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Natriuretic Peptides in Chronic Heart Failure
Hans-Peter Brunner-La Rocca1, Sandra Sanders-van Wijk1
1Department of Cardiology, Maastricht University Medical Center Maastricht, the Netherlands.
Cardiac Failure Review
|March 9, 2019
Summary
Normal brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels can help rule out chronic heart failure in outpatients. Measuring NT-proBNP may improve prognosis for specific heart failure patients when guiding medication adjustments.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Management
Background:
- Normal brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels are valuable in excluding chronic heart failure (CHF) in ambulatory patients.
- These natriuretic peptides also serve as prognostic markers in CHF, though their clinical utility in guiding therapy requires further clarification.
Purpose of the Study:
- To evaluate the role of normal BNP and NT-proBNP levels in excluding chronic heart failure in the ambulatory setting.
- To assess the potential of natriuretic peptides in screening at-risk patients for early intervention to prevent heart failure development.
- To investigate the clinical value of natriuretic peptides as prognostic markers and their application in guiding medical therapy for chronic heart failure.
Main Methods:
- Review and analysis of studies investigating the diagnostic and prognostic accuracy of BNP and NT-proBNP in chronic heart failure.
- Examination of research exploring the use of natriuretic peptide levels to guide treatment adjustments in heart failure patients.
Main Results:
- Normal BNP and NT-proBNP levels are effective in excluding chronic heart failure in ambulatory patients, though less studied than in acute settings.
- Natriuretic peptides show promise in screening patients at risk for heart failure, potentially enabling timely interventions.
- While prognostic value is established, studies on guiding therapy with natriuretic peptides yield mixed results, with no clear outcome improvement shown.
Conclusions:
- Normal natriuretic peptide levels are useful for ruling out chronic heart failure in outpatients.
- Measuring NT-proBNP to guide medication titration may improve prognosis in specific heart failure patients with reduced ejection fraction and few comorbidities.
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