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    8456 results match your criteria Natriuretic Peptides in Congestive Heart Failure

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    Neurohumoral Modulation During Waon Therapy in Chronic Heart Failure - Subanalysis of Waon-CHF Study.
    Circ J 2017 Feb 16. Epub 2017 Feb 16.
    Cardiorenal Research Laboratory, Department of Cardiovascular Diseases, Mayo Clinic.
    Background: Heart failure (HF) is a disease of neurohumoral dysfunction and current pharmacological therapies for HF have not improved mortality rates, thus requiring additional new strategies. Waon therapy for HF patients may be a complementary strategy with peripheral vasodilation via nitric oxide. We hypothesized that Waon therapy would improve neurohumoral factors, such as natriuretic peptides (NP) and the renin-angiotensin-aldosterone system (RAAS) in HF. Read More

    The heart failure epidemic: a UK perspective.
    Echo Res Pract 2017 Feb 14. Epub 2017 Feb 14.
    M R Cowie, Faculty of Medicine, National Heart and Lung Institute,Imperial College London, London, UK.
    Heart failure is appropriately described as an epidemic, with 1-2% of healthcare expenditure being directed at its management. In England, the National Institute for Health and Care Excellence (NICE) has issued guidance on best practice for the diagnosis and treatment of acute and chronic heart failure. Echocardiography is key to the diagnosis of the underlying cardiac abnormalities, and access to this (with our without biochemical testing using natriuretic peptides) is key to high quality and speedy diagnosis. Read More

    Relationship among body mass index, NT-proBNP, and mortality in decompensated chronic heart failure.
    Heart Lung 2017 Feb 7. Epub 2017 Feb 7.
    Department of Emergency Medicine, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
    Background: Obesity has been suggested to confer a survival benefit in acute heart failure. The concentrations of NT-proBNP may be reduced in patients with high body mass index (BMI).

    Objectives: To investigate the relationship among BMI, NT-proBNP, and mortality risk in decompensated chronic heart failure (DCHF). Read More

    Changing the treatment of heart failure with reduced ejection fraction: clinical use of sacubitril-valsartan combination.
    J Geriatr Cardiol 2016 Nov;13(11):914-923
    Cardiology Unit, Medicine Department, Hospital Municipal de Badalona.Via Augusta Av. 9-13 (08911), Badalona, Spain.
    Despite significant therapeutic advances, patients with chronic heart failure (HF) remain at high risk of morbidity and mortality. Sacubitril valsartan (previously known as LCZ696) is a new oral agent approved for the treatment of symptomatic chronic heart failure in adults with reduced ejection fraction. It is described as the first in class angiotensin receptor neprilysin inhibitor (ARNI) since it incorporates the neprilysin inhibitor, sacubitril and the angiotensin II receptor antagonist, valsartan. Read More

    Prognostic Prediction in Acute Heart Failure Patients With Extreme BNP values.
    Biomarkers 2017 Jan 30:1-27. Epub 2017 Jan 30.
    a Serviço de Medicina Interna, Centro Hospitalar São João , Porto , Portugal.
    Background: Some patients have good prognosis despite elevated B-type natriuretic peptide (BNP), while others have ominous outcome with low BNP. We aimed to characterize these groups of patients.

    Methods: We analysed patients prospectively included in an acute HF registry. Read More

    Evaluation of NT-proBNP in children with heart failure younger than 3 years old.
    Rom J Intern Med 2017 Jan 23. Epub 2017 Jan 23.
    Introduction: Heart failure (HF) is characterized by neuroendocrine activation. The cardiac natriuretic hormones, including atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP), together with their related pro-peptides (proANP and proBNP) represent a group of peptide hormones produced by the heart. A normal NT-proBNP level has a high negative predictive value for heart failure. Read More

    B-type natriuretic peptides in chronic obstructive pulmonary disease: a systematic review.
    BMC Pulm Med 2017 Jan 10;17(1):11. Epub 2017 Jan 10.
    Division of Respiratory Medicine, University of British Columbia and Institute for Heart and Lung Health, Vancouver, Canada.
    Background: Patients with chronic obstructive pulmonary disease (COPD) have increased cardiovascular risk. Natriuretic peptides (NP) in other populations are useful in identifying cardiovascular disease, stratifying risk, and guiding therapy.

