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Heart Disease (Expert Forum)
BNP
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BNP
by green4sam, Dec 01, 2004 12:00AM
What is the relationship of the BNP to the severity of heart failure? Are there values that correlate to the four stages of heart failure? Is it a marker that can used to follow over time to assess the efficacy of treatment?
I have heard that there is a new drug that is suppose to be released soon that is similar to amiodarone but without all the side effects. Are you aware of this and what do you know about the drug. I now have corneal deposits secondary to amiodarone so I am concerned.
I have also been told that there is a new oral anticoagulant that is suppose to have been available which only requires monthly labs or such but it hasn't been released yet? Is there any new information on that drug?
How exactly does a low serum calcium affect heart function? Does it affect rhythm and contraction etc.?
I have heard that there is a new drug that is suppose to be released soon that is similar to amiodarone but without all the side effects. Are you aware of this and what do you know about the drug. I now have corneal deposits secondary to amiodarone so I am concerned.
I have also been told that there is a new oral anticoagulant that is suppose to have been available which only requires monthly labs or such but it hasn't been released yet? Is there any new information on that drug?
How exactly does a low serum calcium affect heart function? Does it affect rhythm and contraction etc.?
Doctor's Answer
by CCF-M.D.-MJM, Dec 01, 2004 12:00AM
Hi Sam,
Good questions....some don't have answers yet.
1. What is the relationship of the BNP to the severity of heart failure?
Higher BNP levels are usually associated with a worse acute exacerbation of heart failure, but does not help different the New York Heart Association classes of heart failure. For example, a person with decompensated Class I heart failure may have an exceedingly high BNP while a compensated Class IV heart failure patient may have a normal BNP, despite the fact that Class IV CHF is worse than Class I. There are subtleties to interpreting BNP that we are still working on.
I use BNP to help in patients where I am not sure if the symptoms are heart related or lung/deconditioning related.
3. Is it a marker that can used to follow over time to assess the efficacy of treatment?
Symptoms, history, and an occasional echo are best for this. No lab test yet.
4. I have heard that there is a new drug that is suppose to be released soon that is similar to amiodarone but without all the side effects.
I have heard there is a new antiarrhythmic drug in the works, but I don't know the details about it. I am slow to use new antiarrhythmic meds. It is safer to wait and see how the post marketing research reflects on safety after it is released in wider populations. What I am suggesting is that the studies to have a drug approved through the FDA don't always require a huge number of patients. After the drug is released and used in more patients, it is not uncommon for new side effects or complications to appear over time. The FDA requires drugs be followed over time after release incase such complications start appearing. Case in point, your next question.....
5. I have also been told that there is a new oral anticoagulant that is suppose to have been available which only requires monthly labs or such but it hasn't been released yet? Is there any new information on that drug?
Ximelogatran was not approved by the FDA. They found dangerous liver toxicity and increased risk of MI in patients after surgery. I do not think this drug will ever be released.
6. How exactly does a low serum calcium affect heart function? Does it affect rhythm and contraction etc.?
What matters is the serum-ionized calcium. If your ionized calcium is very low, it can make your heart contraction weaker. The more important question is why is it low and what can be done to treat it. Serum calcium is what is usually measured in lab tests and is a good surrogate for ionized calcium. Low calcium can make you more prone to arrhythmia, especially if your potassium levels are high.
I hope this helps.
Good questions....some don't have answers yet.
1. What is the relationship of the BNP to the severity of heart failure?
Higher BNP levels are usually associated with a worse acute exacerbation of heart failure, but does not help different the New York Heart Association classes of heart failure. For example, a person with decompensated Class I heart failure may have an exceedingly high BNP while a compensated Class IV heart failure patient may have a normal BNP, despite the fact that Class IV CHF is worse than Class I. There are subtleties to interpreting BNP that we are still working on.
I use BNP to help in patients where I am not sure if the symptoms are heart related or lung/deconditioning related.
3. Is it a marker that can used to follow over time to assess the efficacy of treatment?
Symptoms, history, and an occasional echo are best for this. No lab test yet.
4. I have heard that there is a new drug that is suppose to be released soon that is similar to amiodarone but without all the side effects.
I have heard there is a new antiarrhythmic drug in the works, but I don't know the details about it. I am slow to use new antiarrhythmic meds. It is safer to wait and see how the post marketing research reflects on safety after it is released in wider populations. What I am suggesting is that the studies to have a drug approved through the FDA don't always require a huge number of patients. After the drug is released and used in more patients, it is not uncommon for new side effects or complications to appear over time. The FDA requires drugs be followed over time after release incase such complications start appearing. Case in point, your next question.....
5. I have also been told that there is a new oral anticoagulant that is suppose to have been available which only requires monthly labs or such but it hasn't been released yet? Is there any new information on that drug?
Ximelogatran was not approved by the FDA. They found dangerous liver toxicity and increased risk of MI in patients after surgery. I do not think this drug will ever be released.
6. How exactly does a low serum calcium affect heart function? Does it affect rhythm and contraction etc.?
What matters is the serum-ionized calcium. If your ionized calcium is very low, it can make your heart contraction weaker. The more important question is why is it low and what can be done to treat it. Serum calcium is what is usually measured in lab tests and is a good surrogate for ionized calcium. Low calcium can make you more prone to arrhythmia, especially if your potassium levels are high.
I hope this helps.
Just a quick question: What exactly is BNP?
Thanks,
Uptown
Uptown
I believe that any comment regarding someone's question being a wasted one, is just an annoyance to others who read it. Just wondering, what was your first question to this forum?????
Erik , I have agreed with you on many occasions, but on this one , I'll just say not one question posted on this forum is a wasted question no matter of insignificant it may same to others here.
PVCs are one of the most common complaints related to the heart and by the way one of the most difficult to treat or reassure patients with this affliction, yes they are those that don't give them the time of the day, others can't, let's be more understanding and considerate to those who need reassurance every now and then, even if many consider a question about PVCs a wasted one.
There are some with PVCs, with symptoms which are so uncomforatble that they would probably trade them for a serious heart condition such cardiomyopathy with swollen ankles and feet, shortness of breath and the list goes on , but does not feel one PVC at all!! Think about it man !!!
Best regards,
I am sure the doctors too are tired of the questions but guess what maybe they should spend more time and money on this chronic problem ... because I am sure people who have cardiomyopathy w/ PVC's see the world very different from those who get them without disease. The issue is simple, I would rather not have them period!!!!!!! But thats not the case and unfortunately many people get them and some very bad indeed. There is always something to ask, something to learn from peoples postings and that's where I get my strength to keep on going. The doctors do a great job on the forum on the PVC questions but I would have to say that the collective information from patients is equally valid and important to me. So please keep the questions comming I am sure someone will identify real triggers and or provide a clue to this problem.
Have a wonderful holiday to everyone-