Heart Failure Reviews

, Volume 15, Issue 4, pp 351–370 | Cite as

Biomarker guided therapy for heart failure: focus on natriuretic peptides

  • Kirkwood F. AdamsJr.
  • G. Michael Felker
  • Ghassan Fraij
  • J. Herbert Patterson
  • Christopher M. O’Connor


The management of heart failure remains challenging despite many therapeutic advances. Rigorous clinical trial evidence supports administration of multiple therapies, but utilization of evidence-based treatment remains inconsistent and suboptimal. Disease management programs appear effective, but remain costly and difficult to implement in today’s care system. Another approach involves optimizing therapy based on serial monitoring of cardiac biomarkers. Emerging results suggest that guiding therapy based on serial changes in natriuretic peptides may be an effective strategy. Although pilot work has provided encouraging results, appropriately designed, large-scale, prospective randomized trials are needed to confirm these preliminary findings and definitively establish this therapeutic approach.


Biomarker Heart failure Natriuretic peptides Therapeutic monitoring 


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Kirkwood F. AdamsJr.
    • 1
  • G. Michael Felker
    • 4
  • Ghassan Fraij
    • 2
  • J. Herbert Patterson
    • 3
  • Christopher M. O’Connor
    • 4
  1. 1.Departments of Medicine and Radiology, School of Medicine, UNC Heart Failure ProgramUniversity of North Carolina at Chapel Hill730 Martin Luther King Jr. Blvd., Suite 207Chapel HillUSA
  2. 2.Department of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.School of PharmacyUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Department of Medicine, Duke Clinical Research InstituteDuke University School of MedicineDurhamUSA

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