A rapid test for B-type natriuretic peptide correlates with falling wedge pressures in patients treated for decompensated heart failure: A pilot study

摘要: Objectives: To determine if changes in B-type natriuretic peptide (BNP) levels can accurately reflect acute pulmonary capillary wedge pressure during treatment of decompensated heart failure. Background: Tailored therapy congestive failure with hemodynamic monitoring is controversial. Other than the expense and complications Swan-Ganz catheters, its use titration drug has no conclusive end point. Because BNP reflects both elevated left ventricular neurohormonal modulation a short half-life, we hypothesized that would decline association falling pressures. Final perhaps signify new set point neuromodulation. Methods Results: Twenty patients New York Heart Association (NYHA) class III-IV (CHF) undergoing tailored were studied. drawn every 2 to 4 hours for first 24 (active phase) then next 48 (stabilization period). Hemodynamic data was recorded simultaneously. In 15 whose responded hours, there significant drop (55%) versus nonresponders (8%). There correlation between percent change from baseline per hour (r = 0.79, P <.05). When kept at stable, low level stabilization phase, continued fall another 37% (937 ± 140 pg/mL 605 128 pg/mL). Patients who died (n 4) had higher final (1,078 123 v 701 107 Conclusions: The suggest rapid testing may be an effective way improve in-hospital management admitted CHF. Although will not obviate need invasive monitoring, it useful adjunct tailoring these patients.