[Clinical applications of brain natriuretic peptide testing]

Natriuretic peptide hormones are a family of vasoactive peptides with many favorable physiological properties and have emerged as useful markers in cardiovascular disease. In particular, brain natriuretic peptide (BNP) is a cardiac neurohormone secreted by the cardiac ventricles as a response to ventricular volume expansion, pressure overload and resultant increased wall tension, directly correlated with both left ventricular filling and pulmonary wedge pressure. It is nowadays considered an important diagnostic tool, adding information to clinical judgment in the evaluation of patients with acute dyspnea, and a useful guide to the treatment of chronic heart failure. Moreover, the prognostic value of BNP has been established in several studies, both in postmyocardial infarction patients with asymptomatic left ventricular dysfunction and in patients with overt heart failure. Furthermore it has been shown that BNP could also predict sudden death and offer an additive and easily obtainable tool for risk stratification of patients with chronic heart failure. This paper summarizes the current evidence concerning the use of this peptide in a variety of clinical scenarios.