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B-type natriuretic peptide changes and left ventricular remodeling dynamics in heart failure with reduced ejection
Erick Romero1, Yevhen Kushnir1, Areej Shahzad1
1Department of Internal Medicine, St. Barnabas Hospital, SBH Health System, City University of New York (CUNY) School of Medicine, Bronx, NY, United States.
Frontiers in Cardiovascular Medicine
|January 26, 2026
Summary
Changes in B-type natriuretic peptide (BNP) levels over time are linked to left ventricular (LV) remodeling and survival in heart failure with reduced ejection fraction (HFrEF) patients. Declining BNP levels correlate with improved LV geometry and better outcomes.
Area of Science:
- Cardiology
- Biomarker Research
- Heart Failure Management
Background:
- B-type natriuretic peptide (BNP) is a key biomarker for heart failure with reduced ejection fraction (HFrEF).
- Understanding BNP dynamics is crucial for managing HFrEF and predicting outcomes.
Purpose of the Study:
- To investigate the relationship between changes in BNP levels and long-term left ventricular (LV) geometry.
- To explore how BNP fluctuations correlate with survival in HFrEF patients.
Main Methods:
- Retrospective analysis of 887 HFrEF patients with baseline and follow-up BNP measurements.
- Patients categorized into tertiles based on percent change in BNP.
- Analysis of LV internal dimensions (LVIDs, LVIDd) and ejection fraction (LVEF) as primary endpoints.
Main Results:
- Decreasing BNP tertiles showed significant reductions in LVIDs and LVIDd, alongside improvements in LVEF compared to rising BNP tertiles.
- The tertile with rising BNP levels exhibited higher all-cause mortality.
- Baseline characteristics varied across BNP change tertiles.
Conclusions:
- BNP is a dynamic marker reflecting LV remodeling in HFrEF.
- Time-dependent BNP changes are significantly associated with LV geometry alterations and patient survival.
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