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1.
Expert Rev Mol Diagn ; 23(6): 521-533, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37216616

RESUMO

INTRODUCTION: Heart failure (HF) is a dominant health problem with an overall poor prognosis. Natriuretic peptides (NPs) are upregulated in HF as a compensatory mechanism. They have been extensively used for diagnosis and risk stratification. AREAS COVERED: This review addresses the history and physiology of NPs in order to understand their current role in clinical practice. It further provides a detailed and updated narrative review on the utility of those biomarkers for risk stratification, monitoring, and guiding therapy in HF. EXPERT OPINION: NPs show excellent predictive ability in heart failure patients, both in acute and chronic settings. Understanding their pathophysiology and their modifications in specific situations is key for an adequate interpretation in specific clinical scenarios in which their prognostic value may be weaker or less well evaluated. To better promote risk stratification in HF, NPs should be integrated with other predictive tools to develop multiparametric risk models. Both inequalities of access to NPs and evidence caveats and limitations will need to be addressed by future research in the coming years.


Assuntos
Insuficiência Cardíaca , Peptídeo Natriurético Encefálico , Humanos , Peptídeo Natriurético Encefálico/uso terapêutico , Fragmentos de Peptídeos , Biomarcadores , Medição de Risco , Peptídeos Natriuréticos/uso terapêutico
2.
Can J Cardiol ; 37(11): 1873-1876, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34333027

RESUMO

IgG4-related disease is an immune-mediated fibro-inflammatory disorder with multisystemic involvement. Aortitis and peri-aortitis are the most common cardiovascular manifestations of the disease. We present the case of a 65-year-old man with symptomatic severe aortic stenosis and concomitant IgG4 aortitis. The diagnosis was confirmed by IgG4 serum levels, positive positron emission computed tomography (PET-CT) scans, and pathology from mediastinal dissection. Surgical aortic valve replacement (SAVR) was unfeasible owing to extensive mediastinal fibrosis, and transcatheter aortic valve replacement (TAVR) was successfully performed. As ascending aorta access for SAVR in IgG4 aortitis with long-run fibrosis entails a high risk of mortality, TAVR could be considered in certain suitable patients.


Assuntos
Aorta Torácica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Aortite/complicações , Próteses Valvulares Cardíacas , Doença Relacionada a Imunoglobulina G4/complicações , Substituição da Valva Aórtica Transcateter/métodos , Idoso , Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/diagnóstico , Estenose da Valva Aórtica/etiologia , Aortite/diagnóstico , Aortite/imunologia , Seguimentos , Humanos , Imunoglobulina G/imunologia , Doença Relacionada a Imunoglobulina G4/diagnóstico , Doença Relacionada a Imunoglobulina G4/imunologia , Masculino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Índice de Gravidade de Doença , Fatores de Tempo
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