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Pulmonary Hypertension

Abstract

Recommended Article

Echocardiographic Screening for Pulmonary Hypertension in Congenital Heart Disease: JACC Review Topic of the Week Risk Stratification in PAH A prediction model of simple echocardiographic variables to screen for potentially correctable shunts in adult patients with pulmonary arterial hypertension associated with atrial septal defects: a cross-sectional study Stress Echocardiography and PH: What Do the Findings Mean? Active and Passive Vaccination for Pulmonary Arterial Hypertension: A Novel Therapeutic Paradigm Exercise unmasks distinct pathophysiologic features in heart failure with preserved ejection fraction and pulmonary vascular disease Noninvasive Screening for Pulmonary Hypertension by Exercise Testing in Congenital Heart Disease Percutaneous Pulmonary Angioplasty for Patients With Takayasu Arteritis and Pulmonary Hypertension

Review Article2018 Apr;15(2):37-43.

JOURNAL:Curr Heart Fail Rep. Article Link

The Future of Biomarker-Guided Therapy for Heart Failure After the Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) Study

Ibrahim NE, Januzzi JL Jr. Keywords: Biomarkers; Clinical trials; Guidelines; Heart failure; Heart failure therapy; Natriuretic peptides

ABSTRACT


PURPOSE OF REVIEW - Biomarker-guided management of patients with chronic heart failure with reduced ejection fraction (HFrEF) remains controversial.

 

RECENT FINDINGS - Biomarkers have established roles for diagnosis and prognostication in HF. Pilot data suggested that use of natriuretic peptides might be helpful to guide HF care. The recent Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) randomized-controlled trial did not find therapy guided by NT-proBNP to be more effective than usual care in improving the primary endpoint of HF hospitalization or cardiovascular mortality amongst patients with chronic HFrEF. Patients inGUIDE-ITreceived similar care and had similar NT-proBNP lowering regardless of treatment allocation. Though biomarkers retain important standing for diagnosis and prognosis in HF, theGUIDE-ITtrial results suggest carefully managed patients may not benefit from a biomarker-guided strategy. Future studies focusing this intervention on patients treated in a more real-world setting are needed.