    Methods: We performed a systematic literature review to examine NP in COPD, utilising Medline, EMBASE, and the Cochrane Library. Read More

    Associations of Body Mass Index With Laboratory and Biomarkers in Patients With Acute Heart Failure.
    Circ Heart Fail 2017 Jan;10(1)
    From the Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (K.W.S., J.M.t.M., H.L.H., D.J.v.V., A.A.V., P.v.d.M.); National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Imperial College, London, United Kingdom (J.G.C.); Inova Heart and Vascular Institute, Falls Church, VA (C.M.O'C.); Momentum Research, Durham, NC (B.A.D.); University of Brescia, Italy (M.M.); Brigham and Women's Hospital, Boston, MA (M.M.G.); University of California at San Francisco and San Francisco Veterans Affairs Medical Center (J.R.T.); Medical University, Clinical Military Hospital, Wroclaw, Poland (P.P.); Merck Research Laboratories, Rahway, NJ (D.M.B.); and University of Iowa Carver College of Medicine Cardiovascular Research Center (H.C.D.).
    Background: Plasma concentrations of natriuretic peptides decline with obesity in patients with heart failure. Whether this is true for other biomarkers is unknown. We investigated a wide range of biomarker profiles in acute heart failure across the body mass index (BMI) spectrum. Read More

    Soluble CD146 Is a Novel Marker of Systemic Congestion in Heart Failure Patients: An Experimental Mechanistic and Transcardiac Clinical Study.
    Clin Chem 2017 Jan 25;63(1):386-393. Epub 2016 Oct 25.
    INSERM UMR-S 942, Paris, France;
    Background: Soluble CD146 (sCD146), is an endothelial marker with similar diagnostic power as natriuretic peptides in decompensated heart failure (HF). While natriuretic peptides are released by the failing heart, sCD146 may be released by veins in response to stretch induced by systemic congestion in HF. This study investigated the source, effects of vascular stress on release and prognostic properties of sCD146 in HF. Read More

    Unraveling the Molecular Complexity of O-Glycosylated Endogenous (N-Terminal) pro-B-Type Natriuretic Peptide Forms in Blood Plasma of Patients with Severe Heart Failure.
    Clin Chem 2017 Jan 8;63(1):359-368. Epub 2016 Nov 8.
    Division of Clinical Biochemistry and Protein Micro-Analysis Facility, Biocenter, Innsbruck Medical University, Innsbruck, Austria;
    Background: Currently, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and its physiologically active counterpart, BNP, are most frequently used as biomarkers for diagnosis, prognosis, and disease monitoring of heart failure (HF). Commercial NT-proBNP and BNP immunoassays cross-react to varying degrees with unprocessed proBNP, which is also found in the circulation. ProBNP processing and immunoassay response are related to O-linked glycosylation of NT-proBNP and proBNP. Read More

    Specificity of B-Type Natriuretic Peptide Assays: Cross-Reactivity with Different BNP, NT-proBNP, and proBNP Peptides.
    Clin Chem 2017 Jan 15;63(1):351-358. Epub 2016 Nov 15.
    Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN;
    Background: B-type natriuretic peptides (BNPs) are used clinically to diagnose and monitor heart failure and are present in the circulation as multiple proBNP-derived fragments. We investigated the specificity of BNP immunoassays with glycosylated and nonglycosylated BNP, N-terminal proBNP (NT-proBNP), and proBNP peptides to probe the cross-reactivity of each assay.

    Methods: Nine B-type natriuretic peptides were studied,including synthetic and recombinant BNP (Shionogi, Scios, Mayo), human and synthetic glycosylated and nonglycosylated NT-proBNP (HyTest, Roche Diagnostics), and human glycosylated and nonglycosylated proBNP (HyTest, Scios). Read More

    Beyond Natriuretic Peptides for Diagnosis and Management of Heart Failure.
    Clin Chem 2017 Jan 10;63(1):211-222. Epub 2016 Oct 10.
    Cardiology Division, Massachusetts General Hospital, Boston, MA;
    Background: Heart failure (HF) is a complex syndrome with an enormous societal burden in terms of cost and morbidity and mortality. Natriuretic peptide (NP) testing is now widely used to support diagnosis, prognostication, and management of patients with HF, but NPs come with limitations, including vulnerability to the presence of obesity, atrial fibrillation, and renal dysfunction, for example. Beyond the NPs, novel biomarkers may supplement traditional clinical and laboratory testing to improve understanding of the complex disease process of HF, and possibly to personalize care for those affected through better individual phenotyping. Read More

    Biochemistry, Therapeutics, and Biomarker Implications of Neprilysin in Cardiorenal Disease.
    Clin Chem 2017 Jan 15;63(1):108-115. Epub 2016 Nov 15.
    Cardiorenal Research Laboratory, Department of Cardiovascular Diseases, Mayo Clinic, Rochester MN.
    Background: Neprilysin (NEP) is a membrane-bound neutral endopeptidase that degrades a variety of bioactive peptides. The substrates include natriuretic peptides (NPs), which are important regulating mediators for cardiovascular and renal biology. Inhibition of NEP activity and exogenous NP administration thus have emerged as potential therapeutic strategies for treating cardiorenal diseases. Read More

    Natriuretic Peptides and Analytical Barriers.
    Clin Chem 2017 Jan 10;63(1):50-58. Epub 2016 Oct 10.
    Division of Cardiovascular Diseases, Department of Medicine, Rochester, MN;
    Background: The natriuretic peptide system is an endocrine, autocrine and paracrine system that plays an important role in the maintenance of cardiovascular homeostasis. Biomarkers based on these peptides are important diagnostic and prognostic tools for myocardial function.

