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Review |
1 CNR Institute of Clinical Physiology, Laboratory of Cardiovascular Endocrinology, Pisa, Italy.
aAddress correspondence to this author at: Laboratory of Cardiovascular Endocrinology and Cell Biology, CNR Institute of Clinical Physiology, Via Trieste 41, 56126 Pisa, Italy. Fax 39-0585-493601; e-mail clerico{at}ifc.cnr.it.
Background: The pathophysiologic and clinical relevance of cardiac natriuretic hormone (CNH) assays has been investigated in numerous experimental and clinical studies. Authors have sought to evaluate the diagnostic accuracy and prognostic relevance of the measurement of CNHs according to evidence-based laboratory medicine principles.
Methods: In June 2003, we ran a computerized literature search on National Library of Medicine using keywords "ANP" and "BNP" and found more than 12 300 and 1200 articles, respectively. A more refined search with keywords "ANP or BNP assay" extracted 
7000 and 800 articles, respectively. Only studies specifically designed to evaluate the diagnostic accuracy and prognostic relevance of CNH measurements were selected from this huge mass of articles to be discussed in this review.
Content: Several studies suggested that CNH assays may be clinically useful for the screening and classification of patients with heart failure, as a prognostic marker in cardiovascular disease, in the follow-up of patients with heart failure, and because they may reduce the need for further cardiac investigation. However, it is difficult to compare even the best-designed studies because not only did the authors evaluate different populations, they also used different gold standards.
Conclusions: CNH assays and conventional diagnostic work-ups provide complementary information for evaluation of the presence and severity of cardiac dysfunction and clinical disease. Several aspects of CNH assays are still to be elucidated, and further work is needed to carefully assess their diagnostic accuracy and prognostic value in cardiac disease.
The following articles in journals at HighWire Press have cited this article:
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F. L. Dini, P. Fontanive, E. Panicucci, D. Andreini, P. Chella, and S. M. De Tommasi Prognostic significance of tricuspid annular motion and plasma NT-proBNP in patients with heart failure and moderate-to-severe functional mitral regurgitation Eur J Heart Fail, June 1, 2008; 10(6): 573 - 580. [Abstract] [Full Text] [PDF]
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M. Codognotto, A. Piccoli, M. Zaninotto, M. Mion, M. Plebani, U. Vertolli, F. Tona, L. Ruzza, A. Barchita, and G. M. Boffa Renal Dysfunction Is a Confounder for Plasma Natriuretic Peptides in Detecting Heart Dysfunction in Uremic and Idiopathic Dilated Cardiomyopathies Clin. Chem., December 1, 2007; 53(12): 2097 - 2104. [Abstract] [Full Text] [PDF]
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C. Vassalle, M. G. Andreassi, C. Prontera, M. Fontana, L. Zyw, C. Passino, and M. Emdin Influence of ScaI and Natriuretic Peptide (NP) Clearance Receptor Polymorphisms of the NP System on NP Concentration in Chronic Heart Failure Clin. Chem., November 1, 2007; 53(11): 1886 - 1890. [Abstract] [Full Text] [PDF]
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M. Emdin, C. Passino, C. Prontera, M. Fontana, R. Poletti, A. Gabutti, C. Mammini, A. Giannoni, L. Zyw, G. Zucchelli, et al. Comparison of Brain Natriuretic Peptide (BNP) and Amino-Terminal ProBNP for Early Diagnosis of Heart Failure Clin. Chem., July 1, 2007; 53(7): 1289 - 1297. [Abstract] [Full Text] [PDF]
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A. Clerico, M. Fontana, L. Zyw, C. Passino, and M. Emdin Comparison of the Diagnostic Accuracy of Brain Natriuretic Peptide (BNP) and the N-Terminal Part of the Propeptide of BNP Immunoassays in Chronic and Acute Heart Failure: A Systematic Review Clin. Chem., May 1, 2007; 53(5): 813 - 822. [Abstract] [Full Text] [PDF]
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M. Pitzalis, M. Iacoviello, M. Anaclerio, C. Forleo, F. Di Serio, L. Varraso, and N. Pansini Methodical approach to collecting and preserving plasma samples containing B-type natriuretic peptide Eur J Heart Fail, February 1, 2007; 9(2): 215 - 215. [Full Text] [PDF]
