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Titolo:
The impact of cardiac natriuretic peptide determination on the diagnosis and management of heart failure
Autore:
Mair, J; Hammerer-Lercher, A; Puschendorf, B;
Indirizzi:
Innsbruck Univ, Sch Med, Dept Internal Med, Div Cardiol,Klin Innere Med,Klin Abt Kardiol, A-6020 Innsbruck, Austria Innsbruck Univ Innsbruck Austria A-6020 rdiol, A-6020 Innsbruck, Austria Innsbruck Univ, Sch Med, Dept Med Chem & Biochem, Div Clin Biochem, A-6020Innsbruck, Austria Innsbruck Univ Innsbruck Austria A-6020 iochem, A-6020Innsbruck, Austria
Titolo Testata:
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
fascicolo: 7, volume: 39, anno: 2001,
pagine: 571 - 588
SICI:
1434-6621(200107)39:7<571:TIOCNP>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR DYSFUNCTION; ACUTE MYOCARDIAL-INFARCTION; PLASMA BRAIN; SYSTOLIC DYSFUNCTION; CLINICAL-PRACTICE; PULMONARY-HYPERTENSION; DIASTOLIC DYSFUNCTION; BIOCHEMICAL MARKER; CONVERTING ENZYME; SERINE-PROTEASE;
Keywords:
atrial natriuretic peptide; brain natriuretic peptide; N-terminal pro-atrial natriuretic peptide; N-terminal pro-brain natriuretic peptide; heart failure; ventricular dysfunction; risk stratification;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
115
Recensione:
Indirizzi per estratti:
Indirizzo: Mair, J Innsbruck Univ, Sch Med, Dept Internal Med, Div Cardiol,Klin Innere Med,Klin Abt Kardiol, Anichstr 35, A-6020 Innsbruck, Austria Innsbruck Univ Anichstr 35 Innsbruck Austria A-6020 ruck, Austria
Citazione:
J. Mair et al., "The impact of cardiac natriuretic peptide determination on the diagnosis and management of heart failure", CLIN CH L M, 39(7), 2001, pp. 571-588

Abstract

The long-predicted endocrine function of the heart has been proven by the discovery of atrial natriuretic peptide (atrial natriuretic factor, A-type natriuretic peptide; ANP) 20 years ago. This subsequently led to the description of a whole family of structurally similar but genetically distinct peptides, the natriuretic peptide family, which contributes to cardiovascularhomeostasis. These looped peptides promote natriuresis and diuresis, act as vasodilators, and exert antimitogenic effects on cardiovascular tissues. Two members, ANP and brain natriuretic peptide (B-type natriuretic peptide;BNP) are secreted by the heart mainly in response to myocardial stretch induced by volume load. The natriuretic peptides are synthesized as preprohormones. The C-terminal endocrinological active peptides (ANP, BNP) and theirN-terminal prohormone fragments are found in plasma. The natriuretic peptide system is activated to its highest degree in ventricular dysfunction. However, natriuretic peptides are increased in ail patients with edematous disorders which lead to an increase in atrial tension or central blood volume, such as renal failure or ascitic liver cirrhosis. It could be demonstrated that in chronic heart failure patients and during the subacute phase of myocardial infarction, of all tested neurohormones, the cardiac natriuretic peptides were best markers to identify heart failure and the most powerful predictors of morbidity and mortality. Natriuretic peptides are independentmarkers for risk assessment. In comparative studies BNP was superior to ANP and its N-terminal prohormone fragments in myocardial infarction as well as in chronic heart failure patients. Less data on N-terminal proBNP (NT-proBNP) is available, but BNP and NT-proBNP appear to be equivalent markers. For primary care physicians natriuretic peptide measurement is useful to decide which patient with suspected heart failure warrants further investigation, particularly when assessment of left ventricular function is not readily available, Natriuretic peptides have an excellent negative predictive value, particularly in high risk patients. An increase in BNP is serious enough to warrant follow-up examinations. For the cardiologists the natriureticpeptides are helpful for guidance of therapy and monitoring disease coursein heart failure patients and for risk stratification in heart failure andmyocardial infarction.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/01/20 alle ore 07:08:04