

..In conclusion, natriuretic peptide values may improve risk stratification in ACS when used in addition to troponin levels and other prognostic markers, but more data are needed to define their role in ACS therapy...

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..However, natriuretic peptides should be used as an adjunct test as many circumstances can also influence changes in natriuretic peptide levels...

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..In this Review, we will provide an update on biomarkers considered state of the art in the diagnosis and management of patients with acute HF...

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..9) NP levels can accelerate accurate diagnosis of heart failure presenting in primary care. 10) NP levels may be helpful to screen for asymptomatic left ventricular dysfunction in high-risk patients...

..Finally, it is possible that use of BNP levels might not only be helpful in assessing whether or not a dyspneic patient has heart failure, but it my turn out to be useful in making both triage and management decisions...

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..At the end of this review we highlight some of the biomarker-guided approaches and strategies that might lead to better and more-effective care of patients...

..This article reviews the literature concerning the use of these peptides in a variety of clinical scenarios and the use of recombinant B-type natriuretic peptide in decompensated heart failure...

..Surrogate markers are increasingly employed as predictive endpoints for treatment...

..B-type natriuretic peptide (BNP) is secreted from the cardiac ventricles in response to increased wall tension...

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..Additionally, this might be a useful model in which to study other immune-mediated cardiomyopathies...

..This study examines B-type natriuretic peptide (BNP) levels in patients with systolic versus non-systolic dysfunction presenting with shortness of breath...

..Renal dysfunction portends significant risk after discharge from acute heart failure (AHF). Thus, a sensitive marker of renal injury might also help to risk stratify HF patients...

..We hypothesized that BNP might therefore be useful as a screening tool before echocardiography in patients with suspected LV dysfunction...

..Finally, the role of BNP in the outpatient cardiac or primary care clinic may be one of critical importance in titration of therapies and in assessment of the state of neurohormonal compensation of the patient...

..B-type natriuretic peptide is released from the cardiac ventricles in response to increased wall tension...

..The aim of this study was to determine the prognostic utility of midregion proadrenomedullin (MR-proADM) in all patients, cardiac and noncardiac, presenting with acute shortness of breath...

..As a result, nesiritide is not arrhythmogenic. Nesiritide should be considered for patients presenting with acutely typical or useful decompensated heart failure, especially those with dyspnea at rest or with minimal activity...

..Measurement of BNP may also be an excellent screening tool for LV dysfunction. Key Words: Natriuretic peptides; neurohormonal; left-ventricular pressure;..

..Although BNP levels will not obviate the need for invasive hemodynamic monitoring, it may be a useful adjunct in tailoring therapy to these patients...

..CONCLUSION: In this study population, BNP levels measured in patients presenting with dyspnea to the ED are highly predictive of cardiac events over the next 6 months...

..73). CONCLUSIONS: In this high-risk hypertensive population, BNP, NT-BNP, and ICG were useful to identify the presence of LVD. The use of ICG with natriuretic peptide testing may improve the ability to detect LVD...

..A lower cut-point (BNP > or = 54 pg/mL) should be used in severely obese patients to preserve sensitivity. A higher cut-point in lean patients (BNP > or = 170 pg/mL) could be used to increase specificity...

..99). Both peptides are useful prognostic tools for predicting mortality and cardiac hospitalization in renal patients...

..To prospectively determine the prognostic utility of serial sampling of the interleukin-1 receptor family member, ST2, for predicting 90-day mortality in patients with heart failure (HF) admitted to a Veteran Affairs Medical Center...

..The present study sought to evaluate the clinical utility of pro-B-type natriuretic peptides (proBNP) in patients admitted with acute decompensated heart failure...

..CONCLUSION: Knowledge of these commonly obtained variables should aid clinicians in the interpretation of moderately elevated BNP results in patients presenting with acute dyspnea in the emergency department...

..Consequently, the development of clinical pathways has the potential to reduce the current variability in care, enhance guideline adherence, and improve outcomes for patients...