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J. Coste, P. Jourdain, and J. Pouchot A Gray Zone Assigned to Inconclusive Results of Quantitative Diagnostic Tests: Application to the Use of Brain Natriuretic Peptide for Diagnosis of Heart Failure in Acute Dyspneic Patients Clin. Chem., December 1, 2006; 52(12): 2229 - 2235. [Abstract] [Full Text] [PDF]
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N. Aspromonte, V. Ceci, A. Chiera, C. Coletta, A. D'Eri, M. Feola, P. Giovinazzo, L. Milani, F. Noventa, A. B. Scardovi, et al. Rapid Brain Natriuretic Peptide Test and Doppler Echocardiography for Early Diagnosis of Mild Heart Failure Clin. Chem., September 1, 2006; 52(9): 1802 - 1808. [Abstract] [Full Text] [PDF]
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S. Masson, R. Latini, I. S. Anand, T. Vago, L. Angelici, S. Barlera, E. D. Missov, A. Clerico, G. Tognoni, J. N. Cohn, et al. Direct Comparison of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP in a Large Population of Patients with Chronic and Symptomatic Heart Failure: The Valsartan Heart Failure (Val-HeFT) Data Clin. Chem., August 1, 2006; 52(8): 1528 - 1538. [Abstract] [Full Text] [PDF]
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 T. Mueller and M. Haltmayer Natriuretic peptide measurements as part of the diagnostic work-up in pleural effusions: an emerging concept? Eur. Respir. J., July 1, 2006; 28(1): 7 - 9. [Full Text] [PDF]
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C. Passino, S. Severino, R. Poletti, M. F. Piepoli, C. Mammini, A. Clerico, A. Gabutti, G. Nassi, and M. Emdin Aerobic Training Decreases B-Type Natriuretic Peptide Expression and Adrenergic Activation in Patients With Heart Failure J. Am. Coll. Cardiol., May 2, 2006; 47(9): 1835 - 1839. [Abstract] [Full Text] [PDF]
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J. V. St. Peter, G. G. Hartley, M. M. Murakami, and F. S. Apple B-Type Natriuretic Peptide (BNP) and N-Terminal Pro-BNP in Obese Patients without Heart Failure: Relationship to Body Mass Index and Gastric Bypass Surgery Clin. Chem., April 1, 2006; 52(4): 680 - 685. [Abstract] [Full Text] [PDF]
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C. Passino, R. Poletti, F. Bramanti, C. Prontera, A. Clerico, and M. Emdin Neuro-hormonal activation predicts ventilatory response to exercise and functional capacity in patients with heart failure Eur J Heart Fail, January 1, 2006; 8(1): 46 - 53. [Abstract] [Full Text] [PDF]
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I. Brandt, A.-M. Lambeir, J.-M. Ketelslegers, M. Vanderheyden, S. Scharpe, and I. De Meester Dipeptidyl-Peptidase IV Converts Intact B-Type Natriuretic Peptide into Its des-SerPro Form Clin. Chem., January 1, 2006; 52(1): 82 - 87. [Abstract] [Full Text] [PDF]
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S. Del Ry, C. Passino, M. Maltinti, M. Emdin, and D. Giannessi C-type natriuretic peptide plasma levels increase in patients with chronic heart failure as a function of clinical severity Eur J Heart Fail, December 1, 2005; 7(7): 1145 - 1148. [Abstract] [Full Text] [PDF]
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T. Mueller, A. Gegenhuber, B. Dieplinger, W. Poelz, and M. Haltmayer Capability of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP as Indicators of Cardiac Structural Disease in Asymptomatic Patients with Systemic Arterial Hypertension Clin. Chem., December 1, 2005; 51(12): 2245 - 2251. [Abstract] [Full Text] [PDF]
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A. Lev-Sagie, B. Bar-Oz, L. Salpeter, D. Hochner-Celnikier, I. Arad, and A. Nir Plasma Concentrations of N-Terminal Pro-B-Type Natriuretic Peptide in Pregnant Women near Labor and during Early Puerperium Clin. Chem., October 1, 2005; 51(10): 1909 - 1910. [Full Text] [PDF]
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M. Mockel, R. Muller, J. O. Vollert, C. Muller, A. Carl, D. Peetz, F. Post, J. K. Kohse, and K. J. Lackner Role of N-Terminal Pro-B-Type Natriuretic Peptide in Risk Stratification in Patients Presenting in the Emergency Room Clin. Chem., September 1, 2005; 51(9): 1624 - 1631. [Abstract] [Full Text] [PDF]
