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More Than a Stretch

Marvin A. Konstam, MD

JAMA. 2007;297:212-214.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In patients with known or suspected cardiovascular disease, biomarkers are increasingly being explored as indicators of disease presence, severity, or activity; prognosis; and therapeutic efficacy. A biomarker may be a by-product of the disease state and may also directly participate in its pathogenesis or modulation. The cardiac natriuretic peptides (secreted in response to myocardial stretch) promote vasodilation and natriuresis and are believed to mitigate adverse cardiovascular remodeling. Circulating levels of these peptides have proved useful in gauging the severity of heart failure and in assessing the differential diagnosis of acute dyspnea.¹ N-terminal fragment of the prohormone brain-type natriuretic peptide (NT-proBNP)² is an inactive cleavage product with much slower clearance than the biologically active BNP.³ Its plasma concentration, therefore, principally reflects myocardial secretion over a prolonged time.

Prior investigations have identified plasma BNP and NT-proBNP levels as independent predictors of mortality or cardiovascular events in populations . . . [Full Text of this Article]

Author Affiliations: Department of Medicine, Tufts University School of Medicine and Tufts-New England Medical Center, Boston, Mass.

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