心力衰竭中纳利测试策略:2023年更新
Thanat Chaikijurajai1, Hernan Rincon-Choles2, W H Wilson Tang3
1Kaufman Center for Heart Failure Treatment and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States; Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Advances in clinical chemistry
|January 27, 2024
概括
性尿素 (NP),如B型性尿素 (BNP) 和N-终端亲BNP (NT-proBNP),有助于诊断心力衰竭. 连续NP测量可能有利于特定的患者群体,改善结果和治疗优化.
科学领域:
- 心脏病学 心脏病学
- 生物标志物 生物标志物
- 心脏衰竭研究研究
背景情况:
- 尿素 (NP),包括B型尿素 (BNP) 和N-终端亲BNP (NT-proBNP),是已知的心力衰竭 (HF) 生物标志物.
- 布朗尼基抗击与高温相关的神经激素激活,而NT-proBNP反映心肌细胞应激.
研究的目的:
- 评估序列性尿酸测量在指导慢性心力衰竭治疗中的作用.
- 为了确定NP指导疗法是否影响死亡率,HF住院和指导方针导向医疗疗 (GDMT) 优化.
主要方法:
- 对研究的综述,研究了串行BNP和NT-proBNP测量在心力衰竭管理中的临床效用.
- 分析随着时间的推移实现目标NP水平的结果.
主要成果:
- 关于NP引导慢性HF治疗直接死亡率和住院效益的结果存在矛盾.
- 达到目标BNP或NT-proBNP水平与更好的结果相关,特别是在极端基线水平的HF患者中.
- 序列NP测量越来越多地用于HF治疗指导,GDMT优化和识别有风险的患者.
结论:
- 虽然直接的益处是有争议的,但连续NP监测对特定的心力衰竭表型有希望.
- 在严重的HF患者中,NP导向治疗可能是最有益的,这可能表明有性尿素抗或心综合征.
- 扩大BNP和NT-proBNP的临床使用有助于优化HF护理和风险分层.
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