Nicholas Wettersten, MD, Alan S. Maisel, MD

Slides:

Advertisements

Similar presentations

Low-Dose Aspirin in Patients with Stable Cardiovascular Disease: A Meta-analysis Jeffrey S. Berger, MD, MS, David L. Brown, MD, Richard C. Becker, MD The.

Advertisements

An Unusual Electrocardiogram in a Heart Transplant Recipient Hamish I. MacLachlan, BSc, MBBS, Jonathan R. Dalzell, MD, MRCP The American Journal of Medicine.

Date of download: 6/28/2016 Copyright © The American College of Cardiology. All rights reserved. From: Utility of B-type natriuretic peptide in the diagnosis.

The Epidemic of the 20th Century: Coronary Heart Disease

Optimal Noninvasive Assessment of Diastolic Heart Failure in Patients with Atrial Fibrillation: Comparison of Tissue Doppler Echocardiography, Left Atrium.

B-type Natriuretic Peptide in the Early Diagnosis and Risk Stratification of Acute Chest Pain Philip Haaf, MD, Tobias Reichlin, MD, Nils Corson, MD,

The Extent of Myocardial Injury During Prolonged Targeted Temperature Management After Out-of-Hospital Cardiac Arrest Anders Morten Grejs, MD, Jakob.

Pneumothorax Recurrence Related to High-speed Lift

Volume 66, Issue 6, Pages (December 2015)

Impact of the History of Congestive Heart Failure on the Utility of B-Type Natriuretic Peptide in the Emergency Diagnosis of Heart Failure: Results from.

EMPA-REG OUTCOME: The Endocrinologist's Point of View

Amay Parikh, MD, MBA, MS, Kunal Gupta, MD, MBA, Alan C

Ahmed Abuzaid, MD, Carly Fabrizio, DO, Kevin Felpel, MD, Haitham S

‘Chest Pain Typicality’ in Suspected Acute Coronary Syndromes and the Impact of Clinical Experience Edward W. Carlton, MBChB, Martin Than, MBBS, Louise.

Cardiac Biomarkers.

Electrocardiographic Diagnosis of Right Ventricular Infarction by Proximal Occlusion of a Very Dominant Right Coronary Artery Javier García-Niebla, RN,

Biomarkers in Heart Failure

How Well Are Pulses Measured

Aruna D. Pradhan, MD, Nader Rifai, PhD, Julie E. Buring, ScD, Paul M

Clyde W. Yancy et al. JACC 2017;70:

The Utility of Biomarkers in Sorting Out the Complex Patient

Significance of Elevated Cardiac Troponin T Levels in Critically Ill Patients with Acute Respiratory Disease Vlad C. Vasile, MD, PhD, High-Seng Chai,

B-type Natriuretic Peptide in the Early Diagnosis and Risk Stratification of Acute Chest Pain Philip Haaf, MD, Tobias Reichlin, MD, Nils Corson, MD,

Trends in Comorbidity, Disability, and Polypharmacy in Heart Failure

EMPA-REG OUTCOME: The Endocrinologist's Point of View

Prediction of severe acute kidney injury after pediatric cardiac surgery with the use of novel biomarkers: A new trend in clinical research and risk stratification

Nancy M. Albert, PhD, Gregg C. Fonarow, MD, William T

Impact of the History of Congestive Heart Failure on the Utility of B-Type Natriuretic Peptide in the Emergency Diagnosis of Heart Failure: Results from.

The Extent of Myocardial Injury During Prolonged Targeted Temperature Management After Out-of-Hospital Cardiac Arrest Anders Morten Grejs, MD, Jakob.

A Greener Oregon: Acute Inpatient Delirium

The Epidemic of the 20th Century: Coronary Heart Disease

Kay Lee Park, MD, Robert J. Goldberg, PhD, Frederick A

Medical professionalism and the generation gap

Challenges in the Clinical Management of Blood-Culture Negative Endocarditis: Case of Bartonella henselae Infection Divya Gupta, MD, Jacqueline Green,

Looking Back at Lyme Carditis

Recent advances in mechanical ventilation

Individualizing Insulin Therapy in the Management of Type 2 Diabetes

The Reply The American Journal of Medicine

Myasthenia of the Heart

Gout in African Americans

Treatment of hepatitis C

Risk Stratification in Non-ST-segment Elevation Acute Coronary Syndromes: Troponin Alone Is not Enough Philippe Gabriel Steg, Gordon FitzGerald, Keith.

