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Will the therapy of chronic heart failure be guided by plasma levels of natriuretic peptides?


Authors: J. Hradec;  J. Krupička;  T. Janota
Authors‘ workplace: Univerzita Karlova v Praze, 1. lékařská fakulta, III. interní klinika VFN
Published in: Čas. Lék. čes. 2009; 148: 383-388
Category: Review Article

Overview

Natriuretic peptides, especially BNP and NT-proBNP became useful tool for both, the diagnostics and the estimation of prognosis in chronic heart failure. As the plasma levels of natriuretic peptides copy changes in clinical status, an attractive hypothesis was formed saying that BNP/NT-proBNP guided therapy could have better clinical outcomes than therapy guided by patients’ clinical status (symptoms). In past few years this hypothesis was tested in several randomized controlled clinical trials (STARS-BNP, TIME-CHF, PRIMA). However, results of these trials are very controversial.

There are preliminary results of clinical trial OPTIMA referred in this paper, too. This one-centre study was performed at the authors’ institution. Altogether 52 patients with chronic heart failure were randomized to one of the above mentioned treatment strategies. The rate of cardiovascular events was lower in the patients in whom the treatment was guided by BNP values compared to the patients in whom the treatment was guided by their clinical status. However, the difference was not statistically significant.

Key words:
BNP/NT-proBNP, chronic heart failure, BNP-guided treatment, OPTIMA study.


Sources

1. Petrášek J. Feochromocytom. Edice Thomayerova sbírka č. 471. Praha: Avicenum 1976.

2. Hradec J, Marek J, Král J, Janota T, Poloniecki J, Malik M. Long-term echocardiographic follow-up of acromegalic heart disease. Am J Cardiol 1993; 72: 205–210.

3. Hradec J, Král J, Janota T, Kršek M, Hána V, Marek J, Malik M. Regression of acromegalic left ventricular hypertrophy after lanreotide (a slow release somatostatin analog). Amer J Cardiol 1999; 83: 1506–1509.

4. De Bold AJ, Borenstein HB, Veress AT, Sonnenberg H. A rapid and potent natriuretic response to intravenous injection of atrial myocardial extract in rats. Life Sci 1981; 28: 89–94.

5. Flynn TG, de Bold ML, de Bold AJ. The amino acid sequence of an atrial peptide with potent diuretic and natriuretic properties Biochem Biophys Res Commun 1983; 117: 859–865.

6. Sudoh T, Kangawa K, Minamino N, Matsuo H. A new natriuretic peptide in porcine brain. Nature 1988; 332: 78–81.

7. Sudoh T, Minamino N, Kangawa K, Matsuo H. C-type natriuretic peptide (CNP): a new member of natriuretic peptide family identified in porcine brain. Biochem Biophys Res Commun 1990; 168: 863–870.

8. Mair J, Hammerer-Lercher A, Puschendorf B. The impact of cardiac natriuretic peptide determination on the diagnosis and management of heart failure. Clin Chem Lab Med 2001; 39: 571–588.

9. McDonagh TA, Robb SD, Murdoch DR, et al. Biochemical detection of left-ventricular systolic dysfunction. Lancet 1998; 351: 9–13

10. Morrison LK, Harrison A, Krishnaswamy P, et al. Utility of rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea. J Am Coll Cardiol 2002; 39: 202–209.

11. Hradec J. Mohou se stát natriuretické peptidy křišťálovou koulí kardiologa? J Am Coll Cardiol - CZ 2003; 5: 255–257.

12. Cowie MR, Struthers AD, Wood DA, et al. Value of natriuretic peptides in assessment of patients with possible new heart failure in primary care. Lancet 1997; 350: 1347–1351.

13. Dickstein K, Cohen-Solal A, Fillipatos G, et al. for the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the Europen Society of Cardiology. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008. Eur J Heart Fail 2008; 10: 933–989.

14. Kirk V, Bay M, Parner J, et al. N-terminal proBNP and mortality in hospitalised patients with heart failure and preserved vs. reduced systolic function: data from the prospective Copenhagen Hospital Heart Failure Study (CHHF). Eur J Heart Fail 2004; 6: 335–341.

15. Hartmann F, Packer M, Coats A, et al. NT-proBNP in severe heart failure: rationale, design and preliminary results of the COPERNICUS NT-proBNP substudy. Eur J Heart Fail 2004; 6: 343–350.

16. Jakubík P, Janota T, Widimský J jr, et al. Impact of essential hypertension and primary aldosteronism on plasma brain natriuretic peptide concentration. Blood pressure 2006; 15: 302–307.

17. Hildebrandt P, Boesen M, Olsen M, et al. N-terminal pro brain natriuretic peptide in arterial hypertension – a marker for left ventricular dimensions and prognosis. Eur J Hear Fail 2004; 6: 313–317.

18. Janota T, Jakubík P, Wichterle D, et al. Předpovědní hodnota BNP po kardioverzi fibrilace síní pro dlouhodobé udržení sinusového rytmu. Cor Vasa 2007; 49: K273–K274.

19. The Study Group of Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology. The EuroHeart Failure Survey program – a survey on the quality of care among patints with heart failure in Europe. Part 2: treatment. Eur Heart J 2003; 24: 464–474.

20. Hradec J, Wikstrand J, Černáková L. Charakteristika a farmakoterapie nemocných s chronickým srdečním selháním ischemické etiologie v České Republice. Cor Vasa 2009; 51: 268–273.

21. Troughton RW, Frampton CM, Yandle TG, et al. Treatment of heart failure guided by plasma amino terminal brain natriuretic peptide (N-BNP) levels improves outcome. Lancet 2000; 355: 1126–1130.

22. Jourdain P, Jondeau G, Funck F, et al. Plasma brain natriuretic peptide-guided therapy to improve outcome in heart failure. The STARS-BNP Multicenter Study. J Am Coll Cardiol 2007; 49: 1733–1739.

23. Pfisterer M, Buser P, Rickli H, et al. BNP-guided vs symptom-guided heart failure therapy. The trial of intensified vs standard medical therapy in elderly patients with congestive heart failure (TIME-CHF) randomized trial. JAMA 2009; 301: 383–392.

24. Eurlings L, Pinto Y. PRIMA Study. NT-proBNP-guided management of heart failure based on individual target value. Předneseno na kongresu American College of Cardiology, Orlando, USA, 29. 3. – 1. 4. 2009.

25. Špinar J, Hradec J, Meluzín J, et al. Doporučení pro diagnostiku a léčbu chronického srdečního selhání ČKS 2006. Cor Vasa 2007; 49: K5–K34.

26. Krupička J, Janota T, Kasalová Z, Hradec J. Natriuretic peptides - physiology, patophysiology and clinical use in heart failure. Phys Res 2009; 58: 171–177.

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