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BNP-Guided Therapy for Heart Failure
Ileana L. Piña, MD;
Christopher OConnor, MD
JAMA. 2009;301(4):432-434.
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Clinicians continue to search for that one test, the one biomarker that will help them diagnose, prognosticate, and treat specific syndromes. Heart failure is undoubtedly one of those syndromes. All physicians who treat patients with heart failure seek a robust marker for this syndrome, and some may wonder, with the mounting evidence on brain natriuretic peptide (BNP), is such a biomarker finally here?
The current status of BNP in heart failure has been the result of an important historic journey. In 1981, de Bold et al1 injected myocardial homogenates into nondiuretic rats. The atrial muscle extract increased sodium and chloride excretion 30-fold, along with an impressive increase in urine volume. By 1985, this same group had identified specific granules that secreted the peptide, now known as atrial natriuretic factor (ANF), and noted that the substance also had a hypotensive effect and an inhibitory . . . [Full Text of this Article]
Author Affiliations: School of Medicine, Case Western Reserve University, Cleveland, Ohio (Dr Piña); Louis Stokes VA Medical Center, Cleveland, Ohio (Dr Piña); and Department of Medicine, Duke University, Durham, North Carolina (Dr OConnor).
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