BNP在非CHF中的意义.pdfVIP

DOI 10.3349/ymj.2051 Review Article pISSN: 0513-5796, eISSN: 1976-2437 Yonsei Med J 51(2):151-163, 2010 Interpretation and Use of Natriuretic Peptides in Non-Congestive Heart Failure Settings 1 1 1 1 2 Shih-Hung Tsai, Yen-Yue Lin, Shi-Jye Chu, Ching-Wang Hsu, and Shu-Meng Cheng 1 2 Department of Emergency Medicine, Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Natriuretic peptides (NPs) have been found to be useful markers in differentiating acute dyspneic patients presenting to the emergency department (ED) and emerged as potent prognostic markers for patients with congestive heart failure (CHF). The best-established and widely used clinical application of BNP and NT-proBNP testing is for the emergent diagnosis of CHF in patients presenting with acute dyspnea. Nevertheless, elevated NPs levels can be found in many circumstances involving left ventricular (LV) dysfunction or hypertrophy; right ventricular (RV) dysfunction secondary to pulmonary diseases; cardiac inflammatory or infectious diseases; endocrinology diseases and high output status without decreased LV ejection fraction. Even in the absence of significant clinical evidence of volume overload or LV dysfunction, markedly elevated NP levels can be found in patients with multiple comorbidities with a certain degree of prognostic value. Potential clinical applications of NPs are expanded accompanied by emerging reports regarding screening the presence of secondary cardiac dysfunction;