    Content: Although natriuretic peptides were discovered more than 2 decades ago, their intricate and complex biology is associated with important questions not yet elucidated. Read More

    Determinants and prognostic value of B-type natriuretic peptide in patients with aortic valve stenosis.
    Int J Cardiol 2017 Mar 24;230:371-377. Epub 2016 Dec 24.
    Department of Cardiology, Bichat Hospital, Paris, France; INSERM U1148, Bichat Hospital, Paris, France; University Paris 7, Paris, France. Electronic address:
    Background: The prognostic value of N-terminal fragment of pro B-type natriuretic peptide (Nt-proBNP) in aortic stenosis (AS) is still being debated. We sought to evaluate the determinants of Nt-proBNP in AS and its prognostic value in asymptomatic patients.

    Methods: Patients with pure isolated at least mild degenerative AS enrolled in our prospective cohort (2006-2013) constituted our population. Read More

    Natriuretic Peptides in Anxiety and Panic Disorder.
    Vitam Horm 2017 5;103:131-145. Epub 2016 Oct 5.
    University of Göttingen Medical Centre, Göttingen, Germany; German Centre for Cardiovascular Research, University of Göttingen, Göttingen, Germany.
    Natriuretic peptides exert pleiotropic effects on the cardiovascular system, including natriuresis, diuresis, vasodilation, and lusitropy, by signaling through membrane-bound guanylyl cyclases. In addition to their use as diagnostic and prognostic markers for heart failure, accumulating behavioral evidence suggests that these hormones also modulate anxiety symptoms and panic attacks. This review summarizes our current knowledge of the role of natriuretic peptides in animal and human anxiety and highlights some novel aspects from recent clinical studies on this topic. Read More

    Clinical and Echocardiographic Characteristics and Cardiovascular Outcomes According to Diabetes Status in Patients With Heart Failure and Preserved Ejection Fraction: A Report From the I-Preserve Trial (Irbesartan in Heart Failure With Preserved Ejection Fraction).
    Circulation 2017 Feb 4;135(8):724-735. Epub 2017 Jan 4.
    From BHF Cardiovascular Research Centre, University of Glasgow, Scotland, UK (S.L.K., U.M.M., P.S.J., M.C.P., J.J.V.M.); Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark (S.L.K., U.M.M., L.K.); Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK (D.P.); Mayo Clinic, Rochester, MN (S.W.); Western University, London, ON, Canada (R.S.M.); Ralph H. Johnsons Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); Division of Cardiology, University of Minnesota, Minneapolis (I.S.A.); Université Paris 6 and Hospital Pitié-Salpétrière, Paris, France (M.K.); University of Maryland Medical Center, Baltimore (J.S.G.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
    Background: In patients with heart failure and preserved ejection fraction, little is known about the characteristics of, and outcomes in, those with and without diabetes mellitus.

    Methods: We examined clinical and echocardiographic characteristics and outcomes in the I-Preserve trial (Irbesartan in Heart Failure With Preserved Ejection Fraction) according to history of diabetes mellitus. Cox regression models were used to estimate hazard ratios for cardiovascular outcomes adjusted for known predictors, including age, sex, natriuretic peptides, and comorbidity. Read More

    The Role of Diastolic Stress Testing in the Evaluation for HFpEF:A Simultaneous Invasive-Echocardiographic Study.
    Circulation 2016 Dec 30. Epub 2016 Dec 30.
    The Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN
    Background: -Diagnosis of heart failure (HF) with preserved ejection fraction (HFpEF) is challenging and relies largely on demonstration of elevated cardiac filling pressures (pulmonary capillary wedge pressure, PCWP). Current guidelines recommend use of natriuretic peptides (NT-proBNP) and rest/exercise echocardiography (E/e' ratio) to make this determination. Data to support this practice is conflicting. Read More

    Efficacy and safety of sacubitril/valsartan (LCZ696) in Japanese patients with chronic heart failure and reduced ejection fraction: Rationale for and design of the randomized, double-blind PARALLEL-HF study.
    J Cardiol 2016 Dec 23. Epub 2016 Dec 23.
    Novartis Pharmaceutical Corporation, East Hanover, NJ, USA.
    Background: The prognosis of heart failure patients with reduced ejection fraction (HFrEF) in Japan remains poor, although there is growing evidence for increasing use of evidence-based pharmacotherapies in Japanese real-world HF registries. Sacubitril/valsartan (LCZ696) is a first-in-class angiotensin receptor neprilysin inhibitor shown to reduce mortality and morbidity in the recently completed largest outcome trial in patients with HFrEF (PARADIGM-HF trial). The prospectively designed phase III PARALLEL-HF (Prospective comparison of ARNI with ACE inhibitor to determine the noveL beneficiaL trEatment vaLue in Japanese Heart Failure patients) study aims to assess the clinical efficacy and safety of LCZ696 in Japanese HFrEF patients, and show similar improvements in clinical outcomes as the PARADIGM-HF study enabling the registration of LCZ696 in Japan. Read More