Use of Serum c-Peptide Level to Simplify Diabetes Treatment Regimens in Older Adults Medha N. Munshi, MD, Mellody Hayes, BA, Adrianne Sternthal, Darlene.

When Guidelines Cause Hypertension

The Impact of Prior Heart Failure Hospitalizations on Long-term Mortality Differs by Baseline Risk of Death Naga V.A. Kommuri, MD, Todd M. Koelling,

Repeated Hemoglobin A1C Ordering in the VA Health System

Resistant Hypertension and the Pivotal Role for Mineralocorticoid Receptor Antagonists: A Clinical Update 2016 Murray Epstein, MD, Daniel A. Duprez,

The Malnourished Heart: An Unusual Case of Heart Failure

The Reply The American Journal of Medicine

Combined Use of the Novel Biomarkers High-Sensitivity Troponin T and ST2 for Heart Failure Risk Stratification vs Conventional Assessment Josep Lupón,

Insomnia in the Elderly: Cause, Approach, and Treatment

Ahmed Abuzaid, MD, Carly Fabrizio, DO, Kevin Felpel, MD, Haitham S

John-Michael Gamble, BScPharm, MSc, Dean T. Eurich, PhD, Thomas J

Variability in United States Allopathic Medical School Tuition

An Unusual Initial Manifestation of Acute Leukemia

Devraj Sukul, MD, Shashank S. Sinha, MD, MSc, Andrew M

A Review of Learner Impact on Faculty Productivity

Late to the Feast: Primary Care and US Health Policy

Plasma Lactescence in Acute Pancreatitis

Michael H. Chiu, MD, Msc, Nakul C. Sharma, MD, MPH CJC Open

Tombstone ST Elevations: … Not Necessarily a Harbinger of Doom!

Screening and Treatment of Vitamin D Deficiency on Hospital Admission: Is There a Benefit for Medical Inpatients? Lena Grädel, MD, Meret Merker, BMSc,

Mark L. Homer, PhD, MMSc, Nathan P. Palmer, PhD, Kathe P

Direct Observation of Residents: A Model for an Assessment System

Falls in Older Adults: Risk Assessment, Management and Prevention

Has mortality from acute renal failure decreased

Matthew W. Martinez, MD, Keith G. Rasmussen, MD, Paul S

Toward a More Responsible News Media

Bijin Thajudeen, MD, Mario F. Rubin, MD

Incretin Therapies: Effects Beyond Glycemic Control

Presentation transcript:

Biomarkers for Heart Failure: An Update for Practitioners of Internal Medicine Nicholas Wettersten, MD, Alan S. Maisel, MD The American Journal of Medicine Volume 129, Issue 6, Pages 560-567 (June 2016) DOI: 10.1016/j.amjmed.2016.01.013 Copyright © 2016 Terms and Conditions

Figure 1 Pathophysiologic factors leading to alterations in levels of biomarkers used in the assessment and management heart failure. Note procalcitonin is not actually released from the heart, while NPs, ST2, and high-sensitivity troponin are released from the heart. NP = natriuretic peptide; NEP = neutral endopeptidase; hs = high-sensitivity. The American Journal of Medicine 2016 129, 560-567DOI: (10.1016/j.amjmed.2016.01.013) Copyright © 2016 Terms and Conditions

Figure 2 Soluble ST2 (sST2) acts as a decoy receptor that, when elevated, binds interleukin (IL)-33. This effectively reduces the concentration of IL-33 that is available to bind the ST2 ligand (ST2L) and diminishes the cardioprotective effects of IL-33. Higher levels of sST2 reflect increased inflammation, fibrosis, and wall stress and thus serves like a hemoglobin A1c (HbA1c) for heart failure. The American Journal of Medicine 2016 129, 560-567DOI: (10.1016/j.amjmed.2016.01.013) Copyright © 2016 Terms and Conditions

Figure 3 ST2 levels drawn on admission are highly predictive of future heart failure admissions, more so than B-type natriuretic peptide (unpublished data). AUC = area under the curve; BNP = B-type natriuretic peptide; HF = heart failure. The American Journal of Medicine 2016 129, 560-567DOI: (10.1016/j.amjmed.2016.01.013) Copyright © 2016 Terms and Conditions

Figure 4 Algorithm for use of biomarkers in heart failure from acute presentation, through hospitalization and into clinic follow-up. BNP = B-type natriuretic peptide; hsTn = high-sensitivity troponin; NP = natriuretic peptides. The American Journal of Medicine 2016 129, 560-567DOI: (10.1016/j.amjmed.2016.01.013) Copyright © 2016 Terms and Conditions