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(Circulation. 2003;107:1231.)
© 2003 American Heart Association, Inc.

Editorial

Use of Biomarkers in the Management of Heart Failure

Are We There Yet?

Biykem Bozkurt, MD; Douglas L. Mann, MD

From the Winters Center for Heart Failure Research, Department of Medicine, Baylor College of Medicine, and the Medical Care Line, Houston Veterans Administration Medical Center, Houston, Tex; and The Methodist Hospital, Houston, Tex.

Correspondence to Douglas L. Mann, MD, Winters Center for Heart Failure Research, MS 524, 6565 Fannin, Houston, TX 77030. E-mail dmann@bcm.tmc.edu

Key Words: Key Words: • Editorials • heart failure • morbidity • mortality

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

"What gets you into trouble is not what you don’t know, it’s what you know for sure, that just ain’t so."

— Yogi Berra

Although the advent of clinical practice guidelines and disease management strategies for patients with heart failure has resulted in dramatic overall improvements in patient care, the day-to-day management of individual patients with heart failure remains challenging. As one example, current heart failure practice guidelines recommend that doses of angiotensin-converting enzyme inhibitors and ß-blocker should be titrated to the levels used in clinical trials. Although this "one dose fits all" approach is entirely logical (and necessary) from the standpoint of clinical trial design, it is not necessarily logical in the management of individual heart failure patients, in whom body mass (and hence drug disposition) may range from morbidly obese to cachectic. The above example, which is emblematic of the types of problems that clinicians face when they try to adapt and individualize practice guidelines for their own patients, raises the broader question of how clinicians should individualize management strategies for heart failure.

See p 1278

In the current issue of the Circulation, Anand and colleagues¹ report on changes in brain natriuretic peptide (BNP) and plasma norepinephrine (PNE) levels in patients who were enrolled in the Valsartan Heart Failure Trial (Val-HeFT). The authors measured BNP and NE levels before randomization and during follow-up in approximately 4300 patients enrolled in the trial. As with other studies that have examined therapeutic responses in relation to levels of circulating neurohormones, . . . [Full Text of this Article]

Related Article:

Changes in Brain Natriuretic Peptide and Norepinephrine Over Time and Mortality and Morbidity in the Valsartan Heart Failure Trial (Val-HeFT)

Inder S. Anand, Lloyd D. Fisher, Yann-Tong Chiang, Roberto Latini, Serge Masson, Aldo P. Maggioni, Robert D. Glazer, Gianni Tognoni, Jay N. Cohn for the Val-HeFT Investigators
Circulation 2003 107: 1278-1283. [Abstract] [Full Text]

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