PMID- 11943558
OWN - NLM
STAT- MEDLINE
DCOM- 20020823
LR  - 20191025
IS  - 1043-2760 (Print)
IS  - 1043-2760 (Linking)
VI  - 13
IP  - 4
DP  - 2002 May-Jun
TI  - BNP in hormone-guided treatment of heart failure.
PG  - 151-5
AB  - The pharmacotherapy of heart failure has become complex. Angiotensin-converting 
      enzyme inhibitors (or angiotensin II receptor blockers), beta-blockers, 
      spironolactone, diuretics and digoxin can be prescribed concurrently. Endothelin 
      antagonists and combined inhibitors of converting enzyme and neutral 
      endopeptidase are under investigation. Optimal dosing will become increasingly 
      difficult to judge. Plasma brain natriuretic peptide (BNP) indicates the severity 
      of left ventricular dysfunction. The C-terminal bioactive peptide and N-terminal 
      BNP (N-BNP) circulate at concentrations related to cardiac status. We proposed 
      that plasma levels of N-BNP would provide an index to guide drug treatment in 
      established heart failure. Sixty-nine patients were randomized to treatment 
      adjusted according to clinical criteria or plasma N-BNP. Hormone-guided therapy 
      resulted in fewer clinical end points than did clinical management. This 
      encourages further exploration of hormone guidance of anti-heart failure therapy, 
      which could be extended to patients with preserved ejection fraction, in addition 
      to those with established systolic dysfunction.
FAU - Richards, A Mark
AU  - Richards AM
AD  - Christchurch Cardioendocrine Research Group, Dept Medicine, Christchurch School 
      of Medicine, Riccarton Avenue, PO Box 4345, Christchurch, New Zealand.
FAU - Lainchbury, John G
AU  - Lainchbury JG
FAU - Nicholls, M Gary
AU  - Nicholls MG
FAU - Troughton, Richard W
AU  - Troughton RW
FAU - Yandle, Timothy G
AU  - Yandle TG
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Trends Endocrinol Metab
JT  - Trends in endocrinology and metabolism: TEM
JID - 9001516
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Biomarkers)
RN  - 0 (Diuretics)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 27O7W4T232 (Spironolactone)
RN  - 73K4184T59 (Digoxin)
SB  - IM
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Biomarkers/*blood
MH  - Digoxin/therapeutic use
MH  - Diuretics/therapeutic use
MH  - Double-Blind Method
MH  - Drug Monitoring
MH  - Heart Diseases/blood/*drug therapy
MH  - Humans
MH  - Natriuretic Peptide, Brain/*blood
MH  - Randomized Controlled Trials as Topic
MH  - Spironolactone/therapeutic use
MH  - Ventricular Dysfunction, Left/blood
RF  - 65
EDAT- 2002/04/12 10:00
MHDA- 2002/08/24 10:01
CRDT- 2002/04/12 10:00
PHST- 2002/04/12 10:00 [pubmed]
PHST- 2002/08/24 10:01 [medline]
PHST- 2002/04/12 10:00 [entrez]
AID - S1043276001005549 [pii]
AID - 10.1016/s1043-2760(01)00554-9 [doi]
PST - ppublish
SO  - Trends Endocrinol Metab. 2002 May-Jun;13(4):151-5. doi: 
      10.1016/s1043-2760(01)00554-9.