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Dtsch Med Wochenschr 2017; 142(05): 346-355
DOI: 10.1055/s-0042-117368
DOI: 10.1055/s-0042-117368
Review
Einsatzgebiete und praktischer Nutzen der kardialen Marker BNP und NT-proBNP
Indications and Clinical Implications of the Use of the Cardiac Markers BNP and NT-proBNPFurther Information
Publication History
Publication Date:
10 March 2017 (online)
Zusammenfassung
Die B-Typ natriuretischen Peptide sind Marker der myokardialen Wandspannung. Sie werden in der Notfalldiagnostik zur Differenzialdiagnostik der Dyspnoe eingesetzt und ein normaler BNP- oder NT-proBNP-Wert schließt eine Herzinsuffizienz mit hoher Sicherheit aus. Neue Daten zeigen ihre Bedeutung für die Risikoprädiktion bei Patienten in verschiedenen Stadien der Herzinsuffizienz, aber auch in der Primärprävention. Eine durch natriuretische Peptide laborchemisch geführte Herzinsuffizienztherapie kann die Hochtitration der Herzinsuffizienztherapie verbessern. Dabei ist unter Therapie mit dem neuen Angiotensin-Rezeptor-Neprilysin-Inhibitor Sacubitril/Valsartan das NT-proBNP besser zur Verlaufskontrolle geeignet als BNP. Der folgende Artikel soll die aktuelle Studienlage zu den wichtigsten Anwendungsmöglichkeiten der B-Typ natriuretischen Peptide für das Schnittstellen-Management zwischen Klinik und Praxis zusammenfassen und erarbeitet klinische Empfehlungen zu ihrem Einsatz in der Patientenversorgung.
Abstract
B-type natriuretic peptides are markers of myocardial wall stress. BNP or NT-proBNP are used for the differential diagnosis of acute dyspnoe where normal serum concentrations make a cardiac cause unlikely. New data show their importance for risk prediction in different stages of heart failure and in primary prevention. Natriuretic peptide guided therapy improves titration of heart failure medications. Compared to BNP, NT-proBNP is better suited during therapy with the new angiotensin-rezeptor-neprilysin-inhibitor Sacubitril/Valsartan. This review article summarizes current data on the importance of B-type natriuretic peptides for the interface of ambulatory and hospital care and presents recommendations for their practical use in patient care.
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