B-type natriuretic peptides in heart failure

Confirmation of Stormwater Bioretention Treatment Effectiveness Using Molecular Indicators of Cardiovascular Toxicity in Developing Fish

Urban stormwater runoff is a globally significant threat to the ecological integrity of aquatic habitats. Green stormwater infrastructure methods such as bioretention are increasingly used to improve water quality by filtering chemical contaminants that may be harmful to fish and other species. Ubiquitous examples of toxics in runoff from highways and other impervious surfaces include polycyclic aromatic hydrocarbons (PAHs). Certain PAHs are known to cause functional and structural defects in developing fish hearts. Therefore, abnormal heart development in fish can be a sensitive measure of clean water technology effectiveness. Here we use the zebrafish experimental model to assess the effects of untreated runoff on the expression of genes that are classically responsive to contaminant exposures, as well as heart-related genes that may underpin the familiar cardiotoxicity phenotype. Further, we assess the effectiveness of soil bioretention for treating runoff, as measured by prevention of both visible cardiac toxicity and corresponding gene regulation. We find that contaminants in the dissolved phase of runoff (e.g., PAHs) are cardiotoxic and that soil bioretention protects against these harmful effects. Molecular markers were more sensitive than visible toxicity indicators, and several cardiac-related genes show promise as novel tools for evaluating the effectiveness of evolving stormwater mitigation strategies.

The ease of use and reproducibility of the Alere™ Heart Check System: a comparison of patient and healthcare professional measurement of BNP

AIMS

The aim of the study was to examine the ease of use and the reproducibility of a novel point-of-care BNP measurement system when used by patients and healthcare providers (HCP).

PATIENTS & METHODS

Patients with symptomatic heart failure were recruited from outpatient clinics at four hospitals. They were provided with brief training and instructional material for the use of the point-of-care BNP measurement system. Finger-prick blood BNP concentration was measured by the HCP and the patient (n = 150). Ease of use and reproducibility of the system were assessed.

RESULTS

In total, 80% of the 164 patients who completed a questionnaire on the ease of use of the system found it easy to operate. There was excellent correlation of BNP measurement compared between patients and HCP (r = 0.966; p < 0.001).

CONCLUSION

Patients find the Alere Heart Check BNP measurement system easy to operate. BNP concentration measurements obtained by patients show excellent correlation with those obtained by healthcare providers.

Novel biomarkers in heart failure: an overview

Heart failure is a complex systemic syndrome resulting from significant impairment of cardiac function. A vast array of biological pathways is now known to be involved in heart failure, including deleterious pathways promoting its development and progression, as well as compensatory cardioprotective pathways. Some of the components of these pathways are now recognized as biomarkers of this condition, and can aid diagnosis, prognostication and guide management. As the understanding of the pathophysiology of heart failure progresses, further candidate biomarkers are being identified. This article reviews the literature regarding the more recently identified biomarkers and outlines areas requiring further study.