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(Circulation. 2003;108:2950.)
© 2003 American Heart Association, Inc.

Focused Perspectives

Should B-Type Natriuretic Peptide Be Measured Routinely to Guide the Diagnosis and Management of Chronic Heart Failure?

Milton Packer, MD

From the Division of Circulatory Physiology, Columbia University College of Physicians and Surgeons, New York, NY.

Correspondence and reprint requests to Dr Packer, Division of Circulatory Physiology, Columbia University, College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032. E-mail mp65@Columbia.edu

Key Words: Editorials • natriuretic peptides • tests • heart failure • diagnosis

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Perhaps more than in any other cardiovascular disorder, the diagnosis and treatment of heart failure rely heavily on the scholarship, skills, and judgment of the practicing physician. Proper management of this syndrome requires clinicians to integrate elements of the history, physical examination, and laboratory evaluations together with knowledge of multiple pharmacological and nonpharmacological treatments in an attempt to produce unpredictable degrees of improvement in patients who have a disabling and inexorably progressive disease. There is no diagnostic test for heart failure, and most therapies for the disorder need to be individually titrated, often with the intent of reproducing the treatment strategies used in clinical trials without any means of demonstrating a prognostic benefit in individual patients. Because of these challenges, the diagnosis of heart failure is frequently missed, and useful treatments for heart failure are commonly underutilized. The situation is complicated by the fact that the vast majority of patients with heart failure are managed by primary care physicians and not by cardiologists.

See p 2964

Given all of these difficulties, it is easy to understand why clinicians would be excited about a potential solution to the challenges posed by the syndrome of heart failure. What if one could perform a simple, inexpensive blood test that could be used not only to make the diagnosis, but also to guide the need for and effectiveness of treatment? In theory, such a test would provide clinicians with an intermediate end point similar to the measurement of blood pressure or blood lipids. The . . . [Full Text of this Article]

Related Article:

Plasma B-Type Natriuretic Peptide Levels in Ambulatory Patients With Established Chronic Symptomatic Systolic Heart Failure

W.H. Wilson Tang, John P. Girod, Michael J. Lee, Randall C. Starling, James B. Young, Frederick Van Lente, and Gary S. Francis
Circulation 2003 108: 2964-2966. [Abstract] [Full Text]

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