B-type natriuretic peptides as powerful markers in cardiac diseases – analytical and clinical aspects / B-Typ natriuretische Peptide als aussagekräftige Marker bei kardialen Erkrankungen – analytische und klinische Aspekte

2006 ◽  
Vol 30 (3) ◽  
pp. 165-184
Author(s):  
Angelika Hammerer-Lercher ◽  
Bernd Puschendorf ◽  
Johannes Mair
2006 ◽  
Vol 25 (4) ◽  
pp. 287-308
Author(s):  
Angelika Hammerer-Lercher ◽  
Bernd Puschendorf ◽  
Johannes Mair

Author(s):  
Francois-Xavier Goudot ◽  
Sonia Msadek ◽  
Tanissia Boukertouta ◽  
Pierre-Olivier Schischmanoff ◽  
Christophe Meune

Background: Natriuretic peptides (NPs) have broad indications during heart failure (HF) and the detection of left ventricular dysfunction in high-risk patients. They can also be used for the diagnosis/management of other cardiac diseases. However, very little is known regarding their use in routine practice. Methods: We examined all biological tests performed from February 2010 to August 2015 in two districts from the French Brittany, covering 13,653 km2 and including 22,265 physicians. We report the settings and conditions of N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) measurements (the only locally NP available). Results: From a total of 3,606,432 tests requested in 557,650 adult (older than 20 years) patients, only 56,653 (1.6%) included at least one NT-proBNP measurement. NT-proBNP measurements gradually increased, from 9,188 in 2011 to 12,938 in 2014 (p<0.001). Most NT-proBNP tests were measured in urban laboratories (72.7%) and in private (62.9%) non-hospital/clinics laboratories, they were mostly ordered by general practitioners (66% compared with 11% by cardiologists). The number of NT-proBNP measurements increased with age up to 80-90 years, and 70.3% of tests were measured in ≥75y patients. Creatinine and electrolytes were not associated with NT-proBNP in 15.8% and 19.7% of tests, respectively. Conclusion: Among a very large cohort, we observed that NPs remain largely undermeasured. NT-proBNP is mostly measured in elderly patients, and its interpretation may be hazardous in up to 16% of all individuals because no measurement of creatinine was associated to NT-proBNP.


2019 ◽  
Vol 65 (10) ◽  
pp. 1221-1227 ◽  
Author(s):  
Peter A Kavsak ◽  
Carolyn S P Lam ◽  
Amy K Saenger ◽  
Allan S Jaffe ◽  
Paul Collinson ◽  
...  

Abstract The IFCC Committee on Clinical Applications of Cardiac Bio-Markers (C-CB) has directives and initiatives focused on providing evidence-based educational resources to aid and improve understanding around key analytical and clinical aspects of cardiac biomarkers used in clinical practice and the research setting. As a task force, we have previously published position statements and recommendations focused on use and analytical aspects of high-sensitivity cardiac troponin assays. The current educational document is the first from the C-CB highlighting important biochemical, analytical, and clinical aspects as they relate to the natriuretic peptides (NPs), including B-type natriuretic peptide (BNP) and N-terminal pro–B-type natriuretic peptide (NT-proBNP), with a focus on heart failure.


2010 ◽  
Vol 299 (1) ◽  
pp. H1-H9 ◽  
Author(s):  
Begoña López ◽  
Arantxa González ◽  
Nerea Hermida ◽  
Félix Valencia ◽  
Eduardo de Teresa ◽  
...  

Because of its dynamic nature, the composition and structure of the myocardial collagen network can be reversibly modified to adapt to transient cardiac injuries. In response to persistent injury, however, irreversible, maladaptive changes of the network occur leading to fibrosis, mostly characterized by the excessive interstitial and perivascular deposition of collagen types I and III fibers. It is now becoming apparent that myocardial fibrosis directly contributes to adverse myocardial remodeling and the resulting alterations of left ventricular (LV) anatomy and function present in the major types of cardiac diseases. The enzyme lysyl oxidase (LOX) is a copper-dependent extracellular enzyme that catalyzes lysine-derived cross-links in collagen and elastin. LOX-mediated cross-linking of collagen types I and III fibrils leads to the formation of stiff collagen types I and III fibers and their subsequent tissue deposition. Evidence from experimental and clinical studies shows that the excess of LOX is associated with an increased collagen cross-linking and stiffness. It is thus conceivable that LOX upregulation and/or overactivity could underlie myocardial fibrosis and altered LV mechanics and contribute to the compromise of LV function in cardiac diseases. This review will consider the molecular aspects related to the regulation and actions of LOX, namely, in the context of collagen synthesis. In addition, it will address the information related to the role of myocardial LOX in heart failure and the potential benefits of controlling its expression and function.


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