Obesity and natriuretic peptides, BNP and NT-proBNP: mechanisms and diagnostic implications for heart failure.
Obesity and natriuretic peptides, BNP and NT-proBNP: mechanisms and diagnostic implications for heart failure.
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DOI：
10.1016/j.ijcard.2014.08.007
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发表时间：
2014-10-20
影响因子：
3.5
通讯作者：
Runge, Marschall S.
中科院分区：
文献类型：
--
作者：
Madamanchi, Chaitanya;Alhosaini, Hassan;Sumida, Arihiro;Runge, Marschall S.
近年来，心力衰竭（HF）的诊断和治疗取得了许多进展。心脏生物标志物是临床医生的重要工具：床旁B型利钠肽（BNP）及其N-末端对应物（NT-proBNP）水平有助于区分呼吸困难的心源性和非心源性原因，也可用于预后和监测治疗效果。HF生物标志物的主要局限性之一是在肥胖患者中，其中BNP和NT-proBNP水平与心肌硬度之间的关系复杂。最近的数据表明BNP和NT-proBNP水平与体重指数呈反比关系。鉴于全球范围内肥胖症的患病率不断增加，了解HF生物标志物在该人群中的益处和局限性非常重要。本综述将探讨这些肽的生物学、生理学和病理生理学以及心力衰竭中的心脏内分泌矛盾。我们还研究了肥胖患者BNP水平和HF之间不一致的临床证据、机制和合理的生物学解释。
Many advances have been made in the diagnosis and management of heart failure (HF) in recent years. Cardiac biomarkers are an essential tool for clinicians: point of care B-Type Natriuretic Peptide (BNP) and its N-terminal counterpart (NT-proBNP) levels help distinguish cardiac from non-cardiac causes of dyspnea and are also useful in the prognosis and monitoring of the efficacy of therapy. One of the major limitations of HF biomarkers is in obese patients where the relationship between BNP and NT-proBNP levels and myocardial stiffness is complex. Recent data suggest an inverse relationship between BNP and NT-proBNP levels and body mass index. Given the ever-increasing prevalence of obesity world-wide, it is important to understand the benefits and limitations of HF biomarkers in this population. This review will explore the biology, physiology, and pathophysiology of these peptides and the cardiac endocrine paradox in HF. We also examine the clinical evidence, mechanisms, and plausible biological explanations for the discord between BNP levels and HF in obese patients.
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DOI：
10.1016/j.jchf.2013.03.001
发表时间：
2013-06
期刊：
JACC. Heart failure
影响因子：
--
作者：
Costello-Boerrigter LC;Lapp H;Boerrigter G;Lerman A;Bufe A;Macheret F;Heublein DM;Larue C;Burnett JC Jr
通讯作者：
Burnett JC Jr
影响因子：
15.8
作者：
Civitarese AE;Carling S;Heilbronn LK;Hulver MH;Ukropcova B;Deutsch WA;Smith SR;Ravussin E;CALERIE Pennington Team
通讯作者：
CALERIE Pennington Team
影响因子：
2.8
作者：
Cheng, Susan;Fox, Caroline S.;Wang, Thomas J.
通讯作者：
Wang, Thomas J.
影响因子：
18.2
作者：
Andreassi, MG;Del Ry, S;Giannessi, D
通讯作者：
Giannessi, D
影响因子：
2.8
作者：
Chainani-Wu, Nita;Weidner, Gerdi;Ornish, Dean
通讯作者：
Ornish, Dean