Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Natriuretic peptides (BNP and NT-proBNP) have been shown to be useful tools for risk stratification of patients with acute myocardial ischemia encompassing the whole spectrum of acute coronary syndromes (ACS), particularly for prediction of mortality. Both BNP and NT-proBNP possess several characteristics of the ideal biomarker, showing independent and incremental prognostic value above traditional clinical, electrocardiographic, and biochemical (particularly troponin) risk indicators. Specifically, in ACS patients, BNP and NT-proBNP have powerful prognostic value both in patients without a history of previous heart failure or without clinical or instrumental signs of left ventricular dysfunction on admission or during hospital stay. They can also be easily and rapidly measured in an emergency context. We have performed a meta-analysis of available studies concerning the prognostic value of natriuretic peptides. Our results show that the prognostic value of natriuretic peptides is similar: (1) both at short- and long-term; (2) when natriuretic peptides are measured at first patient contact or during hospital stay; (3) for BNP or NT-proBNP; and (4) in patients with ST elevation myocardial infarction or no ST elevation ACS. These data suggest that natriuretic peptide measurement should be integrated into routine evaluation of patients with an ACS.
 ...
PMID:Natriuretic peptides for risk stratification of patients with acute coronary syndromes. 1498 84

Guidelines for the pharmacological treatment of heart failure (HF) are based on results from large clinical trials demonstrating benefit. State of the art pharmacological management of HF assumes that target doses should be the same as those used in trials. Thus equal doses are recommended for all in practical guidelines, but this strategy might not fit individual needs. NT-proBNP and BNP emerged as potential biomarkers of clinical interest in HF management. NT-proBNP and BNP are related to HF severity and to clinical status. NT-proBNP and BNP are strongly associated with prognosis across the whole spectrum of HF patients. A pilot study has shown that NT-proBNP-guided therapy is associated with improved outcome in HF. Although at present there are still few data to make firm recommendations on the use of NT-proBNP or BNP levels as biomarkers for HF management, future studies will provide further insight on this issue.
 ...
PMID:NT-proBNP and BNP: biomarkers for heart failure management. 1498 89

We have isolated a cardiomyogenic cell line (CMG cell) from murine bone marrow mesenchymal stem cells. The cells showed a fibroblast-like morphology, but the morphology changed after 5-azacytidine exposure. They began spontaneous beating after 2 weeks, and expressed ANP and BNP. Electron microscopy revealed a cardiomyocyte-like ultrastructure. These cells had several types of action potentials; sinus node-like and ventricular cell-like action potentials. The isoform of contractile protein genes indicated that their muscle phenotype was similar to fetal ventricular cardiomyocytes. They expressed alpha1A, alpha1B, alpha1D, beta1, and beta2 adrenergic and M1 and M2 muscarinic receptors. Stimulation with phenylephrine, isoproterenol and carbachol increased ERK phosphorylation and second messengers. Isoproterenol increased the beating rate, which was blocked with CGP20712A (beta1-selective blocker). These findings indicated that cell transplantation therapy for the patients with heart failure might possibly be achieved using the regenerated cardiomyocytes from autologous bone marrow cells in the near future.
 ...
PMID:Application of mesenchymal stem cells for the regeneration of cardiomyocyte and its use for cell transplantation therapy. 1500 38

Utility of the dosage of brain natriuretic factor (BNP) in the diagnosis and treatment of heart failure. Congestive heart failure (HF) is the main reason for hospitalisation of elderly patients. HF affects nearly 15% of patients aged 75 years or older. Prognosis after the diagnosis of HF is comparable to that of cancers with 50% survival after 4 years for mild HF and 50% after one year in more severe cases. Systolic HF defined by a left ventricular ejection fraction (LVEF) < 40% is asymptomatic in half the patients. In patients with symptomatic HF, LVEF is normal in almost 50% of the cases suggesting a diastolic HF. BNP is secreted after distension of left ventricule mainly in patients with systolic or diastolic HF, in proportion to the severity of the disease. A serum level of BNP > 100 pg/ml has a sensitivity of 90 percent and a specificity of 76 percent for the diagnosis of HF. Serum BNP is also increased in kidney insufficiency and in cirrhosis. BNP increase has a prognostic value to predict mortality after cardiac failure or myocardial infarction. Except for digoxin, all the drugs used to treat HF decrease serum levels of BNP. In dyspneic patients, serum levels of BNP < 50 pg/ml can exclude HF with a good probability. However BNP determination is not useful to diagnose HF in a general population.
 ...
PMID:[Use of brain natriuretic peptide (BNP) in the diagnosis and treatment of heart failure]. 1509 95

