Salivary B-type natriuretic peptide: a new method for heart failure diagnosis and follow-up

A unique integrated system demonstrating a significant step beyond proof-of-concept high sensitivity carbon nanotube based sensors for quantitative reading of B-type natriuretic peptide (BNP) in outpatient blood is presented.

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32: B-Type Natriuretic Peptide Testing in Patients With Shortness of Breath in the Emergency Department: A Preliminary Analysis of the Accuracy of Heart Failure Diagnosis

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2008.01.300 ◽

2008 ◽

Vol 51 (4) ◽

pp. 481

Author(s):

D.V. Smit ◽

A. Lokuge ◽

L. Lam ◽

A. Bystrzycki ◽

P.A. Cameron ◽

...

Keyword(s):

Heart Failure ◽

Emergency Department ◽

Natriuretic Peptide ◽

Preliminary Analysis ◽

Failure Diagnosis ◽

Shortness Of Breath ◽

Heart Failure Diagnosis

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Abstract P159: No Gender Difference in All-Cause Mortality Rates in a Cohort of Heart Failure With Preserved Ejection Fraction in the US Veteran Population

Circulation ◽

10.1161/circ.137.suppl_1.p159 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Katherine E Kurgansky ◽

David Gagnon ◽

Kelly Cho ◽

J M Gaziano ◽

Jacob Joseph ◽

...

Keyword(s):

Heart Failure ◽

Mortality Rate ◽

Ejection Fraction ◽

Rate Ratio ◽

Total Mortality ◽

Mortality Rates ◽

Failure Diagnosis ◽

Preserved Ejection Fraction ◽

Heart Failure Diagnosis

Introduction: Heart failure with preserved ejection fraction (HFpEF) affects about 5% of people 65 or older, with a higher prevalence in women. Previous studies suggest that women with HFpEF may live longer than men. Further understanding of mortality outcomes by gender could be useful in implementing gender-specific treatment strategies to improve outcomes in HFpEF patients. Hypothesis: We assessed the hypothesis that women have a lower rate of total mortality than males in a US Veteran HFpEF cohort. Methods: We used a validated algorithm to curate a HFpEF cohort using ICD9 codes, laboratory values, medications, and ejection fraction values from the national Veterans Affairs database. This algorithm had 88% sensitivity and 96% specificity. We examined crude and adjusted mortality rates by gender, beginning at the time of heart failure diagnosis with follow-up through 2016. The adjusted mortality rate was directly standardized to the population of veterans with heart failure (n= 626,179) according to distribution of age, race, cardiovascular disease (CVD), and chronic kidney disease (CKD). Crude and standardized rate ratios were calculated from the mortality rates. Results: Our HFpEF cohort (n= 74,937) included 72,267 men and 2,670 women. Mean age was 72.5 (11.2) in men and 69.1 (14.3) in women at the time of heart failure diagnosis. Males were 85.2% white, 33.7% had CVD, and 27.1% had CKD, whereas females were 82.5% white, 28.7% had CVD, and 20.5% had CKD. During a mean follow up of 4.8 (3.7) years, 52,703 deaths occurred in men and 1,614 deaths occurred in women.The crude mortality rate was significantly lower for females (109.7/1000 person-years) compared to males (153.5/1000 person-years). Corresponding crude incidence rate ratio (95% CI) for total mortality comparing females to males was 0.71 (0.69-0.74; p<.0001). However, after standardizing, there was no significant difference in total mortality rates between men (170.0/1000 person-years) and women (173.4/1000 person-years). The standardized mortality rate ratio was 1.02 (95% CI: 0.84-1.23; p=0.8397). Conclusions: In conclusion, our data do not show any difference in total mortality rate between men and women following the diagnosis of HFpEF.

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B-Type Natriuretic Peptide Testing and the Accuracy of Heart Failure Diagnosis in the Emergency Department

Circulation Heart Failure ◽

10.1161/circheartfailure.109.869438 ◽

2010 ◽

Vol 3 (1) ◽

pp. 104-110 ◽

Cited By ~ 25

Author(s):

Amaali Lokuge ◽

Louisa Lam ◽

Peter Cameron ◽

Henry Krum ◽

de Villiers Smit ◽

...

Keyword(s):

Heart Failure ◽

Emergency Department ◽

Natriuretic Peptide ◽

Failure Diagnosis ◽

Heart Failure Diagnosis

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Chronic heart failure diagnosis: biomarkers

ESC CardioMed ◽

10.1093/med/9780198784906.003.0409_update_002 ◽

2018 ◽

pp. 1778-1781

Author(s):

Christian Mueller

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Natriuretic Peptide ◽

Natriuretic Peptides ◽

Point Of Care ◽

Failure Diagnosis ◽

Central Laboratory ◽

Important Advance ◽

Cardiac Stress ◽

Heart Failure Diagnosis

Natriuretic peptides including B-type natriuretic peptide (BNP), N-terminal (NT)-proBNP, and midregional pro-atrial natriuretic peptide (MR-proANP) are the biomarkers of choice in the diagnosis of heart failure. Assays measuring either BNP, NT-proBNP, or MR-proANP are widely available and run on large analysers operating in the central laboratory or as point-of-care options. Natriuretic peptides are considered quantitative markers of haemodynamic cardiac stress and therefore quantitative markers of heart failure itself. The clinical introduction of natriuretic peptides constitutes the most important advance in the diagnosis of heart failure in the last decade.