    Atrial Fibrillation in Heart Failure With Preserved Ejection Fraction: Association With Exercise Capacity, Left Ventricular Filling Pressures, Natriuretic Peptides, and Left Atrial Volume.
    JACC Heart Fail 2017 Feb 21;5(2):92-98. Epub 2016 Dec 21.
    Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
    Objectives: This study sought to study the association of atrial fibrillation (AF) with exercise capacity, left ventricular filling pressure, natriuretic peptides, and left atrial size in heart failure with preserved ejection fraction (HFpEF).

    Background: The diagnosis of HFpEF in patients with AF remains a challenge because both contribute to impaired exercise capacity, and increased natriuretic peptides and left atrial volume.

    Methods: We studied 94 patients with symptomatic heart failure and left ventricular ejection fractions ≥45% using treadmill cardiopulmonary exercise testing and right- and/or left-sided cardiac catheterization with simultaneous echocardiography. Read More

    Biomarkers for monitoring chemotherapy-induced cardiotoxicity.
    Crit Rev Clin Lab Sci 2016 Dec 26:1-15. Epub 2016 Dec 26.
    a Department of Laboratory Medicine , Unit 37, The University of Texas MD Anderson Cancer Center , Houston , TX , USA and.
    Cardiotoxicity, including acute and late-onset cardiotoxicity, is a well-known adverse effect of many types of antitumor agents. Early identification of patients with cardiotoxicity is important to ensure prompt treatment and minimize toxic effects. The etiology of chemotherapy-induced cardiotoxicity is multifactorial. Read More

    Sacubitril/Valsartan (LCZ696) in Heart Failure.
    Handb Exp Pharmacol 2016 Dec 22. Epub 2016 Dec 22.
    Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ, 07936-1080, USA.
    It has been known since the 1990s that long-term morbidity and mortality is improved in patients with heart failure with reduced ejection fraction (HFrEF) by treatments that target the renin-angiotensin-aldosterone system (RAAS). It has also long been thought that enhancement of the activity of natriuretic peptides (NPs) could potentially benefit patients with HFrEF, but multiple attempts to realize this benefit had failed over the years - until 2014, when a large, phase III, randomized, controlled clinical trial (PARADIGM-HF) was completed comparing sacubitril/valsartan with enalapril, a well-established treatment for HFrEF. Sacubitril/valsartan (formerly known as LCZ696) is a first-in-class angiotensin receptor neprilysin inhibitor (ARNI) that simultaneously suppresses RAAS activation through blockade of angiotensin II type 1 receptors and enhances vasoactive peptides including NPs through inhibition of neprilysin, the enzyme responsible for their degradation. Read More

    Midregional proadrenomedullin and growth differentiation factor-15 are not influenced by obesity in heart failure patients.
    Clin Res Cardiol 2016 Dec 21. Epub 2016 Dec 21.
    Department of General and Interventional Cardiology, University Heart Center Hamburg, Martinistr. 52, 20246, Hamburg, Germany.
    Background: Obesity is a risk factor for heart failure (HF) and identification of symptomatic, and obese HF patients are challenging, because obesity can mimic HF symptoms. We aimed to evaluate novel biomarkers for HF in obese subjects of the general population.

    Methods: Midregional proadrenomedullin (MR-proADM), growth differentiation factor-15 (GDF-15), midregional pro-atrial natriuretic peptide (MR-proANP), and NT-proBNP were measured in 5000 individuals of the population-based Gutenberg Health Study (GHS), including 1204 obese individuals (BMI ≥ 30 kg/m(2)) and 107 individuals with HF. Read More

    The Cardio-Renal Interrelationship.
    Prog Cardiovasc Dis 2016 Dec 16. Epub 2016 Dec 16.
    The Ohio State University, Columbus, OH, USA; Aristotle University of Thessaloniki, Thessaloniki, Greece.
    The heart and the kidney are of utmost importance for the maintenance of cardiovascular (CV) homeostasis. In healthy subjects, hemodynamic changes in either organ may affect hemodynamics of the other organ. This interaction is fine-tuned by neurohumoral activity, including atrial natriuretic peptides, renin-angiotensin aldosterone system and sympathetic activity. Read More

    Diagnostic and prognostic accuracy of galectin-3 and soluble ST2 for acute heart failure.
    Clin Chim Acta 2016 Oct 29. Epub 2016 Oct 29.
    Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz, Austria.
    Background: We aimed to compare head-to-head the diagnostic and prognostic capabilities of galectin-3, soluble ST2 (sST2) and B-type natriuretic peptide (BNP) for heart failure (HF) in an emergency setting.