As there is no cure in patients with Duchenne muscular dystrophy (DMD) yet, we must pay attention to manage cardiopulmonary complications in DMD. They died at 18.2 years old in 1984 in my hospital. From autopsy findings, respiratory failure occupied 75%, and left-sided heart failure occupied 12.5%. First of all, we had to know the relationship between cardiac system and respiratory system. Right-sided heart catheterization revealed that respiratory failure patients were divided into Forrester's subset 1 (left ventricular function was within normal limits). So, it is unnecessary to give digitalis and/or diuretics for patients with respiratory failure. They only need respirator treatment. We tried cuirass ventilation since 1984. This respirator elongated their lives about 3 years. Since 1991 NIPPV was introduced in Japan, this treatment elongated their lives about 5.5 years. Nowadays TIPPV with tracheostomy is not first choice of treatment but we select this treatment not so unwillingly as before. As for left-sided heart failure, BNP (brain natriuretic peptide) is now considered useful parameter for left ventricular function. Japanese clinical researcher proposed treatment based on Values of BNP in left-sided heart failure. In 1980s, from the onset of heart failure until death was only 16 months, we feel that better results already accomplished. Kawai reported that average age at death in Japan was 26.8 years old in 2002. Our efforts must be done more and more until cure of this disease can be found.
 ...
PMID:[Cardiopulmonary failure in Duchenne muscular dystrophy--pathophysiology and management]. 1515 58

Elevated plasma natriuretic peptide levels after AMI (acute myocardial infarction) are associated with adverse outcome. The aim of the present study was to examine the relationship of plasma N-ANP (N-terminal pro-atrial natriuretic peptide) and N-BNP (N-terminal pro-B-type natriuretic peptide) with mortality and heart failure following AMI. We studied 403 patients with AMI. Blood was sampled for measurement of N-ANP and N-BNP on a single occasion between 72 and 96 h after symptom onset. Natriuretic peptide levels were related to all-cause mortality and heart failure episodes. During follow up (median, 462 days; range 5-764), 43 (10.7%), 25 (6.2%) and 49 (12.2%) patients suffered death, heart failure hospitalization and outpatient heart failure respectively. Only N-BNP (P < 0.0005), N-ANP (P = 0.005) and previous AMI (P = 0.016) were independently predictive of death. N-BNP, but not N-ANP, predicted 30-day mortality. N-ANP, but not N-BNP, predicted mortality after 30 days. N-BNP was the better predictor of heart failure. N-ANP and N-BNP were above the median in 35 and 38 respectively, of 43 patients who later died. N-ANP, N-BNP, or both were above the median in 41 out of 43 patients. Of 25 patients hospitalized with heart failure, N-ANP and N-BNP was above the median in 20 and 24 respectively, and one or other was elevated in all cases. Above-median N-ANP predicted 36 and N-BNP predicted 41 out of 49 episodes of outpatient heart failure. One or other peptide was above the median in 45 out of 49 patients. Our results indicate that N-BNP predicts 30-day and N-ANP >30-day mortality. We conclude that consideration of both N-ANP and N-BNP identifies a greater number of patients at risk of death or heart failure than either peptide alone.
 ...
PMID:N-terminal pro-atrial natriuretic peptide (N-ANP) and N-terminal pro-B-type natriuretic peptide (N-BNP) in the prediction of death and heart failure in unselected patients following acute myocardial infarction. 1518 35

