Should B-type natriuretic peptide be measured routinely to guide the diagnosis and management of chronic heart failure?

被引：90

作者：

Packer, M ^{[1
]}

机构：

[1] Columbia Univ Coll Phys & Surg, Div Circulatory Physiol, New York, NY 10032 USA

来源：

CIRCULATION | 2003年 / 108卷 / 24期

关键词：

Editorials; natriuretic peptides; tests; heart failure; diagnosis;

D O I：

10.1161/01.CIR.0000109205.35813.8E

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Additional study is needed to define the role of routine BNP measurements in the diagnosis and management of chronic heart failure. However, evidence to date suggests that levels of BNP (if measured) should not be viewed as a diagnostic test for chronic heart failure. The results of the assay should be interpreted cautiously; specific threshold values should not be used; and the test cannot replace or supersede the judgment of the clinician. Sequential measurements in patients with established heart failure have not been shown to be useful in assisting in the follow-up of patients or in the initiation or titration of appropriate medications. Given these limitations and uncertainties, we might wonder why the measurement of BNP has become so popular in some circles. Are physicians monitoring BNP because they really believe the assay provides unique and valuable information? Or do physicians think that heart failure has become so difficult to manage that they no longer trust their own skills and clinical judgment?

引用

页码：2950 / 2953

页数：4

共 12 条

[1] Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation [J].

Aaronson, KD ;

Schwartz, JS ;

Chen, TM ;

Wong, KL ;

Goin, JE ;

Mancini, DM .

CIRCULATION, 1997, 95 (12) :2660-2667

[2] B-type natriuretic peptide predicts sudden death in patients with chronic heart failure [J].

Berger, R ;

Huelsman, M ;

Strecker, K ;

Bojic, A ;

Moser, P ;

Stanek, B ;

Pacher, R .

CIRCULATION, 2002, 105 (20) :2392-2397

[3] Failure of plasma brain natriuretic peptide to identify left ventricular systolic dysfunction in the community [J].

Hetmanski, DJ ;

Sparrow, NJ ;

Curtis, S ;

Cowley, AJ .

HEART, 2000, 84 (04) :440-441

[4] Plasma concentration of brain natriuretic peptide as a biochemical marker for the evaluation of right ventricular overload and mortality in chronic respiratory disease [J].

Ishii, J ;

Nomura, M ;

Ito, M ;

Naruse, H ;

Mori, Y ;

Wang, JH ;

Ishikawa, T ;

Kurokawa, H ;

Kondo, T ;

Nagamura, Y ;

Ezaki, K ;

Watanabe, Y ;

Hishida, H .

CLINICA CHIMICA ACTA, 2000, 301 (1-2) :19-30

[5] The potential of brain natriuretic peptide as a biomarker for New York Heart Association class during the outpatient treatment of heart failure [J].

Lee, SC ;

Stevens, TL ;

Sandberg, SM ;

Heublein, DM ;

Nelson, SM ;

Jougasaki, M ;

Redfield, MM ;

Burnett, JC .

JOURNAL OF CARDIAC FAILURE, 2002, 8 (03) :149-154

[6] B-type natriuretic peptide levels: Diagnostic and prognostic in congestive heart failure - What's next? [J].

Maisel, A .

CIRCULATION, 2002, 105 (20) :2328-2331

[7] Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure [J].

Maisel, AS ;

Krishnaswamy, P ;

Nowak, RM ;

McCord, J ;

Hollander, JE ;

Duc, P ;

Omland, T ;

Storrow, AB ;

Abraham, WT ;

Wu, AHB ;

Clopton, P ;

Steg, PG ;

Westheim, A ;

Knudsen, CW ;

Perez, A ;

Kazanegra, R ;

Herrmann, HC ;

McCullough, PA .

NEW ENGLAND JOURNAL OF MEDICINE, 2002, 347 (03) :161-167

[8] Stability of B-type natriuretic peptide levels during exercise in patients with congestive heart failure: Implications for outpatient monitoring with B-type natriuretic peptide [J].

McNairy, M ;

Gardetto, N ;

Clopton, P ;

Garcia, A ;

Krishnaswamy, P ;

Kazanegra, R ;

Ziegler, M ;

Maisel, AS .

AMERICAN HEART JOURNAL, 2002, 143 (03) :406-411

[9] Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure [J].

Packer, M ;

Poole-Wilson, PA ;

Armstrong, PW ;

Cleland, JGF ;

Horowitz, JD ;

Massie, BM ;

Rydén, L ;

Thygesen, K ;

Uretsky, BF .

CIRCULATION, 1999, 100 (23) :2312-2318

[10] Plasma B-type natriuretic peptide levels in ambulatory patients with established chronic symptomatic systolic heart failure [J].

Tang, WHW ;

Girod, JP ;

Lee, MJ ;

Starling, RC ;

Young, JB ;

Van Lente, F ;

Francis, GS .

CIRCULATION, 2003, 108 (24) :2964-2966

← 1 2 →