[Therapy optimization of heart failure through the evaluation of the plasma concentration variation of B-type natriuretic peptide].
OBJECTIVE
Our research was based over the critical evaluation of the plasmatic concentration variation of B-type Natriuretic Peptide in emergency in patients with heart failure during therapy with diuretics, anti-aldosterone, ACE-inhibitors, beta-blockers and nitroderivates.


METHODS
We selected 108 patients: 30 control subjects (average 58.40 +/- SD13.32 for 20 M, and 65 +/- SD 14.74 for 10 W), and 78 subjects (average 75.90 +/- SD 9.60 for 41 M, and 77.89 +/- SD 8.62 for 37 W) arrived to the emergency and reception department for dyspnea and/or precordialgia and/or palpitations with heart failure diagnosis according to NYHA Classification. The variation of BNP concentration was evaluated in these subjects at the admission, after 1 week, and 1 month from the beginning of the therapy.


RESULTS
Patients with heart failure had a BNP concentration high during all measurements. The values were high during admission, but after 1 week and after 1 month, they reduced reaching the balance.


CONCLUSIONS
BNP evaluation is a good indicator for the diagnosis of heart failure and for improving the therapy. The main limit of BNP diagnostic role is the need of knowing in advance the specific values for each patient.
Coppola
A
A
Dipartimento Emergenza Accettazione, Medicina d'Urgenza e di Pronto Soccorso, Osservazione A EEA01, Universiteà degli Studi di Roma "La Sapienza", Policlinico Umberto I, Roma, Italia.
De Paola
G
G
Suppa
M
M
Maggi
B
B
Giancaspro
G
G
Colzi
M
M
Scarpellini
M G
MG
Lacenere
L
L
Gerratana
G
G
Aguglia
F
F
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003627:Data Interpretation, Statistical; D004232:Diuretics / Q000627:therapeutic use; D004632:Emergency Medical Services; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009574:Nitro Compounds / Q000627:therapeutic use; D011379:Prognosis; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D009574:Nitro Compounds; D020097:Natriuretic Peptide, Brain