The present study was undertaken to identify the congestive heart failure patients by BNP test. To measure BNP levels in Patients with congestive heart disease, to use the BNP in the heart failure treatment and Routine use of BNP assays may help to more rapidly identify patients with heart failure, thereby saving money on unnecessary echocardiograms. In the present study observe the measurement of B-type natriuretic peptide in the heart failure patients. Heart failure, also called congestive heart failure, is a automated rapid assays have been made available condition in which the heart cannot pump enough to hospital laboratories, an increasing number of oxygenated blood to meet the needs of the body's other studies that were performed by clinical investigators organs. The heart keeps pumping, but not as efficiently as have documented the usefulness of these markers in the a healthy heart. Usually, the loss in the heart's pumping process of diagnosis, prognosis and treatment of cardiac action is a symptom of an underlying heart problem. Heart disease (5). failure affects nearly 35 million adults in world total The present study was undertaken to identify the population (1). It is on the rise with an estimated 4 congestive heart failure patients by BNP test.To measure to7 millions new cases each year. More than 7.5 million BNP levels in Patients with congestive heart disease , to Indian's suffer from CHF and nearly a million new use the BNP in the heart failure treatment and Routine use cases arise each year. Congestive heart failure (CHF), of BNP assays may help to more rapidly identify patients congestive cardiac failure (CCF) or just heart failure is a with heart failure, thereby saving money on unnecessary condition that can result from any structural or functional echocardiograms. cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood through the

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Rapid Measurement of B-Type Natriuretic Peptide in the Emergency Diagnosis of Heart Failure

Administration of a Loading Dose of Atorvastatin Before Percutaneous Coronary Intervention Prevents Inflammation and Reduces Myocardial Injury in STEMI Patients: A Randomized Clinical Study

One of the major reasons for mortality throughout the world is cardiovascular diseases. Therefore, bio-markers of cardiovascular disease are of high importance to diagnose and manage procedure. Detecting biomarkers provided a promising procedure in developing bio-sensors. Fast, selective, portable, accurate, inexpensive, and sensitive biomarker sensing instruments will be necessary for detecting and predicting diseases. One of the cardiac biomarkers may be ordered as C-reactive proteins, lipoprotein-linked phospho-lipase, troponin I or T, myoglobin, interleukin-6, interleukin-1, tumor necrosis factor alpha, LDL and myeloperoxidase. The biomarkers are applied to anticipate cardio-vascular illnesses. Initial diagnoses of these diseases are possible by several techniques; however, they are laborious and need costly apparatus. Current researches designed various bio-sensors for resolving the respective issues. Electrochemical instruments and the proposed bio-sensors are preferred over other methods due to its inexpensiveness, mobility, reliability, repeatability. The present review comprehensively dealt with detecting biomarkers of cardiovascular disease through electro-chemical techniques.

Electrochemical-Based Biosensors: New Diagnosis Platforms for Cardiovascular Disease.

Background: Previous studies reported that patients who had an acute myocardial infarction (AMI) have found that measuring B-type natriuretic peptide (BNP) during the subacute phase of left ventricular (LV) remodeling can predict the possible course of LV remodeling. This study assessed the use of serial BNP serum levels combined with early creatine kinase-MB (CK-MB) to predict the development of significant LV remodeling in AMI patients. Methods: Nighty-seven patients with new onset AMI were assessed using serial echocardiographic studies and serial measurements of BNP levels, both performed on day-2 (BNP1), day-7 (BNP2), day-90 (BNP3), and day-180 (BNP4) after admission. LV remodeling was defined as >20% increase in biplane LV end-diastolic volume on day-180 compared to baseline (day-2). Results: Patients were divided into LV remodeling [LVR(+)] and non LV remodeling [LVR(-)] groups. No first-week BNP level was found to predict remodeling. However, the two groups had significantly different day-90 BNP level (208.1 ± 263.7 pg/ml vs. 82.4 ± 153.7 pg/ml, P = 0.039) and significantly different 3-month BNP decrease ratios ( R BNP13) (14.4 ± 92.2% vs. 69.4 ± 25.9%, P < 0.001). The appropriate cut-off value for R BNP13 was 53.2% (AUC = 0.764, P < 0.001). Early peak CK-MB (cut-off 48.2 ng/ml; AUC = 0.672; P = 0.014) was another independent predictor of remodeling. Additionally, combining peak CK-MB and R BNP13 offered an excellent discrimination for half-year remodeling when assessed by ROC curve (AUC = 0.818, P < 0.001). Conclusion: R BNP13 is a significant independent predictor of 6-month LV remodeling. The early peak CK-MB additionally offered an incremental power to the predictions derived from serial BNP examinations.

