State of the art: Using natriuretic peptide levels in clinical practice

Natriuretic peptide (NP) levels (B-type natriuretic peptide (BNP) and N-terminal proBNP) are now widely used in clinical practice and cardiovascular research throughout the world and have been incorporated into most national and international cardiovascular guidelines for heart failure. The role of NP levels in state-of-the-art clinical practice is evolving rapidly. This paper reviews and highlights ten key messages to clinicians: NP levels are quantitative plasma biomarkers of heart failure (HF). NP levels are accurate in the diagnosis of FIR NP levels may help risk stratify emergency department (ED) patients with regard to the need for hospital admission or direct ED discharge. NP levels help improve patient management and reduce total treatment costs in patients with acute dyspnoea. NP levels at the time of admission are powerful predictors of outcome in predicting death and re-hospitalisation in HF patients. NP levels at discharge aid in risk stratification of the HF patient. NP-guided therapy may improve morbidity and/or mortality in chronic HF. The combination of NP levels together with symptoms, signs and weight gain assists in the assessment of clinical decompensation in HE NP levels can accelerate accurate diagnosis of heart failure presenting in primary care. NP levels may be helpful to screen for asymptomatic left ventricular dysfunction in high-risk patients. Published by Elsevier B.V. on behalf of European Society of Cardiology

{Search for direct production of GeV-scale resonances decaying to a pair of muons in proton-proton collisions at s \sqrt{s} = 13 TeV}

A search for direct production of low-mass dimuon resonances is performed using = 13 TeV proton-proton collision data collected by the CMS experiment during the 2017–2018 operation of the CERN LHC with an integrated luminosity of 96.6 fb−1. The search exploits a dedicated high-rate trigger stream that records events with two muons with transverse momenta as low as 3 GeV but does not include the full event information. The search is performed by looking for narrow peaks in the dimuon mass spectrum in the ranges of 1.1–2.6 GeV and 4.2–7.9 GeV. No significant excess of events above the expectation from the standard model background is observed. Model-independent limits on production rates of dimuon resonances within the experimental fiducial acceptance are set. Competitive or world’s best limits are set at 90% confidence level for a minimal dark photon model and for a scenario with two Higgs doublets and an extra complex scalar singlet (2HDM+S). Values of the squared kinetic mixing coefficient ε2 in the dark photon model above 10−6 are excluded over most of the mass range of the search. In the 2HDM+S, values of the mixing angle sin(θH) above 0.08 are excluded over most of the mass range of the search with a fixed ratio of the Higgs doublets vacuum expectation tan β = 0.5