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Chronic heart failure diagnosis: biomarkers

ESC CardioMed ◽

10.1093/med/9780198784906.003.0409_update_001 ◽

2018 ◽

pp. 1778-1781

Author(s):

Christian Mueller

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Natriuretic Peptide ◽

Natriuretic Peptides ◽

Point Of Care ◽

Failure Diagnosis ◽

Central Laboratory ◽

Important Advance ◽

Cardiac Stress ◽

Heart Failure Diagnosis

Natriuretic peptides including B-type natriuretic peptide (BNP), N-terminal (NT)-proBNP, and midregional pro-atrial natriuretic peptide (MR-proANP) are the biomarkers of choice in the diagnosis of heart failure. Assays measuring either BNP, NT-proBNP, or MR-proANP are widely available and run on large analysers operating in the central laboratory or as point-of-care options. Natriuretic peptides are considered quantitative markers of haemodynamic cardiac stress and therefore quantitative markers of heart failure itself. The clinical introduction of natriuretic peptides constitutes the most important advance in the diagnosis of heart failure in the last decade.

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Chronic heart failure diagnosis: biomarkers

ESC CardioMed ◽

10.1093/med/9780198784906.003.0409 ◽

2018 ◽

pp. 1778-1781

Author(s):

Christian Mueller

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Natriuretic Peptide ◽

Natriuretic Peptides ◽

Point Of Care ◽

Failure Diagnosis ◽

Central Laboratory ◽

Important Advance ◽

Cardiac Stress ◽

Heart Failure Diagnosis

Natriuretic peptides including B-type natriuretic peptide (BNP), N-terminal (NT)-proBNP, and midregional pro-atrial natriuretic peptide (MR-proANP) are the biomarkers of choice in the diagnosis of heart failure. Assays measuring either BNP, NT-proBNP, or MR-proANP are widely available and run on large analysers operating in the central laboratory or as point-of-care options. Natriuretic peptides are considered quantitative markers of haemodynamic cardiac stress and therefore quantitative markers of heart failure itself. The clinical introduction of natriuretic peptides constitutes the most important advance in the diagnosis of heart failure in the last decade.

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High Intraindividual Variation of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP in Patients with Stable Chronic Heart Failure

Clinical Chemistry ◽

10.1373/clinchem.2004.038752 ◽

2004 ◽

Vol 50 (11) ◽

pp. 2052-2058 ◽

Cited By ~ 158

Author(s):

Sanne Bruins ◽

M Rebecca Fokkema ◽

Jeroen W P Römer ◽

Mike J L DeJongste ◽

Fey P L van der Dijs ◽

...

Keyword(s):

Heart Failure ◽

New York ◽

Chronic Heart Failure ◽

Natriuretic Peptide ◽

Heart Association ◽

Failure Diagnosis ◽

Treatment Optimization ◽

Intraindividual Variation ◽

Amino Terminal ◽

Heart Failure Diagnosis

Abstract Background: Plasma B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are promising markers for heart failure diagnosis, prognosis, and treatment. Insufficient data on the intraindividual biological variation (CVi) of BNP and NT-proBNP hamper interpretation of changes in concentration on disease progression or treatment optimization. We therefore investigated CVi values in stable heart failure patients. Methods: We recruited 43 patients with stable chronic heart failure living in Curaçao (22 males, 21 females; median age, 63 years; range, 20–86 years; New York Heart Association classes I–III). Samples were collected for within-day CVi (n = 6; every 2 h starting at 0800), day-to-day CVi (n = 5; samples collected between 0800 and 1000 on 5 consecutive days), and week-to-week CVi (n = 6; samples collected between 0800 and 1000 on the same day of the week for 6 consecutive weeks). NT-proBNP (Roche) and BNP (Abbott) were measured by immunoassay. Results: Median (range) concentrations were 134 (0–1630) ng/L (BNP) and 570 (17–5048) ng/L (NT-proBNP). Analytical variation, week-to-week CVi, and reference change values were 8.4%, 40%, and 113% (BNP), and 3.0%, 35%, and 98% (NT-proBNP). Week-to week CVis were inversely related to median BNP concentrations. Week-to week CVis for BNP were 44% (BNP ≤350 ng/L) and 30% (BNP >350 ng/L). Both BNP and NT-proBNP increased between 0800 and 1000. Median NT-proBNP/BNP ratios were inversely related to median BNP concentrations. Conclusions: The high CVis hamper interpretation of changes in BNP and NT-proBNP concentrations and may partly explain their poor diagnostic values in chronic heart failure. Easily modifiable determinants to lower CVi have not been identified. The value of BNP and NT-proBNP for chronic heart failure diagnosis, and especially for follow-up and treatment optimization of individuals, remains largely to be established.

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