Hypervolemic and optivolemic natriuretic peptides in acute heart failure

Acute heart failure has emerged as the leading diagnosis among hospitalized patients, and challenges in accurate diagnosis, risk stratification and optimized management still remain. Here, biomarkers--with their low cost, objectivity and widespread availability--can play an indispensible role. Among the biomarkers available, natriuretic peptides (NPs) are the most validated and accepted for risk stratification and treatment guidance. The physiological basis for this lies in the strong correlation between NP levels and pulmonary capillary wedge pressure. The ability to classify individuals on the basis of risk could allow clinicians to tailor therapies to fit individual patient needs, thus reducing morbidity, mortality and costs.