| Emergence of blood urea nitrogen as a biomarker of neurohormonal activation in heart failure. | |
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MedLine Citation:
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PMID: 20723648 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The nonosmotic release of arginine vasopressin, concurrent with the activation of the sympathetic nervous system and renin-angiotensin-aldosterone system, is thought to represent the maladaptive response that is central to the pathophysiology of heart failure (HF). The degree of neurohormonal activation correlates with the severity of the disease and can predict the outcomes. However, quantification of components of neurohormonal axis (e.g., serum arginine vasopressin level) is mainly reserved for research purposes rather than routine practice. The results of several recent HF trials have shed light on the differential role of blood urea nitrogen (BUN) and creatinine in predicting the outcomes in this setting. These studies suggest that BUN could indeed represent a surrogate marker for "renal response" to neurohormonal activation in this setting, above and beyond its role in the estimation of renal function. In this report, the relevant physiologic mechanisms underlying urea and water transport in the kidney are first reviewed. Then, the activation of the neurohormonal axis and the impact of its components on renal urea transport, independent of changes in renal function, are explained. Finally, the unique role of BUN as a biomarker of neurohormonal activation in the setting of HF is discussed, and the potential clinical implication of this novel concept is emphasized. In conclusion, this review explains the pathophysiologic basis for the emerging role of BUN as a biomarker in HF. |
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Authors:
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Amir Kazory |
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Publication Detail:
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Type: Journal Article; Review Date: 2010-07-23 |
Journal Detail:
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Title: The American journal of cardiology Volume: 106 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-20 Completed Date: 2010-09-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 694-700 Citation Subset: AIM; IM |
Copyright Information:
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2010 Elsevier Inc. All rights reserved. |
Affiliation:
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University of Florida, Gainesville, USA. amir.kazory@medicine.ufl.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Biological Markers
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blood* Blood Urea Nitrogen* Creatinine / blood Heart Failure / blood*, diagnosis, physiopathology* Humans Neuropeptides / physiology* Predictive Value of Tests Prognosis Renin-Angiotensin System / physiology* Sympathetic Nervous System / physiopathology |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Neuropeptides; 60-27-5/Creatinine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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