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Tailored therapy for heart failure: neurohormones
1Department of Medicine, University of Otago, P.O. Box 4345, Christchurch, New Zealand. mark.richards@cdhb.govt.nz
Canadian Journal of Physiology and Pharmacology
|August 5, 2011
Summary
Serial measurements of plasma B-type natriuretic peptides can guide therapy for chronic heart failure. This approach may reduce cardiac mortality and hospital admissions in specific patient groups.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Management
Background:
- Plasma B-type natriuretic peptides (BNP) are established indicators of cardiac structure and function.
- BNP levels aid in diagnosing acute heart failure and predicting prognosis across cardiovascular diseases.
Purpose of the Study:
- To review randomized controlled trials on using serial BNP measurements to guide chronic heart failure therapy.
- To assess the efficacy of BNP-guided treatment adjustments.
Main Methods:
- Review of 8 randomized controlled trials completed between 2000-2010.
- Analysis of trial designs, patient populations, follow-up durations, endpoints, and target BNP levels.
- Inclusion of data from 2 meta-analyses for aggregated findings.
Main Results:
- Despite variations in study designs, a consistent trend emerged across trials.
- Meta-analyses support the efficacy of BNP-guided therapy.
- BNP-guided treatment adjustment, combined with clinical methods, appears beneficial.
Conclusions:
- Serial BNP measurements can effectively guide therapy titration in chronic heart failure.
- This strategy is associated with reduced cardiac mortality and heart failure admissions.
- The benefits are most evident in patients under 75 with impaired left ventricular systolic function.
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