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M. Herrmann, I. Kindermann, S. Muller, T. Georg, M. Kindermann, M. Bohm, and W. Herrmann Relationship of Plasma Homocysteine with the Severity of Chronic Heart Failure Clin. Chem., August 1, 2005; 51(8): 1512 - 1515. [Full Text] [PDF]
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M. T. Sandri, M. Salvatici, D. Cardinale, L. Zorzino, R. Passerini, P. Lentati, M. Leon, M. Civelli, G. Martinelli, and C. M. Cipolla N-Terminal Pro-B-Type Natriuretic Peptide after High-Dose Chemotherapy: A Marker Predictive of Cardiac Dysfunction? Clin. Chem., August 1, 2005; 51(8): 1405 - 1410. [Abstract] [Full Text] [PDF]
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C. Prontera, S. Storti, M. Emdin, C. Passino, L. Zyw, G. C. Zucchelli, and A. Clerico Comparison of a Fully Automated Immunoassay with a Point-of-Care Testing Method for B-Type Natriuretic Peptide Clin. Chem., July 1, 2005; 51(7): 1274 - 1276. [Full Text] [PDF]
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D. L. Crimmins Human N-Terminal proBNP Is a Monomer Clin. Chem., June 1, 2005; 51(6): 1035 - 1038. [Full Text] [PDF]
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A. Clerico, G. C. Zucchelli, A. Pilo, and M. Emdin Clinical Relevance of Biological Variation of B-Type Natriuretic Peptide Clin. Chem., May 1, 2005; 51(5): 925 - 926. [Full Text] [PDF]
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B. Bar-Oz, A. Lev-Sagie, I. Arad, L. Salpeter, and A. Nir N-Terminal pro-B-Type Natriuretic Peptide Concentrations in Mothers just before Delivery, in Cord Blood, and in Newborns Clin. Chem., May 1, 2005; 51(5): 926 - 927. [Full Text] [PDF]
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 T Mueller, A Gegenhuber, W Poelz, and M Haltmayer Diagnostic accuracy of B type natriuretic peptide and amino terminal proBNP in the emergency diagnosis of heart failure Heart, May 1, 2005; 91(5): 606 - 612. [Abstract] [Full Text] [PDF]
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M. Ala-Kopsala, H. Ruskoaho, J. Leppaluoto, L. Seres, R. Skoumal, M. Toth, F. Horkay, and O. Vuolteenaho Single Assay for Amino-Terminal Fragments of Cardiac A- and B-Type Natriuretic Peptides Clin. Chem., April 1, 2005; 51(4): 708 - 718. [Abstract] [Full Text] [PDF]
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A. Clerico, C. Prontera, M. Emdin, C. Passino, S. Storti, R. Poletti, L. Zyw, and G. C. Zucchelli Analytical Performance and Diagnostic Accuracy of Immunometric Assays for the Measurement of Plasma B-Type Natriuretic Peptide (BNP) and N-Terminal proBNP Clin. Chem., February 1, 2005; 51(2): 445 - 447. [Full Text] [PDF]
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R. Rej Clinical Chemistry through Clinical Chemistry: A Journal Timeline Clin. Chem., December 1, 2004; 50(12): 2415 - 2458. [Abstract] [Full Text] [PDF]
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 E. C. Perin, H. F.R. Dohmann, R. Borojevic, S. A. Silva, A. L.S. Sousa, G. V. Silva, C. T. Mesquita, L. Belem, W. K. Vaughn, F. O.D. Rangel, et al. Improved Exercise Capacity and Ischemia 6 and 12 Months After Transendocardial Injection of Autologous Bone Marrow Mononuclear Cells for Ischemic Cardiomyopathy Circulation, September 14, 2004; 110(11_suppl_1): II-213 - II-218. [Abstract] [Full Text] [PDF]
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M. Ala-Kopsala, J. Magga, K. Peuhkurinen, J. Leipala, H. Ruskoaho, J. Leppaluoto, and O. Vuolteenaho Molecular Heterogeneity Has a Major Impact on the Measurement of Circulating N-Terminal Fragments of A- and B-Type Natriuretic Peptides Clin. Chem., September 1, 2004; 50(9): 1576 - 1588. [Abstract] [Full Text] [PDF]
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J. P. Goetze Biochemistry of Pro-B-Type Natriuretic Peptide-Derived Peptides: The Endocrine Heart Revisited Clin. Chem., September 1, 2004; 50(9): 1503 - 1510. [Abstract] [Full Text] [PDF]
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H. G. Wahl, S. Graf, H. Renz, and W. Fassbinder Elimination of the Cardiac Natriuretic Peptides B-Type Natriuretic Peptide (BNP) and N-Terminal proBNP by Hemodialysis Clin. Chem., June 1, 2004; 50(6): 1071 - 1074. [Full Text] [PDF]
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