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(Circulation. 2007;115:3045-3047.)
© 2007 American Heart Association, Inc.

Editorial

Can We IMPROVE-CHF Management By Measuring Natriuretic Peptides?

Barry Greenberg, MD

From the Advanced Heart Failure Program, University of California, San Diego, Calif.

Correspondence to Barry Greenberg, MD, Advanced Heart Failure Treatment Program, University of California, San Diego Medical Center, 200 W Arbor St, San Diego, CA 92103–8411. E-mail bgreenberg@ucsd.edu

Key Words: Editorials • heart failure • natriuretic peptides

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

Acute decompensated heart failure (ADHF) is a major public health problem throughout the world. In the United States alone, this condition accounts for >1 million hospitalizations annually, and it is likely that this number will increase in the future just as it has done over the past several decades.¹ Although some progress has been made in reducing in-hospital death rates and length of hospital stay for ADHF, mortality and readmission rates over the 6-month period after discharge remain alarmingly high. In addition, costs of managing patients with ADHF are substantial, with 60% of all funds spent on heart failure being consumed during hospitalizations. Despite recognition of the importance of ADHF, however, there has been little progress in either defining universally accepted management strategies or generating new treatment approaches that alter these outcomes.

Article p 3103

The use of biomarkers to detect risk, assess prognosis, and guide management of disease has been a major advance in the practice of medicine. Measurement of B-type natriuretic peptide (BNP) or the amino terminal fragment of the precursor protein (NT-proBNP) have been shown to be useful in detecting the presence of heart failure in dyspneic patients and in determining prognosis.^2–4 Although measurement of these peptides is widely used, questions about whether the test results can effectively help guide management strategies and whether they lead to better outcomes at lower cost to the healthcare system have not been fully addressed.^5,6 In this issue of Circulation, Moe and colleagues⁷ present results of the IMPROVE-CHF study in . . . [Full Text of this Article]