    Methods: We studied 251 consecutive patients with dyspnoea as a chief compliant presenting to an emergency department. The diagnosis of HF was based on the Framingham score for HF plus echocardiographic evidence of systolic or diastolic dysfunction. Read More

    Natriuretic Peptides, 6-Min Walk Test, and Quality-of-Life Questionnaires as Clinically Meaningful Endpoints in HF Trials.
    J Am Coll Cardiol 2016 Dec;68(24):2690-2707
    INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Université de Lorraine, CHRU de Nancy and F-CRIN INI-CRCT, Nancy, France. Electronic address:
    The Expedited Access for Premarket Approval and De Novo Medical Devices Intended for Unmet Medical Need for Life Threatening or Irreversibly Debilitating Diseases or Conditions document was issued as a guidance for industry and for the Food and Drug Administration. The Expedited Access Pathway was designed as a new program for medical devices that demonstrated the potential to address unmet medical needs for life threatening or irreversibly debilitating conditions. The Food and Drug Administration would consider assessments of a device's effect on intermediate endpoints that, when improving in a congruent fashion, are reasonably likely to predict clinical benefit. Read More

    Increased Activity of the Intracardiac Oxytocinergic System in the Development of Postinfarction Heart Failure.
    Biomed Res Int 2016 10;2016:3652068. Epub 2016 Nov 10.
    Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Sciences, Medical University of Warsaw, Warsaw, Poland.
    Aim. The present study was designed to test the hypothesis that the development of postinfarction heart failure is associated with a change of activity of the intracardiac oxytocinergic system. Methods. Read More

    Amino terminal pro brain natriuretic peptide predicts all-cause mortality in patients with chronic obstructive pulmonary disease: Systematic review and meta-analysis.
    Chron Respir Dis 2016 Dec 12. Epub 2016 Dec 12.
    Cardiology Unit, Azienda Ospedaliero-Universitaria S.Anna, Cona (FE), Italy.
    Natriuretic peptides (NPs) are a family of prognostic biomarkers in patients with heart failure (HF). HF is one of the most frequent comorbidities in patients with chronic obstructive pulmonary disease (COPD). However, the prognostic role of NP in COPD patients remains unclear. Read More

    Pedal Edema as an Indicator of Early Heart Failure in the Community: Prevalence and Associations With Cardiac Structure/Function and Natriuretic Peptides (MESA [Multiethnic Study of Atherosclerosis]).
    Circ Heart Fail 2016 Dec;9(12)
    From the Heart and Vascular Center of Excellence (J.Y., W.Q., S.A.) and Department of Epidemiology (A.B.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Cardiology and Radiology, Johns Hopkins University, Baltimore, MD (J.A.C.L.); Kantonsspital Graubuenden Clinic of Radiology, Loestrasse 170, 7000 Chur, Switzerland (N.K.-B.); National Institutes of Health Clinical Center, Bethesda, MD (D.A.B.); and Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.).
    Background: The prevalence of pedal edema (PE) and its associations with abnormal cardiac structure/function, natriuretic peptides, and incident heart failure (HF) is unknown, especially in community-dwelling adults without a history of cardiovascular disease.

    Methods And Results: Out of 5004 MESA (Multiethnic Study of Atherosclerosis) participants who had cardiac magnetic resonance imaging, 4196 had complete data and were included in this analysis (3501 for the right ventricle analysis). Logistic regression and Cox proportional hazard analyses were used to assess the associations among self-reported PE, 2-pillow orthopnea, paroxysmal nocturnal dyspnea, left and right ventricular structure and function, natriuretic peptide levels, and incident HF. Read More

    Echo and BNP serial assessment in ambulatory heart failure care: Data on loop diuretic use and renal function.
    Data Brief 2016 Dec 9;9:1074-1076. Epub 2016 Nov 9.
    Division of Cardiology, Fondazione Salvatore Maugeri, IRCCS, Veruno, Italy.
    We compared the follow-up data on loop diuretic use and renal function, as assessed by serum creatinine levels, and the estimated glomerular filtration rate (eGFR), of two groups of consecutive ambulatory HF patients: 1) the clinically-guided group, in which management was clinically driven based on the institutional protocol of the HF Unit of the Cardiovascular and Thoracic Department of Pisa (standard of care) and 2) the echo and B-type natriuretic peptide (BNP) guided group (patients conforming to the protocol of the Network Labs Ultrasound (NEBULA) in HF Study Group: Pisa, Perugia, Pavia; Verona, Auckland, and Veruno), in which therapy was delivered according to the serial assessment of BNP and echocardiography. Patients whose follow-up was based on standard of care had a significant higher prevalence of worsening renal function, that was likely related to higher diuretic dosages, whilst, a better management of renal function was observed in the echo-BNP-guided group. The data is related to "Echo and natriuretic peptide guided therapy improves outcome and reduces worsening renal function in systolic heart failure: An observational study of 1137 outpatients" (A. Read More

