PMID- 24338787
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140224
LR  - 20211021
IS  - 1568-5888 (Print)
IS  - 1876-6250 (Electronic)
IS  - 1568-5888 (Linking)
VI  - 22
IP  - 3
DP  - 2014 Mar
TI  - Biomarkers in outpatient heart failure management; Are they correlated to and do 
      they influence clinical judgment?
PG  - 115-21
LID - 10.1007/s12471-013-0503-y [doi]
AB  - AIMS: Heart failure (HF) management is complicated by difficulties in clinical 
      assessment. Biomarkers may help guide HF management, but the correspondence 
      between clinical evaluation and biomarker serum levels has hardly been studied. 
      We investigated the correlation between biomarkers and clinical signs and 
      symptoms, the influence of patient characteristics and comorbidities on New York 
      Heart Association (NYHA) classification and the effect of using biomarkers on 
      clinical evaluation. METHODS AND RESULTS: This post-hoc analysis comprised 622 
      patients (77 +/- 8 years, 76 % NYHA class >/=3, 80 % LVEF </=45 %) participating in 
      TIME-CHF, randomising patients to either NT-proBNP-guided or symptom-guided 
      therapy. Biomarker measurements and clinical evaluation were performed at 
      baseline and after 1, 3, 6, 12 and 18 months. NT-proBNP, GDF-15, hs-TnT and to a 
      lesser extent hs-CRP and cystatin-C were weakly correlated to NYHA, oedema, 
      jugular vein distension and orthopnoea (rho-range: 0.12-0.33; p < 0.01). NT-proBNP 
      correlated more strongly to NYHA class in the NT-proBNP-guided group compared 
      with the symptom-guided group. NYHA class was significantly influenced by age, 
      body mass index, anaemia, and the presence of two or more comorbidities. 
      CONCLUSION: In HF, biomarkers correlate only weakly with clinical signs and 
      symptoms. NYHA classification is influenced by several comorbidities and patient 
      characteristics. Clinical judgement seems to be influenced by a clinician's 
      awareness of NT-proBNP concentrations.
FAU - Peeters, J M P W U
AU  - Peeters JM
AD  - Department of Cardiology, Maastricht University Medical Center, CARIM, P. 
      Debyelaan 25, PO box 5800, 6202 AZ, Maastricht, the Netherlands, 
      jeanmarie.peeters@mumc.nl.
FAU - Sanders-van Wijk, S
AU  - Sanders-van Wijk S
FAU - Bektas, S
AU  - Bektas S
FAU - Knackstedt, C
AU  - Knackstedt C
FAU - Rickenbacher, P
AU  - Rickenbacher P
FAU - Nietlispach, F
AU  - Nietlispach F
FAU - Handschin, R
AU  - Handschin R
FAU - Maeder, M T
AU  - Maeder MT
FAU - Muzzarelli, S F
AU  - Muzzarelli SF
FAU - Pfisterer, M E
AU  - Pfisterer ME
FAU - Brunner-La Rocca, H P
AU  - Brunner-La Rocca HP
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Neth Heart J
JT  - Netherlands heart journal : monthly journal of the Netherlands Society of 
      Cardiology and the Netherlands Heart Foundation
JID - 101095458
PMC - PMC3931853
EDAT- 2013/12/18 06:00
MHDA- 2013/12/18 06:01
PMCR- 2013/12/14
CRDT- 2013/12/17 06:00
PHST- 2013/12/17 06:00 [entrez]
PHST- 2013/12/18 06:00 [pubmed]
PHST- 2013/12/18 06:01 [medline]
PHST- 2013/12/14 00:00 [pmc-release]
AID - 503 [pii]
AID - 10.1007/s12471-013-0503-y [doi]
PST - ppublish
SO  - Neth Heart J. 2014 Mar;22(3):115-21. doi: 10.1007/s12471-013-0503-y.