Will sacubitril-valsartan diminish the clinical utility of B-type natriuretic peptide testing in acute cardiac care?

Mair, JohannesMed Univ Innsbruck, Dept Internal Med Cardiol & Angiol 3, Innsbruck, Austria. (författare)

Since the approval of sacubitril-valsartan for the treatment of chronic heart failure with reduced ejection fraction, a commonly raised suspicion is that a wider clinical use of this new drug may diminish the clinical utility of B-type natriuretic peptide testing as sacubitril may interfere with B-type natriuretic peptide clearance. In this education paper we critically assess this hypothesis based on the pathophysiology of the natriuretic peptide system and the limited published data on the effects of neprilysin inhibition on natriuretic peptide plasma concentrations in humans. As the main clinical application of B-type natriuretic peptide testing in acute cardiac care is and will be the rapid rule-out of suspected acute heart failure there is no significant impairment to be expected for B-type natriuretic peptide testing in the acute setting. However, monitoring of chronic heart failure patients on sacubitril-valsartan treatment with B-type natriuretic peptide testing may be impaired. In contrast to N-terminal-proBNP, the current concept that the lower the B-type natriuretic peptide result in chronic heart failure patients, the better the prognosis during treatment monitoring, may no longer be true.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Sacubitril-valsartan
natriuretic peptides
B-type natriuretic peptide
diagnosis
heart failure
acute cardiac care

Lindahl, Bertil,1957-Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)belin227 (författare)
Giannitsis, EvangelosHeidelberg Univ, Med Klin 3, Heidelberg, Germany. (författare)
Huber, KurtWilhelminen Hosp, Dept Med Cardiol & Intens Care Med, Vienna, Austria. (författare)
Thygesen, KristianAarhus Univ Hosp, Dept Cardiol, Aarhus, Denmark. (författare)
Plebani, MarioUniv Hosp Padova, Dept Lab Med, Padua, Italy. (författare)
Moeckel, MartinCharite Univ Med Berlin, Div Emergency Med, Berlin, Germany.;Charite Univ Med Berlin, Dept Cardiol, Berlin, Germany. (författare)
Mueller, ChristianUniv Hosp Basel, Dept Cardiol, Basel, Switzerland.;Univ Hosp Basel, Cardiovasc Res Inst Basel, Basel, Switzerland. (författare)
Jaffe, Allan S. (författare)
Med Univ Innsbruck, Dept Internal Med Cardiol & Angiol 3, Innsbruck, Austria.Kardiologi (creator_code:org_t)

Ingår i:European Heart Journal: Oxford University Press (OUP)6:4, s. 321-3282048-87262048-8734

Av författaren/redakt...: Mair, Johannes; Lindahl, Bertil, ...; Giannitsis, Evan ...; Huber, Kurt; Thygesen, Kristi ...; Plebani, Mario; visa fler...; Moeckel, Martin; Mueller, Christi ...; Jaffe, Allan S.; visa färre...

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