Berthelot Emmanuelle, Eliahou Ludivine, Jagu Annabelle, Damy Thibaud, Hanon Olivier, Hulot Jean-Sébastien, Meune Christophe, Roig Clemence, Roubille François, Sabouret Pierre, Logeart Damien, Mewton Nathan
AP-HP, service de cardiologie, hôpital Bicêtre, Le Kremlin-Bicêtre, France.
Centre national de référence pour le syndrome de Marfan et les maladies apparentées, VASCERN HTAD European Reference Centre, AP-HP, hôpital Bichat-Claude-Bernard, Paris, France. Service de cardiologie, AP-HP, hôpital Bichat-Claude-Bernard, Paris, France.
Rev Prat. 2024 Feb;74(2):185-193.
NATRIURETIC PEPTIDES IN THE DIAGNOSIS AND MONITORING OF CARDIAC FAILURE. Heart failure (HF) is a serious and common disease requiring a prompt diagnosis for appropriate management. Natriuretic peptides, such as BNP and NT-proBNP, play a crucial role in diagnosing HF due to their s pecificity and reproducibility. It is important to measuring natriuretic peptides, especially in cases of acute dyspnea, to differentiate cardiac causes from others. Specific thresholds are recommended, with high values strongly suggest HF, while normal levels rule out the diagnosis. Clinical characteristics, such as age, renal function, atrial fibrillation, obesity, and gender, influence natriuretic peptides levels and should be considered in interpretation. For diabetic, hypertensive, and obese patients, early screening for HF through natriuretic peptides measurement is crucial. Furthermore, these natriuretic peptides are useful for monitoring chronic heart failure patients. They assist in confirming decompensation, titrating treatment, evaluating treatment response, and establishing prognosis. However, it's essential to choose a single biomarker (BNP or NT-proBNP) to avoid confusion.
利钠肽在心力衰竭的诊断和监测中的应用。心力衰竭（HF）是一种严重且常见的疾病，需要及时诊断以便进行适当的管理。利钠肽，如脑钠肽（BNP）和N末端脑钠肽原（NT-proBNP），因其特异性和可重复性，在心力衰竭的诊断中起着至关重要的作用。测量利钠肽很重要，尤其是在急性呼吸困难的情况下，以区分心脏原因和其他原因。推荐了特定的阈值，高值强烈提示心力衰竭，而正常水平可排除诊断。年龄、肾功能、心房颤动、肥胖和性别等临床特征会影响利钠肽水平，在解读时应予以考虑。对于糖尿病、高血压和肥胖患者，通过测量利钠肽进行心力衰竭的早期筛查至关重要。此外，这些利钠肽对监测慢性心力衰竭患者很有用。它们有助于确认失代偿、调整治疗、评估治疗反应和确定预后。然而，选择单一生物标志物（BNP或NT-proBNP）以避免混淆至关重要。
