Alexander E Berezin
The current interest in guided-based therapy of acutely decompensated and chronic heart failure (CHF) is steadily increased. The measurements of circulating levels of brain natriuretic peptide (BNP) and N-terminal pro-hormone of BNP (NT-pro-BNP) to be risk stratified of the patients with symptomatic CHF is not widely approached in routine clinical practice. Likewise several conceptual, methodological, and as a result practical limitations of the natriuretic peptideguided therapy are not able to fulfilled change the contemporary strategic approach based on symptoms and echo-guided treatment of CHF. Clinically significant biological variability of natriuretic peptide level, high cost and slow time-course, as well as the lack of conclusive scientific evidence within long-term period of intensive scientific investigations may not support idea about needing new biological markers or constructing novel combinations for multiple biomarker predictive score and biomarker guided-based therapy. The review is dedicated to consideration of potency and clinical advantages of novel strategic approach in the field of CHF treatment based on serial measurements of biomarkers and creating optimal its combinations.
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