We investigated whether a simple blood test of plasma N-brain natriuretic peptide (N-BNP), compared with echocardiographic left ventricular ejection fraction (LVEF), both measured at rest, correlated well with aerobic exercise capacity (peak oxygen consumption [VO(2)]) in patients with chronic heart failure. Plasma N-BNP was found to significantly correlate with peak VO(2) (p <0.001) and exercise duration (p = 0.001), whereas LVEF showed very poor correlations with peak VO(2) and exercise duration (both p >0.3). The results suggest that N-BNP actually reflects functional cardiac impairment better than LVEF.
 ...
PMID:Comparison of plasma N-brain natriuretic peptide, peak oxygen consumption, and left ventricular ejection fraction for severity of chronic heart failure. 1519 38

It is possible that plasma BNP measurement might be to heart failure what glycated haemoglobin measurement is to diabetes mellitus. Indeed, within 12-24 months, BNP testing might become a routine addition to the monitoring of patients with heart failure. In the meantime its main role is in helping to rule out heart failure in patients with new symptoms
 ...
PMID:B type natriuretic peptide testing: where are we now? 1520 Dec 34

Activation of the naturiuretic peptide system is a hallmark of heart failure (HF). In this paper the authors review aspects of the structure, regulation and physiology of the natriuretic peptides. The role of natriuretic peptides in HF progression is discussed. Potential clinical applications of BNP include diagnostic and prognosis in HF and myocardial infarction, as well as therapeutic monitoring of HF patients. Finally we review the therapeutic use of BNP.
 ...
PMID:[Type B natriuretic peptide. Role in heart failure physiopathology, diagnosis, and prognosis]. 1522 53

Recently, in a cross-sectional study, a correlation of moderate degree was documented between serum BNP (brain natriuretic peptide) and exercise capacity in patients with chronic heart failure (CHF). However, it remains unknown if BNP, which increases in response to high myocardial wall stress, is sufficiently sensitive for changes in exercise capacity during clinical follow-up. To elucidate this, 42 CHF patients were recruited and randomized into a training (T; 58 +/- 10 years; n = 14 NYHA II; n = 5 NYHA III) and a control group (CO; 54 +/- 9, n = 17 NYHA II; n = 6 NYHA III). T carried out 12 weeks of endurance training on a cycle ergometer (4 sessions per week, 45 min duration). Venous blood sampling and cycle ergometry with simultaneous gas exchange measurements were carried out prior to and after the experimental phase. Due to its superior stability during laboratory procedures, NTproBNP was determined instead of BNP. Both proteins are secreted in equimolar amounts and share an identical diagnostic meaning. In both groups, NT-proBNP decreased slightly (T: from 1092 +/- 980 to 805 +/- 724 pg x ml(-1); CO: from 1075 +/- 1068 to 857 +/- 1138 pg x ml(-1); T vs CO: p = 0.65). Anaerobic threshold (AT) as a measure of exercise capacity went up in T (from 0.96 +/- 0.17 to 1.10 +/- 0.22 l x min(-1)) but remained almost constant in CO (pre: 1.02 +/- 0.27; post: 1.00 +/- 0.27 l x min(-1); T vs CO: p < 0.001). The correlation between changes in NT-proBNP and changes in AT remained insignificant (r = 0.02, p = 0.89)-even if only T was considered (r = 0.09, p = 0.72). Improved exercise capacity in CHF patients due to 3 months of endurance training is not reflected in the course of NT-proBNP. These findings are inconsistent with a sufficient sensitivity of this parameter to detect changes in exercise capacity during clinical follow-up. Changes in NT-proBNP beyond its spontaneous variability are more likely to be detected following therapeutical interventions which aim more clearly at the myocardium. In determining alterations of functional capacity ergometric testing cannot be replaced by serial determinations of NT-proBNP.
 ...
PMID:Can serum NT-proBNP detect changes of functional capacity in patients with chronic heart failure? 1524 65


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>