The Queen Elizabeth Hospital, Department of Cardiology, Basil Hetzel Institute, The University of Adelaide, Australia.
Curr Opin Cardiol. 2014 Mar;29(2):160-6. doi: 10.1097/HCO.0000000000000036.
To evaluate new development in the utility of brain natriuretic peptide and N-Terminal brain natriuretic peptide (BNP/NT-Pro-BNP) in the management of various cardiovascular diseases. The determination of plasma BNP levels has an established role in the discrimination of pulmonary oedema from other causes of acute dyspnoea, and there is increasing evidence of the utility of BNP/NT-Pro-BNP assay both as a prognostic tool in chronic heart failure and as a means of guiding therapy in heart failure patients aged below 70 years.
Findings have substantially extended the clinical utility of BNP/NT-Pro-BNP assay. In heart failure with preserved left ventricular ejection fraction, BNP elevation may also facilitate diagnosis, although its precise utility is uncertain.In the acute catecholamine-induced myocardial inflammatory condition of Tako-Tsubo cardiomyopathy (TTC), BNP/NT-Pro-BNP elevations are marked and persist for at least 3 months, despite the absence of pulmonary oedema. In TTC, BNP/NT-Pro-BNP therefore serves as an ancillary diagnostic measure as well as a marker of recovery. Among other conditions in which BNP assay may provide prognostic information are atrial fibrillation (in which the extent of elevation predicts thromboembolic risk) and pulmonary hypertension.
BNP/NT-Pro-BNP assay has widespread utility as an adjunct to cardiovascular disease diagnosis and management.
评估脑利钠肽和 N 末端脑利钠肽（BNP/NT-Pro-BNP）在各种心血管疾病治疗中的新应用。测定血浆 BNP 水平在鉴别肺水肿和其他急性呼吸困难的病因方面具有明确的作用，并且越来越多的证据表明 BNP/NT-Pro-BNP 检测既可以作为慢性心力衰竭的预后工具，也可以作为指导 70 岁以下心力衰竭患者治疗的方法。
研究结果大大扩展了 BNP/NT-Pro-BNP 检测的临床应用。在左心室射血分数保留的心力衰竭中，BNP 升高也可能有助于诊断，尽管其确切的作用尚不确定。在 Takotsubo 心肌病（TTC）这种急性儿茶酚胺诱导的心肌炎症状态中，BNP/NT-Pro-BNP 升高明显，并持续至少 3 个月，尽管没有肺水肿。因此，在 TTC 中，BNP/NT-Pro-BNP 不仅是一种辅助诊断措施，也是一种恢复的标志物。在心房颤动（其中升高的程度预测血栓栓塞风险）和肺动脉高压等其他情况下，BNP 检测也可能提供预后信息。
BNP/NT-Pro-BNP 检测在心血管疾病的诊断和治疗中有广泛的应用。