    microRNAs in cardiovascular disease - clinical application.
    Clin Chem Lab Med 2016 Dec 3. Epub 2016 Dec 3.
    microRNAs (miRNAs) are well-known, powerful regulators of gene expression, and their potential to serve as circulating biomarkers is widely accepted. In cardiovascular disease (CVD), numerous studies have suggested miRNAs as strong circulating biomarkers with high diagnostic as well as prognostic power. In coronary artery disease (CAD) and heart failure (HF), miRNAs have been suggested as reliable biomarkers matching up to established protein-based such as cardiac troponins (cT) or natriuretic peptides. Read More

    Evolution of the clinical profile of patients with acute heart failure treated in Spanish emergency departments.
    Rev Clin Esp 2016 Nov 29. Epub 2016 Nov 29.
    Servicio de Urgencias, Corta Estancia y Hospitalización a Domicilio, Hospital General de Alicante, Departamento de Medicina Clínica, Universidad Miguel Hernández; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-FISABIO), Alicante, España. Electronic address:
    Objective: To analyse the changes in epidemiology, outpatient and emergency department clinical care, and outcomes of patients treated for acute heart failure (AHF) in Spanish hospital emergency departments (HEDs) between 2007 and 2014.

    Method: A multicentre cohort study was conducted that consecutively included patients with AHF diagnosed in 9HEDs during 4 periods (2007, 2009, 2011 and 2014). The study analysed the changes observed in 20 variables corresponding to baseline data, outpatient care and emergency care data and outcome data. Read More

    Prognostic Implications of Changes in N-Terminal Pro-B-Type Natriuretic Peptide in Patients With Heart Failure.
    J Am Coll Cardiol 2016 Dec;68(22):2425-2436
    Brigham and Women's Hospital, Boston, Massachusetts.
    Background: Natriuretic peptides (NP) have prognostic value in heart failure (HF), although the clinical importance of changes in NP from baseline is unclear.

    Objectives: The authors assessed whether a reduction in N-terminal pro-B-type NP (NT-proBNP) was associated with a decrease in HF hospitalization and cardiovascular mortality (primary endpoint) in patients with HF and reduced ejection fraction, whether treatment with sacubitril/valsartan reduced NT-proBNP below specific partition values more than enalapril, and whether the relationship between changes in NT-proBNP and changes in the primary endpoint were dependent on assigned treatment.

    Methods: In PARADIGM-HF (Prospective Comparison of ARNI [Angiotensin Receptor-Neprilysin Inhibitor] with ACEI [Angiotensin-Converting-Enzyme Inhibitor] to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial), baseline NT-proBNP was measured in 2,080 patients; 1,292 had baseline values >1,000 pg/ml and were reassessed at 1 and 8 months. Read More

    New and Evolving Concepts Regarding the Prognosis and Treatment of Cardiac Amyloidosis.
    Curr Heart Fail Rep 2016 Dec;13(6):267-272
    Clinica Medica II, Department of Internal Medicine, University of Pavia, P. le Golgi 19, 27100, Pavia, Italy.
    Systemic amyloidoses are rare and proteiform diseases, caused by extracellular accumulation of insoluble misfolded fibrillar proteins. Prognosis is dictated by cardiac involvement, which is especially frequent in light chain (AL) and in transthyretin variants (ATTR, both mutated, (ATTRm), and wild-type, (ATTRwt)). Recently, ATTRwt has emerged as a potentially relevant cause of a heart failure with preserved ejection fraction (HFpEF). Read More

    Impact of Body Mass Index on the Accuracy of N-Terminal Pro-Brain Natriuretic Peptide and Brain Natriuretic Peptide for Predicting Outcomes in Patients With Chronic Heart Failure and Reduced Ejection Fraction: Insights From the PARADIGM-HF Study (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial).
    Circulation 2016 Nov;134(22):1785-1787
    From Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.L.C., A.S.D., S.D.S.); Department of Internal Medicine, University of Campinas, Campinas, Brazil (W.N.); British Heart Foundation Cardiovascular Research Centre, University of Glasgow, United Kingdom (J.J.M.); Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, TX (M.P.); Division of Cardiology, Medical University of South Carolina, Ralph H. Johnston Veterans Administration Medical Center, Charleston (M.R.Z.); Institut de Cardiologie de Montréal, Université de Montréal, Canada (J.L.R.); Department of Molecular and Clinical Medicine, University of Gothenburg, Sweden (K.S.); and Novartis Pharmaceuticals Corporation, East Hanover, NJ (M.L., V.C.S., M.F.P.).

