Natriuretic peptides in chronic heart failure

Natriuretic peptides in chronic heart failure

Hans-Peter Brunner-La Rocca
Presented by
Hans-Peter Brunner-La Rocca
Head of the Heart Failure Clinic 
Maastricht UMC+, NL
 
 

Measurement of natriuretic peptides (NP) is well established in the diagnostic process of heart failure (HF). It is particularly helpful for exclusion of HF, both in acute decompensation and in the outpatient setting. Still, levels of NPs are influenced by many factors other than HF. It is important to understand these factors for more accurate interpretation of the results. NPs have strong prognostic power, but the question is how this influences clinical practice. On the one hand, some studies used NPs as inclusion criterium and should therefore be considered. On the other hand, various studies investigated the role of NPs to guide therapy in the chronic setting. Results are conflicting and the most recent and largest study (GUIDE-IT) was neutral. The conflicting results are due to significant differences between trials. Importantly, effects in HFrEF and HFpEF are different. If only considering HFrEF studies in chronic HF, meta-analysis shows a survival benefit of app. 20% by using NP guidance of HF therapy. Finally, the new drug sacubitril may influence levels of NPs and this effect is smallest for NT-proBNP. This webinar discusses the clinical value of NPs in the setting of (chronic) HF and where measurement of NPs is useful.

 

 

Dr Hitoshi Matsuo

Hans-Peter Brunner-La Rocca is a heart failure cardiologist, trained in Switzerland and has been working in the Academic Hospital Maastricht, in the Netherlands for 10 years. He is head of the Heart Failure Clinic and head of the division of Structural Heart Diseases. His main research interests are biomarkers and eHealth to achieve personalised treatment in heart failure. He was the trial leader of the TIME-CHF study. He has published >200 scientific articles in the field and is a renowned expert in clinical biomarker research.

This webinar aims to provide a summary of the use of natriuretic peptides in clinical practice and aims to answer the following questions:

  • What is the clinical use of measuring natriuretic peptide for diagnosis of heart failure in different setting?
  • How can the results of natriuretic peptides in the acute and chronic setting of heart failure be interpreted?
  • What is the influence of sacubitril/valsartan on natriuretic peptide levels?
  • Should the interpretation of the values be changed?
  • What is the clinical value of the strong prognostic value of natriuretic peptides in heart failure?
  • What are the characteristics and the differences between the studies investigating therapy guidance by BNP and NT-proBNP?
  • How should results of the (NT-pro)BNP-guidance therapy studies in chronic heart failure be interpreted and how do these results impact the treatment of heart failure?
  • What do we learn from these studies?
  • What do we learn from these studies?
  • General cardiology
  • Heart failure specialists
  • Heart failure nurses
  • General practitioners
  • Internal medicine
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  • Taylor KS, Verbakel JY, Feakins BG, et al. Diagnostic accuracy of point-of-care natriuretic peptide testing for chronic heart failure in ambulatory care: systematic review and meta-analysis. BMJ 2018;361:k1450. doi.org/10.1136/bmj.k1450; PMID: 29785952.
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