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ADHF = Acute decompensated heart failure; ESC = European Society of Cardiology; KCCQ = Kansas City Cardiomyopathy Questionnaire; ML-WHFQ = Minnesota Living With Heart Failure Questionnaire; NT-proBNP = N-terminal pro-hormone B-type Natriuretic Peptide; NYHA = New York Heart Association; POC=Point of Care; SF-36 = Short Form (36) Health Survey.
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Despite important advances in diagnosis and medical therapy of heart failure (HF), disease monitoring and therapy guidance remains to be based on clinical signs and symptoms. NT-proBNP was repeatedly demonstrated to be a strong and independent predictor of morbidity and mortality in patients with HF. Only few – and conflicting – data are available...
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... Thereby, there are limited data from studies supporting the role of point-of-care NP serial testing in ambulatory care as a tool for monitoring patients with HF and there are no established guidelines recommendations in this regard. The POC-HF (Point-of-Care in heart failure) is a pilot study conceived to demonstrate the usefulness of serial NT-proBNP measurements using POCT in patients hospitalized for acute decompensation of HF [152,153]. ...
Worsening chronic heart failure (HF) is responsible for recurrent hospitalization and increased mortality risk after discharge, irrespective to the ejection fraction. Symptoms and signs of pulmonary and systemic congestion are the most common cause for hospitalization of acute decompensated HF, as a consequence of increased cardiac filling pressures. The elevated cardiac filling pressures, also called hemodynamic congestion, may precede the occurrence of clinical congestion by days or weeks. Since HF patients often have comorbidities, dyspnoea, the main symptom of HF, may be also caused by respiratory or other illnesses. Recent studies underline the importance of the diagnosis and treatment of hemodynamic congestion before HF symptoms worsen, reducing hospitalization and improving prognosis. In this paper we review the role of integrated evaluation of biomarkers and imaging technics, i.e., echocardiography and pulmonary ultrasound, for the diagnosis, prognosis and treatment of congestion in HF patients.
... Only a fewand probably conflictingdata seems to be available on the efficacy of NT-proBNP serial measurement as a tool for treatment monitoring in heart failure. Dr. Zuesli et al. targeted the serial size of NT-proBNP as a tool for treatment monitoring in heart failure patients hospitalized for acute decompensation of heart failure [15]. This study aimed to investigate whether the availability of serial NT-proBNP measurements may influence treatment decisions in these patients. ...
... The Cobas h232 NT-proBNP POC test (Roche Diagnostics, Basel, Switzerland) has been demonstrated to be an accurate, user-friendly and appropriate test in primary care [16]. In assessing Dr. Zusli et al.'s work, we emphasize that POCT for NT-proBNP in the Roche Cobas h232 system to be used by Zusli et al. [15] has a measuring range of 60-9000 ng/L. It takes 12 min before the measurement is done. ...
... Although healthcare quality and policy regulators may see some positivity, speed may be no need. The timing of measurements is every two days in the study of Zusli [15]. On the other hand, a study assessed NT-proBNP measures during hospitalization [17]. ...
Point-of-care Testing (POCT) is a medical diagnostic approach carried out outside the clinical laboratory and close to the patient. The results are used for the immediate clinical decision to improve patient care. Accreditation Canada and Diagnostic Accreditation Programs regulatory standards and the College of the American Pathologists for Point-Of-Care Testing have implemented several guidelines and certifications. POC in heart failure (POC-HF) will demonstrate that it is helpful to develop a preliminary understanding of the value of serial NT-proBNP measurements in the diagnostic and therapeutic process in patients hospitalized with acute decompensation of heart failure. In addition, POC-HF will hopefully answer questions on the workability of this approach in clinical routine and the usefulness and justification to perform larger-scale studies investigating this strategy.