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Predictors of left ventricle remodeling: Combined plasma B-type natriuretic peptide decreasing ratio and peak creatine kinase-MB

Background: Idiopathic nonischemic dilated cardiomyopathy (INIDCM) is associated with increased left ventricular diastolic volume and decreased left ventricular ejection fraction (LVEF). B-type natriuretic peptide (BNP) is secreted from the left ventricle in normal adults and patients who have left ventricular dysfunction and is useful in diagnosing acute heart failure from ischemic or nonischemic causes. Limited information is available about the association between intraventricular conduction delay (IVCD) and BNP levels in patients who have INIDCM. Methods: In patients evaluated in urgent care for chest pain and acute shortness of breath, there were 33 patients who had INIDCM and 39 patients who had idiopathic dyspnea. Evaluation included determination of plasma BNP level, LVEF, and presence of IVCD. Results: The mean BNP level was significantly greater in the INIDCM (947 ng/L) than idiopathic dyspnea group (43 ng/L; P ≤ .001). The mean LVEF was lower in the INIDCM (27%) than idiopathic dyspnea group (62%; P ≤ .001). There was high IVCD (QRS complex > 120 ms) in 10 patients (30%) who had INIDCM and none with idiopathic dyspnea. In the patients with INIDCM, patients who had high IVCD had greater mean BNP (initial and 3-mo follow-up) and lower LVEF than patients who had low IVCD (QRS duration ≤ 120 ms). Conclusions: Increased plasma BNP levels may facilitate the diagnosis of INIDCM and may be associated with high IVCD.

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B-Type Natriuretic Peptide and Intraventricular Conduction Delay in Idiopathic Nonischemic Dilated Cardiomyopathy

Background: After acute myocardial infarction (AMI), left ventricular (LV) function is a well-established prognostic marker. Recent studies indicate that serum levels of brain natriuretic peptide (BNP) also represent an prognostic marker in this setting but so far without a precise cut-off value.

Objective: The aim of this study was to assess the predictive value of BNP serum levels for LV function assessed by echocardiography in STEMI patients undergoing revascularization.

Methods: We prospectively studied a cohort of 88 consecutive patients (mean age 51.6 years, 88.6% males) hospitalized in our clinic for STEMI in Killip class I (50% anterior infarction), who underwent reperfusion therapy. Serum BNP levels were measured on admission, at 24h and at 30 days after reperfusion. Detailed echocardiography was performed at baseline, at 24 hours after reperfusion, on discharge and at follow-up at 1 month. Left ventricular systolic and diastolic dysfunction were defined by LVEF < 45% and E/A ratio respectively.

Results: ROC curve analysis showed that BNP measurements on admission and at 24 hours after revascularization have no predictive value neighter for diastolic LV dysfunction in anteior or inferior AMI patients, nor for systolic LV dysfunction in inferior AMI patients. Only BNP levels at 24 hours after revascularization can predict systolic LV dysfunction in anterior AMI patients with a 90.3% sensitivity and a 60% false positive rate at a cutt off value of 90pg/ml.

Conclusions: Early measurement of BNP levels may allow early prediction of anterior STEMI patients at risk of developing systolic LV dysfunction after revascularization therapy.

Ana-Gabriela Fruntelata

Papers

B-Type Natriuretic Peptide (BNP) and Left Ventricular (LV) Function in Patients with ST-Segment Elevation Myocardial Infarction (STEMI).