scholarly journals Increased natriuretic peptides not associated with heart failure

2021 ◽  
Vol 25 ◽  
pp. 4140
Author(s):  
A. M. Chaulin ◽  
D. V. Duplyakov
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Natriuretic Peptides ◽  
Oral Fluid ◽  
Biological Fluids ◽  
Diagnostic Value ◽  
Coronary Syndrome ◽  
Myocardial Wall ◽  
Patients With Heart Failure ◽  
Artery Disease

Natriuretic peptides (NPs) are key diagnostic and prognostic biomarkers for patients with heart failure (HF). The main mechanism for increasing serum NP levels, which is characteristic of heart failure, is secretion in response to myocardial wall distention. At the same time, according to Russian and foreign literature, an increase in NPs is reported in a number of many other conditions that are not associated with HF. The study of these causes and mechanisms is necessary to improve the differential diagnosis of HF.This article discusses the mechanisms of increasing NPs and their diagnostic value in heart failure, as well as a number of other conditions, such as acute coronary syndrome and coronary artery disease, atrial fibrillation, exercise, kidney failure, taking cardiotoxic drugs (chemotherapy) and sacubitril/valsartan. The article also provides data on identifying NPs in non-invasively obtained biological fluids (urine and oral fluid).

scholarly journals Clinical Applications of Natriuretic Peptides in Heart Failure and Atrial Fibrillation

2019 ◽  
Vol 20 (11) ◽  
pp. 2824 ◽  
Author(s):  
Masako Baba ◽  
Kentaro Yoshida ◽  
Masaki Ieda
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Natriuretic Peptides ◽  
Clinical Applications ◽  
Current Evidence ◽  
Clinical Prognosis ◽  
Diagnosis And Management ◽  
Artery Disease

Natriuretic peptides (NPs) have become important diagnostic and prognostic biomarkers in cardiovascular diseases, particularly in heart failure (HF). Diagnosis and management of coronary artery disease and atrial fibrillation (AF) can also be guided by NP levels. When interpreting NP levels, however, the caveat is that age, sex, body mass index, renal dysfunction, and race affect the clearance of NPs, resulting in different cut-off values in clinical practice. In AF, NP levels have been associated with incident AF in the general population, recurrences after catheter ablation, prediction of clinical prognosis, and the risk of stroke. In this article, we first review and summarize the current evidence and the roles of B-type NP and atrial NP in HF and coronary artery disease and then focus on the increasing utility of NPs in the diagnosis and management of and the research into AF.

Opportunistic screening for heart failure with natriuretic peptides in patients with atrial fibrillation: a meta-analysis of individual participant data of four screening studies

Heart ◽  
2018 ◽  
Vol 104 (15) ◽  
pp. 1236.1-1237 ◽  
Author(s):  
Sander van Doorn ◽  
Geert-Jan Geersing ◽  
Rogier F Kievit ◽  
Yvonne van Mourik ◽  
Loes C Bertens ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Natriuretic Peptide ◽  
Natriuretic Peptides ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Community Dwelling ◽  
Individual Participant Data ◽  
Cut Point ◽  
Individual Participant

ObjectiveHeart failure (HF) often coexists in atrial fibrillation (AF) but is frequently unrecognised due to overlapping symptomatology. Furthermore, AF can cause elevated natriuretic peptide levels, impairing its diagnostic value for HF detection. We aimed to assess the prevalence of previously unknown HF in community-dwelling patients with AF, and to determine the diagnostic value of the amino-terminal pro B-type natriuretic peptide (NTproBNP) for HF screening in patients with AF.MethodsIndividual participant data from four HF-screening studies in older community-dwelling persons were combined. Presence or absence of HF was in each study established by an expert panel following the criteria of the European Society of Cardiology. We performed a two-stage patient-level meta-analysis to calculate traditional diagnostic indices.ResultsOf the 1941 individuals included in the four studies, 196 (10.1%) had AF at baseline. HF was uncovered in 83 (43%) of these 196 patients with AF, versus 381 (19.7%) in those without AF at baseline. Median NTproBNP levels of patients with AF with and without HF were 744 pg/mL and 211 pg/mL, respectively. At the cut-point of 125 pg/mL, sensitivity was 93%, specificity 35%, and positive and negative predictive values 51% and 86%, respectively. Only 23% of all patients with AF had an NTproBNP level below the 125 pg/mL cut-point, with still a 13% prevalence of HF in this group.ConclusionsWith a prevalence of nearly 50%, unrecognised HF is common among community-dwelling patients with AF. Given the high prior change, natriuretic peptides are diagnostically not helpful, and straightforward echocardiography seems to be the preferred strategy for HF screening in patients with AF.

