Sinha A-M, Breithardt O-A
2. Medizinische Klinik, Klinikum Coburg, Ketschendorfer Strasse 33, 96450 Coburg.
Herzschrittmacherther Elektrophysiol. 2006;17 Suppl 1:I51-5. doi: 10.1007/s00399-006-1108-6.
During recent years, heart failure has been recognized as a complex disease involving both hemodynamic abnormalities caused by reduced contractile forces and neurohormonal changes characterized by an increase in sympathetic tone and an activation of the renin-angiotensin-aldosterone system as well as the endothelial pathways. Neurohumoral factors represent the natural response of the individual to heart failure. Among them natriuretic peptides, i. e., brain natriuretic peptide (BNP) and amino-terminal pro BNP (Nt-proBNP) release have recently been shown to be a reliable and rapid marker for diagnosis, optimization of pharmacological treatment and risk stratification in heart failure patients. This article summarizes important aspects of the release of natriuretic peptides as a guide for diagnosis, therapy and prognosis of patients with heart failure and cardiac resynchronization therapy.
近年来，心力衰竭已被公认为是一种复杂的疾病，涉及因收缩力降低引起的血流动力学异常以及以交感神经张力增加、肾素-血管紧张素-醛固酮系统激活以及内皮途径激活为特征的神经激素变化。神经体液因素代表个体对心力衰竭的自然反应。其中，利钠肽，即脑利钠肽（BNP）和氨基末端前BNP（Nt-proBNP）的释放，最近已被证明是心力衰竭患者诊断、优化药物治疗和风险分层的可靠且快速的标志物。本文总结了利钠肽释放的重要方面，作为心力衰竭和心脏再同步治疗患者诊断、治疗及预后的指导。