    Combined use of tissue Doppler imaging and natriuretic peptides as prognostic marker in asymptomatic aortic stenosis.
    Int J Cardiol 2017 Feb 10;228:890-894. Epub 2016 Nov 10.
    Cardiology Department, Heart Diseases Biomedical Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
    Introduction: Tissue Doppler imaging (TDI) and N-terminal-pro-Brain Natriuretic Peptide (NT-proBNP) provides useful non-invasive information about left ventricle filling pressures and both have demonstrated to be a prognostic marker in some valve disease as aortic stenosis (AS).

    Objectives: To assess the clinical value of combined TDI and NT-proBNP information in asymptomatic AS patients.

    Material And Methods: Prospective study of 350 initially asymptomatic moderate to severe AS patients with: Mean aortic valve area 0. Read More

    Predictors of Long-Term Mortality in Older Patients Hospitalized for Acutely Decompensated Heart Failure: Clinical Relevance of Natriuretic Peptides.
    J Am Geriatr Soc 2016 Nov 27. Epub 2016 Nov 27.
    Division of Cardiology and Cardiac Rehabilitation, "S. Maugeri" Foundation, IRCCS, Institute of Cassano Murge, Bari, Italy.
    Background: Acute heart failure is a common cause of hospitalization among older patients. Optimized risk stratification might improve the outcome for this subgroup of patients. Natriuretic peptides have been used in the diagnosis of heart failure and in evaluating the prognosis of patients hospitalized for heart failure. Read More

    Preoperative Optimization of the Heart Failure Patient Undergoing Cardiac Surgery.
    Can J Cardiol 2017 Jan 6;33(1):72-79. Epub 2016 Aug 6.
    Department of Medicine, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada. Electronic address:
    Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Read More

    Efficacy and Safety of Intravenous Urapidil for Older Hypertensive Patients with Acute Heart Failure: A Multicenter Randomized Controlled Trial.
    Yonsei Med J 2017 Jan;58(1):105-113
    Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
    Purpose: Urapidil is putatively effective for patients with hypertension and acute heart failure, although randomized controlled trials thereon are lacking. We investigated the efficacy and safety of intravenous urapidil relative to that of nitroglycerin in older patients with hypertension and heart failure in a randomized controlled trial.

    Materials And Methods: Patients (>60 y) with hypertension and heart failure were randomly assigned to receive intravenous urapidil (n=89) or nitroglycerin (n=91) for 7 days. Read More

    Evolving Use of Natriuretic Peptides as Part of Strategies for Heart Failure Prevention.
    Clin Chem 2017 Jan 21;63(1):66-72. Epub 2016 Nov 21.
    Heart Failure Unit, St. Vincent's University Hospital and University College, Dublin, Ireland.
    Background: Heart failure (HF) remains one of the major cardiovascular challenges to the Western world. Once established, HF is characterized by compromised life expectancy and quality of life with considerable dependence on hospital care for episodic clinical deterioration. Much is understood about the risk factors that predispose to the development of HF. Read More

    [ANMCO/ELAS/SIBioC Consensus document: Recommendations for the use of cardiac biomarkers in heart failure patients].
    G Ital Cardiol (Rome) 2016 Sep;17(9):615-656
    S.C. Laboratorio Analisi, A.O. Ordine Mauriziano, Torino.
    Biomarkers have dramatically impacted the way heart failure (HF) patients are evaluated and managed. A biomarker is a characteristic that is objectively measured and evaluated as an indicator of normal biological or pathogenic processes, or pharmacological responses to a therapeutic intervention. Natriuretic peptides (B-type natriuretic peptide [BNP] and N-terminal proBNP) are the gold standard biomarkers in determining the diagnosis and prognosis of HF, and a natriuretic peptide-guided HF management looks promising. Read More

    Dementia-related adverse events in PARADIGM-HF and other trials in heart failure with reduced ejection fraction.
    Eur J Heart Fail 2017 Jan 20;19(1):129-137. Epub 2016 Nov 20.
    BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
    Aims: Inhibition of neprilysin, an enzyme degrading natriuretic and other vasoactive peptides, is beneficial in heart failure with reduced ejection fraction (HFrEF), as shown in PARADIGM-HF which compared the angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril/valsartan with enalapril. As neprilysin is also one of many enzymes clearing amyloid-β peptides from the brain, there is a theoretical concern about the long-term effects of sacubitril/valsartan on cognition. Therefore, we have examined dementia-related adverse effects (AEs) in PARADIGM-HF and placed these findings in the context of other recently conducted HFrEF trials. Read More

    N-terminal pro-brain natriuretic peptide is a useful marker to identify latent heart failure patients in older adults in a rural outpatient clinic.
    Geriatr Gerontol Int 2016 Nov 17. Epub 2016 Nov 17.
    Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan.
    Aim: Although measurement of natriuretic peptides including N-terminal pro-brain natriuretic peptide (NT-proBNP) has been recommended for identifying heart failure (HF) patients, the prevalence of elderly patients with latent HF who are attending an outpatient clinic is unknown.

