Assessment of heart failure with plasma natriuretic peptides

McMurray, J. , Davie, A.P. and McClure, S.J. (1998) Assessment of heart failure with plasma natriuretic peptides. Lancet, 351(9100), p. 444. (doi: 10.1016/s0140-6736(05)78386-0) (PMID:9482327)

Abstract

SIR—Martin Cowie and colleagues1 are to be congratulated on assessing the usefulness of natriuretic peptides in clinical practice. Their report is, however, puzzling in several respects.<p></p> Too little information is given about the patients studied. Why did such a high proportion (11/35, 31%) of patients have an unknown cause for their heart failure? That Cowie and his co-workers chose to define heart failure, as opposed to left ventricular systolic dysfunction, is also puzzling, since it is the latter we generally wish to identify and know how to treat.2 and 3 At least ten of 35 patients would seem to have had causes other than left ventricular systolic dysfunction (for their heart failure) which would certainly be readily clinically apparent and merit further investigation in their own right (ie, atrial fibrillation, complete heart block, valvular disease). What they are really saying, it would seem, is that natriuretic peptides are useful in identifying that there is something wrong with the heart (hypertension, complete heart block, atrial fibrillation, &c). The more important question is, however, are natriuretic peptides useful or not in identifying left ventricular systolic dysfunction, in ordinary clinical practice? Can Cowie and colleagues provide an answer?<p></p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McMurray, Professor John
• Authors: McMurray, J., Davie, A.P., and McClure, S.J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Lancet
• Publisher: The Lancet Publishing Group
• ISSN: 0140-6736
• ISSN (Online): 1474-547X