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..However, relationships between BNP, renal function, and heart failure as an emergency diagnosis are unknown...

..Thus, it is likely that future algorithms incorporating BNP levels and other clinical indicators will become available to guide critical-care physicians in making management decisions for their CHF patients...

..Postoperatively, elevated peak BNP levels and elevated change to peak BNP levels were associated with prolonged hospital stay and mortality within one year...

..Knowing a patient's NP levels might thus assist with hemodynamic assessment and subsequent treatment titration. Monitoring NP levels in the outpatient setting might also improve patient care and outcomes...

..This study investigated the prognostic value of detectable cardiac troponin T (TnT) and elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in a population of community-dwelling older adults...

..We sought to determine the degree to which B-type natriuretic peptide (BNP) adds to clinical judgment in the diagnosis of congestive heart failure (CHF)...

..Among systolic HF patients, the presence of a low hemoglobin concentration is not a factor in the interpretation of BNP results...

..The predictive value of ST2 levels in outpatients is unknown. We studied the clinical and echocardiographic correlates of ST2 levels and evaluated their prognostic use in outpatients referred for echocardiograms...

..Tools such as the natriuretic peptides are important adjuncts to the physical examination and chest radiographs and often obviate the need for invasive hemodynamic assessment...

..The findings provide evidence of how physical fitness might protect individuals from inflammatory responses to exercise...

..Prior activity should not influence BNP levels in patients with congestive heart failure. Therefore, when a patient presents to clinic with a marked change in their BNP level, it may reflect a real change in their condition...

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..Finally, the role of BNP in the outpatient cardiac or primary care clinic may be one of critical importance in titration of therapies as well as in assessing the state of neurohormonal compensation of the patient...

..Here we review current publications exploring the relationship between B-natriuretic peptide (BNP) and diastolic dysfunction...

..05) lower than baseline. CONCLUSION: Nesiritide, in combination with standard therapy, significantly lowered the endogenous concentrations of natriuretic peptides during infusion and after dosing was completed...

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..There was a marked decrease in survival in the patient group with BNP >120 pg/ml. CONCLUSIONS: B-type natriuretic peptide appears to be a reliable predictor of future cardiac and all-cause mortality in diabetic patients...

..This review focuses on biomarkers resulting from hemodynamic stress, injury and inflammation, and their clinical relevance in modern practice...

..Effective disease management requires an accurate diagnosis. B-type natriuretic peptide (BNP) is increased in patients with HF and is normal in PD patients without cardiac involvement...

..This article reviews the literature concerning the use of these peptides in a variety of clinical scenarios...

..Heart failure, asthma, and chronic obstructive pulmonary disease (COPD) are syndromes where dyspnea and wheezing are overlapping signs, and hence, these syndromes are often difficult to differentiate...

..Echocardiography and B-type natriuretic peptide (BNP) are diagnostic tests for congestive heart failure (CHF), but an emergency diagnosis can be difficult...

..When considering demographics, severity of disease, and renal function, BMI is not independently related to BNP levels in a small subgroup when detailed information about CHF severity is known...

..CONCLUSIONS: In patients with established CHF, those with gray zone BNP levels have a better prognosis than those with non-gray zone levels despite being perceived by physicians as having New York Heart Association class III or IV CHF...

..We determined the effect of diabetes on B-type natriuretic peptide (BNP) concentrations in patients presenting to the emergency department with dyspnea...

..These studies describe molecular forms of circulating B-type natriuretic peptide (BNP) as well as their biological activity...

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..The aim of this study was to examine the value of measurement of the interleukin-1 receptor family member ST2 in patients with dyspnea...

..This proposed tool requires detailed validation but has face validity for the uniform assessment of dyspnoea...

..CONCLUSION: In patients presenting to the emergency department with acute dyspnea, BNP levels and chest radiographs provide complementary diagnostic information that may be useful in the early evaluation of heart failure...

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