NATRIURETIC PEPTIDES - MARKERS FOR MYOCARDIAL DYSFUNCTION AND HEMODYNAMIC STRESS

Abstract

Heart disease is the most common cause of death in the modern world. More than half of all deaths worldwide are due to them. In our country, Bulgaria, more than 60% of mortality is due to ischemic heart disease and cerebrovascular disease. The topic is significant because cardiovascular diseases are one of the most common causes of disability in the affected population in developed countries. In this regard, the specialty of clinical laboratory is constantly developing and improving - new clinical and laboratory tests are being introduced, which enable medical specialists to make quick and adequate medical decisions for patients with cardiovascular diseases. The aim of the study is to study and analyze natriuretic peptides as markers of myocardial dysfunction and hemodynamic stress, and their role in the diagnosis, prognosis and therapy of patients with cardiovascular pathology. The study includes the analysis of various sources regarding the application of these indicators in modern clinical and laboratory practice, their sensitivity and diagnostic specificity. The study used methods of analysis and theoretical reasoning based on contemporary scientific literature. Based on the literature review, the following conclusions can be drawn: natriuretic peptides perform an important cardio protective function, participate in the regulation of vascular tone and blood pressure, participate in the maintenance of cardiovascular homeostasis, levels of natriuretic peptides increase rapidly after myocardial ischemia, Their increase in acute coronary syndrome is proportional to myocardial damage and is an important predictor of adverse clinical outcome. They help assess absolute risk and thus may influence clinical decision-making. Multiple studies support a certain threshold for these indicators. Values below this threshold exclude cardiac dysfunction with high certainty in patients with symptoms of heart failure. Values above a certain threshold may be a sign of myocardial dysfunction and are associated with an increased risk of cardiac complications (myocardial infarction, heart failure, death). They are also used to monitor the effect of treatment in patients with left ventricular dysfunction. Together with the cardiac enzyme troponin, natriuretic peptides are currently the only markers-predictors for heart failure and are increasingly used in modern clinical and laboratory practice.