Hosted by the trial leader of the TIME-CHF study, this webinar discusses the clinical value of NPs in the setting of (chronic) HF and where measurement of NPs is useful.
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 approximately 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.
- Prof Hans-Peter Brunner-La Rocca, Heart Failure Cardiologist, trained in Switzerland and has been working in the Academic Hospital Maastrict, Netherlands, for 10 years.
This is a Radcliffe Cardiology independent webinar.