Antithrombotic therapy in acute coronary syndrome and stable coronary artery disease patients with atrial fibrillation: a 3-year retrospective cohort study

2019 ◽  
Vol 16 (5) ◽  
pp. 399-407
Author(s):  
Jun Wu ◽  
Shenglan Lin ◽  
Chen Men ◽  
Xiangming Wang ◽  
Sen Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Congestive Heart Failure ◽  
Coronary Artery ◽  
Dual Antiplatelet Therapy ◽  
Stable Coronary Artery Disease ◽  
Anticoagulation Therapy ◽  
Coronary Syndrome ◽  
Artery Disease

Aim: Acute coronary syndrome (ACS) and stable coronary artery disease (SCAD) occur frequently in patients with atrial fibrillation (AF). However, the optimal antithrombotic therapy is still debated. Methods & results: We analyzed 976 coronary artery disease patients with AF from 2013 to 2014. ACS+AF patients tend to take dual antiplatelet therapy (p < 0.001), whereas SCAD+AF patients prefer anticoagulation therapy (warfarin: p < 0.001, dabigatran: p < 0.05). Ventricular arrhythmia, congestive heart failure and ACS were the top three reasons for SCAD group patients’ readmission, while reinfarction and congestive heart failure were two major factors in readmission of ACS group. Conclusion: ACS+AF group patients more likely choose dual antiplatelet therapy, whereas SCAD+AF group patients prefer anticoagulation therapy. Compared with ACS group, SCAD group had a higher rate of readmission.

scholarly journals Determination of B-Type Natriuretic Peptides: Clinical And Analytical Quality

2007 ◽  
Vol 26 (1) ◽  
pp. 1-9
Author(s):  
Radmila Kovačević ◽  
Milutin Mirić
Keyword(s):  
Heart Failure ◽  
Natriuretic Peptides ◽  
Volume Expansion ◽  
Diagnostic Value ◽  
Biological Variability ◽  
Analytical Quality ◽  
Plasma Volume Expansion ◽  
Patients With Heart Failure ◽  
Cardiac Ventricles

Determination of B-Type Natriuretic Peptides: Clinical And Analytical QualityB-type natriuretic peptide (BNP), a neurohormone synthesized in the cardiac ventricles, is released as preproBNP and then enzymatically cleaved to the N-terminal-proBNP (NT-proBNP) and BNP upon ventricular myocite stretch. This hormone has a role in the body's defense against hypertension and plasma volume expansion. Measurements of circulating B-type natriuretic peptides have been shown to be of diagnostic value in patients with heart failure. BNP levels correlate with the severity of heart failure, as well as with prognosis. Better control of the preanalytical and analytical sources of variations will undoubtedly lead to improvement in B-type natriuretic peptides measurements. A number of preanalytical and analytical factors including specimen type and stability, assay imprecision, and standardization are reviewed here. Further research is required to better define the performance characteristics necessary for assays bearing the designation natriuretic peptides. These characteristics include developing guidelines for the total analytical error from a careful review of the intraindividual biological variability of the analyte under conditions that will be encountered in clinical practice, then validating these guidelines in the clinical setting, and completing the standardization efforts.

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