Bettencourt Paulo
Departamento de Medicina Interna, Serviço de Medicina B - Hospital S. João, Faculdade de Medicina da Universidade do Porto, Unidade I&D Cardiovascular do Porto, Porto, Portugal.
Eur J Heart Fail. 2004 Mar 15;6(3):359-63. doi: 10.1016/j.ejheart.2004.01.008.
Guidelines for the pharmacological treatment of heart failure (HF) are based on results from large clinical trials demonstrating benefit. State of the art pharmacological management of HF assumes that target doses should be the same as those used in trials. Thus equal doses are recommended for all in practical guidelines, but this strategy might not fit individual needs. NT-proBNP and BNP emerged as potential biomarkers of clinical interest in HF management. NT-proBNP and BNP are related to HF severity and to clinical status. NT-proBNP and BNP are strongly associated with prognosis across the whole spectrum of HF patients. A pilot study has shown that NT-proBNP-guided therapy is associated with improved outcome in HF. Although at present there are still few data to make firm recommendations on the use of NT-proBNP or BNP levels as biomarkers for HF management, future studies will provide further insight on this issue.
心力衰竭(HF)的药物治疗指南基于大型临床试验显示出获益的结果。目前HF的药物管理技术认为目标剂量应与试验中使用的剂量相同。因此,在实用指南中建议所有人使用相同剂量,但这种策略可能并不适合个体需求。N末端脑钠肽前体(NT-proBNP)和脑钠肽(BNP)已成为HF管理中具有临床意义的潜在生物标志物。NT-proBNP和BNP与HF严重程度及临床状态相关。在整个HF患者范围内,NT-proBNP和BNP与预后密切相关。一项初步研究表明,NT-proBNP指导的治疗与HF患者预后改善相关。尽管目前关于将NT-proBNP或BNP水平用作HF管理生物标志物的使用,仍缺乏足够数据来做出明确推荐,但未来研究将为该问题提供进一步见解。