scholarly journals Prognostic potential of midregional pro-adrenomedullin following decompensation for systolic heart failure: comparison with cardiac natriuretic peptides

2017 ◽  
Vol 19 (9) ◽  
pp. 1166-1175 ◽  
Author(s):  
Caroline Morbach ◽  
Almuth Marx ◽  
Mathias Kaspar ◽  
Gülmisal Güder ◽  
Susanne Brenner ◽  
...  
Keyword(s):  
Heart Failure ◽  
Natriuretic Peptides ◽  
Systolic Heart Failure ◽  
Cardiac Natriuretic Peptides

scholarly journals Use of Natriuretic Peptides to Guide and Monitor Heart Failure Therapy

2012 ◽  
Vol 58 (1) ◽  
pp. 62-71 ◽  
Author(s):  
A Mark Richards ◽  
Richard W Troughton
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Natriuretic Peptides ◽  
Hospital Admissions ◽  
Systolic Heart Failure ◽  
Prognostic Indicators ◽  
Full Spectrum ◽  
Cardiac Natriuretic Peptides ◽  
Design Characteristics ◽  
And Function

Abstract BACKGROUND Plasma B-type cardiac natriuretic peptides reflect cardiac structure and function and have proven roles in assisting in the diagnosis of acute heart failure. They are independent prognostic indicators across the full spectrum of cardiovascular disease. Serial changes in plasma B-type cardiac natriuretic peptides parallel prognosis in chronic heart failure. Beneficial responses to medications and devices used in the treatment of heart failure are associated with decreases in plasma B-type peptide concentrations. This effect has led to the hypothesis that intensified treatment directed at reducing B-peptide concentrations may improve outcomes in heart failure. CONTENT The efficacy of serial measurements of plasma B-type peptides in guiding titration of therapy for chronic heart failure has been the subject of several randomized controlled trials reported in the peer-reviewed literature since 2000. These reports are summarized in this review. Trial design, characteristics of the heart-failure population studied, duration of follow-up, exact end points recorded, and target peptide concentrations pursued all differ somewhat between trials. In addition, in studies in which benefits were seen, the exact mechanisms mediating the improvements in outcome were unclear. However, an overall consistency is emerging that is supported by 2 metaanalyses. SUMMARY In aggregate the existing trial data suggest that adjustment of treatment in chronic heart failure according to serial B-type peptide measurements, used in conjunction with established clinical methods, is likely to reduce cardiac mortality and hospital admissions with heart failure, at least in patients with systolic heart failure who are younger than 75 years and relatively free of comorbidities.

Cardiac Natriuretic Peptides in Heart Failure

1993 ◽  
Vol 25 (6) ◽  
pp. 503-505 ◽  
Author(s):  
M. Gary Nicholls ◽  
A. Mark Richards ◽  
Ian G. Crozier ◽  
Eric A. Espiner ◽  
Hamid Ikram
Keyword(s):  
Heart Failure ◽  
Natriuretic Peptides ◽  
Cardiac Natriuretic Peptides

scholarly journals INTERACTING DISCIPLINES: Cardiac natriuretic peptides and obesity: perspectives from an endocrinologist and a cardiologist

2015 ◽  
Vol 4 (3) ◽  
pp. R25-R36 ◽  
Author(s):  
Hugo R Ramos ◽  
Andreas L Birkenfeld ◽  
Adolfo J de Bold
Keyword(s):  
Heart Disease ◽  
Natriuretic Peptide ◽  
Natriuretic Peptides ◽  
Plasma Levels ◽  
Association Studies ◽  
Systolic Heart Failure ◽  
Metabolic Effects ◽  
Mechanical Stimuli ◽  
Cardiac Natriuretic Peptides ◽  
Atrial Natriuretic

Since their discovery in 1981, the cardiac natriuretic peptides (cNP) atrial natriuretic peptide (also referred to as atrial natriuretic factor) and brain natriuretic peptide have been well characterised in terms of their renal and cardiovascular actions. In addition, it has been shown that cNP plasma levels are strong predictors of cardiovascular events and mortality in populations with no apparent heart disease as well as in patients with established cardiac pathology. cNP secretion from the heart is increased by humoral and mechanical stimuli. The clinical significance of cNP plasma levels has been shown to differ in obese and non-obese subjects. Recent lines of evidence suggest important metabolic effects of the cNP system, which has been shown to activate lipolysis, enhance lipid oxidation and mitochondrial respiration. Clinically, these properties lead to browning of white adipose tissue and to increased muscular oxidative capacity. In human association studies in patients without heart disease higher cNP concentrations were observed in lean, insulin-sensitive subjects. Highly elevated cNP levels are generally observed in patients with systolic heart failure or high blood pressure, while obese and type-2 diabetics display reduced cNP levels. Together, these observations suggest that the cNP system plays a role in the pathophysiology of metabolic vascular disease. Understanding this role should help define novel principles in the treatment of cardiometabolic disease.

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