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The role of B-type natriuretic Peptide testing in guiding outpatient heart failure treatment

Noreen P Kelly1, James L Januzzi

  • 1Division of Cardiology, Massachusetts General Hospital, 32 Fruit Street, Yawkey 5984, Boston, MA, 02114, USA.

Current Treatment Options in Cardiovascular Medicine
|May 14, 2013
PubMed

Insights

Utilizing B-type natriuretic peptide (BNP) or NT-proBNP levels can guide heart failure (HF) treatment. Achieving target biomarker values through interventions improves patient outcomes and prognosis.

Area of Science:

  • Cardiology
  • Biomarker Research

Background:

  • Heart failure (HF) treatment guidelines face implementation challenges due to a lack of objective clinical decision-making data.
  • B-type natriuretic peptide (BNP) and NT-proBNP serve as objective prognostic markers in HF.

Purpose of the Study:

  • To explore the role of BNP and NT-proBNP in guiding HF treatment and monitoring patient response.
  • To define target biomarker values for successful HF management.

Main Methods:

  • Regular monitoring of BNP or NT-proBNP levels in HF patients.
  • Implementation of lifestyle modifications, exercise, and medication adjustments to achieve target values.
  • Assessment of prognosis based on achieved natriuretic peptide concentrations.

Main Results:

  • Successful HF management involves achieving and maintaining target BNP (≤125 pg/mL) or NT-proBNP (≤1000 pg/mL) levels.
  • Failure to reach biomarker targets indicates a poorer prognosis.
  • Significant biomarker nonresponse is associated with poor outcomes, necessitating alternative therapeutic strategies.

Conclusions:

  • BNP and NT-proBNP are valuable objective markers for guiding HF therapy and monitoring treatment effectiveness.
  • Achieving target natriuretic peptide levels is crucial for improving HF patient prognosis.
  • A lack of biomarker response signals the need for reassessment and alternative treatment approaches in HF care.
Abstract

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