    Methods: We measured NT-proBNP levels in 393 patients (aged 75 ± 9 years) in a rural outpatient clinic. Patients with a diagnosis of heart disease were excluded. Read More

    Focus on the Novel Cardiovascular Drug LZC696: from Evidence to Clinical Consideration.
    Cardiovasc Drugs Ther 2016 Dec;30(6):623-633
    Department of Cardiology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
    LCZ696, a first-in-class angiotensin receptor neprilysin inhibitor (ARNI), is comprised of the angiotensin receptor blocker valsartan and the neprilysin inhibitor pro-drug sacubitril (AHU377). After oral administration, AHU377 is rapidly metabolized to the active neprilysin inhibitor LBQ657. LCZ696 exerts its effects of diuresis, natriuresis, vasodilation and aldosterone secretion inhibition through simultaneous renin-angiotensin-aldosterone system (RAAS) blockade and natriuretic peptides system (NPS) enhancement. Read More

    Heart Failure With Preserved Ejection Fraction and Atrial Fibrillation: Vicious Twins.
    J Am Coll Cardiol 2016 Nov;68(20):2217-2228
    University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Electronic address:
    Heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) are age-related conditions that are increasing in prevalence, commonly coexist, and share clinical features. This review provides a practical update on the epidemiology, pathophysiology, diagnosis, and management of patients with concomitant HFpEF and AF. Epidemiological studies highlight the close and complex links between HFpEF and AF, the shared risk factors, the high AF occurrence in the natural history of HFpEF, and the independent contribution of each condition to poor outcomes. Read More

    Diagnostic rules and algorithms for the diagnosis of non-acute heart failure in patients 80 years of age and older: a diagnostic accuracy and validation study.
    BMJ Open 2016 Oct 6;6(10):e012888. Epub 2016 Oct 6.
    Department of Public Health and Primary Care, KU Leuven (KUL), Leuven, Belgium.
    Objectives: Different diagnostic algorithms for non-acute heart failure (HF) exist. Our aim was to compare the ability of these algorithms to identify HF in symptomatic patients aged 80 years and older and identify those patients at highest risk for mortality.

    Design: Diagnostic accuracy and validation study. Read More

    From ARB to ARNI in Cardiovascular Control.
    Curr Hypertens Rep 2016 Dec;18(12):86
    Division of Pharmacology and Vascular Medicine Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.
    Coexistence of hypertension, diabetes mellitus and chronic kidney disease synergistically aggravates the risk of cardiovascular and renal morbidity and mortality. These high-risk, multi-morbid patient populations benefit less from currently available anti-hypertensive treatment. Simultaneous angiotensin II type 1 receptor blockade and neprilysin inhibition ('ARNI') with valsartan/sacubitril (LCZ696) might potentiate the beneficial effects of renin-angiotensin-aldosterone inhibition by reinforcing its endogenous counterbalance, the natriuretic peptide system. Read More

    Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide, Troponin-T, and Growth-Differentiation Factor 15 in Adult Congenital Heart Disease.
    Circulation 2017 Jan 3;135(3):264-279. Epub 2016 Nov 3.
    From Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands (V.J.M.B., A.E.v.d.B., J.A.E., A.-R.W.S., J.A.A.E.C., M.W., F.Z., E.B., J.W.R.-H.); Cardiovascular Research School COEUR, Rotterdam, the Netherlands (V.J.M.B., J.A.E., E.B.); Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands (M.d.W., R.H.N.v.S.); and Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (E.B.).
    Background: The number of patients with adult congenital heart disease (ACHD) is rapidly increasing. To optimize patient management, there is a great need to accurately identify high-risk patients. Still, no biomarker has been firmly established as a clinically useful prognostic tool in this group. Read More

    High Dose β-Blocker Therapy Triggers Additional Reverse Remodeling in Patients With Idiopathic Non-Ischemic Cardiomyopathy.
    Int Heart J 2016 Dec 4;57(6):717-724. Epub 2016 Nov 4.
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
    Carvedilol has established its evidence to improve prognosis and facilitate left ventricular reverse remodeling (LVRR) in heart failure patients with reduced left ventricular ejection fraction (LVEF), and many studies have supported its dose-dependency. However, there are few studies demonstrating the effect of high dose carvedilol in Japan. We enrolled 23 patients with idiopathic non-ischemic cardiomyopathy, in whom LVEF remained 45% or less despite 20 mg/ day of carvedilol therapy for > 3 months. Read More

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