An experienced cardiologist recently reminded me that most heart failure patients have a medical history of arteriosclerosis and coronary artery disease (CAD) (Figure 1). With or without myocardial infarction, the ventricular myocardium becomes hypoxic during increased workload, which, in turn, strangulates cardiac performance and initiates pathological remodelling of the myocardium. In the cou...

STUDY OBJECTIVES In dyspneic patients without left ventricular enlargement, it may be difficult to differentiate between obstructive lung disease and diastolic heart failure. Determination of plasma brain natriuretic peptide (BNP) levels, known to increase with ventricular stretch, may be of clinical relevance in this situation. We compared the discriminant power of BNP blood levels and of echo...

OBJECTIVES This study sought to hypothesize that elevated B-type natriuretic peptide (BNP) could act as an endogenous neprilysin inhibitor. BACKGROUND A hallmark of acute decompensated heart failure (ADHF) is the overproduction of natriuretic peptides (NPs) by stretched cardiomyocytes. Various strategies have been developed to potentiate the beneficial effect of the NPs, including the recent ...

BACKGROUND Recombinant human B-type natriuretic peptide (rhBNP) has been indicated for the treatment of acute decompensated heart failure (ADHF). However, the therapeutic efficacy of intravenous rhBNP is not always satisfactory in patients with extremely high blood BNP levels. In this study, we evaluated the effects of rhBNP on patients with different BNP levels. METHODS One hundred and five ...

B-type (or brain) natriuretic peptide (BNP) is synthesized in cardiac myocytes and released constitutively into the circulation. Pressure/volume overload, neurohumoral factors, cytokines, ischemia enhance BNP gene expression, then precursor proBNP produced. It has been thought that cleaved active molecule inactive marker NT-proBNP intracellularly by processing enzyme furin, they are However, re...

We read the article titled ‘‘High levels of B-type natriuretic peptide (BNP) predict weaning failure from mechanical ventilation in adult patients after cardiac surgery’’ by Thiago Martins Lara et al. with interest (1). The authors aimed to evaluate whether serum levels of Btype natriuretic peptide are a predictor of weaning failure from mechanical ventilation after cardiac surgery. They conclu...

I. Overview of Heart Failure. . . . . . . . . . . . . . . . . . . . . . .e99 A. Context of Biochemical Marker Testing in Heart Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e99 B. Background and Definition of Terms . . . . . . . . . .e100 C. B-type Natriuretic Peptide (BNP) and AminoTerminal proB-Type Natriuretic Peptide (NT-proBNP) Metabolism and Measurement . . . .e100 I...

BACKGROUND The pathophysiological role of cortisol, which binds to the mineralocorticoid receptor with an affinity equal to that of aldosterone (ALD), may be influenced by oxidative stress in patients with chronic heart failure. We evaluated cardiac event prediction using cortisol levels in chronic heart failure, in comparison with ALD, adrenocorticotropic hormone, and brain natriuretic peptide...

BACKGROUND AND PURPOSE Assessment of left atrial appendage (LAA) function with transesophageal echocardiography is useful for detecting patients at high risk for thromboembolism as a result of atrial fibrillation (AF). A recent study reported that the atrium is the main source of brain natriuretic polypeptide (BNP) in AF patients without overt heart failure. The purpose of this study was to ass...