Role of B-type natriuretic peptide (BNP) in heart failure

Abstract

Introduction: Early clinical diagnosis of heart failure (HF) is challenging because the signs and symptoms are neither sensitive nor specific for diagnosis. B-type natriuretic peptide (BNP), a cardiac neurohormone is a useful biomarker for patients with HF. Objectives: The purpose of this review is to evaluate the role of BNP in HF as a diagnostic, prognostic, and therapeutic marker in both outpatient care and urgent care settings. Methodology: An extensive literature review was conducted for this study. Findings: Determination of BNP is particularly useful as a rule-out test for suspected cases of HF in patients with dyspnoea. HF is very unlikely in patients with levels of BNP < 100 pg/mL whereas BNP levels > 400 pg/mL strongly support the diagnosis of HF. Elevated level of BNP indicates a worse prognosis in patients with HF. Conclusion: Although, it is recommended in the diagnostic pathways of guidelines for HF, it is not well established to recommend measurement of BNP to titrate HF medications because of lack of enough evidence. It requires further in-depth research.

A systematic review exploring the significance of measuring epicardial fat thickness in correlation to B-type natriuretic peptide levels as prognostic and diagnostic markers in patients with or at risk of heart failure

“…In addition to their significance in heart failure diagnosis, BNP levels provide additional prognostic information beyond the classical CVD risk factors and have also been shown to predict heart failure mortality independent of age, previous myocardial infarction and altered left ventricular ejection fraction [ 3 ]. The prognostic value of NT-proBNP has been shown in previous studies, where NT-proBNP levels were identified as independent predictors of mortality in hospitalized patients with heart failure [ 12 , 46 ]. Also, NT-proBNP has been consistently correlated with elevated risk for mortality and/or rehospitalization for heart failure in patients with severe congestive heart failure [ 47 ].…”

“…The synthesis and release of BNP is primarily regulated by ventricular stretch, and elevated levels of BNP have been reported in cases of left ventricular end diastolic pressure and pulmonary artery pressure [ 9 ]. Accumulating evidence suggests that increased secretion of BNP from overloaded left ventricles in patients with chronic heart failure may serve as a useful prognostic marker indicating hospital admission and discharge [ 10 – 12 ]. The clinical significance of BNP and NT-proBNP in heart failure diagnosis and prognosis is attributed to their increased sensitivity and high specificity to detect myocardial injury [ 13 ].…”

Cardiovascular biomarkers: exploring troponin and BNP applications in conditions related to carbon monoxide exposure

“…It is difficult to comprehend the pathophysiology of B-type Natriuretic Peptide (BNP) in carbon monoxide (CO) poisoning, since there are several possible causes that include inflammation, oxidative stress, acidosis, and hypoxia brought on by CO [ 12 , 46 – 48 ]. According to a number of research, BNP, which indicates the degree of cardiac damage and dysfunction, is a useful biomarker for both diagnosing and predicting CO poisoning [ 48 , 49 ].…”

“…Troponin functions as a particular marker for myocardial injury as it is highly expressed in heart tissue and is present in low amounts in healthy people [ 10 , 11 ]. On the other hand, BNP, a hormone secreted by cardiac muscle cells in reaction to overstretching or elevated pressure, has vasodilatory, natriuretic, and diuretic properties that help lower cardiac strain and preserve fluid and electrolyte balance [ 12 , 13 ]. BNP levels aid in the diagnosis of heart failure, evaluation of the condition’s severity and origin, tracking of treatment response, prognostic prediction, and risk stratification [ 14 , 15 ].…”

NYHA Class II or III Heart Failure: Who Will Need an Implantable Cardioverter Defibrillator (ICD)?

“…HF is generally considered as a chronic condition traditionally resulting from left ventricular dysfunction with reduced LVEF (≤40%), which can be distinguished from a small proportion of HF with preserved EF (HF PEF) [3]. HF is a major public health issue with substantial mortality and morbidity which also poses a challenge to clinical diagnosis and generally affects the older segment of the population [4] [5]. Various clinical conditions including ischemic and non-ischemic heart diseases, metabolic and endocrine diseases, infectious and chronic diseases, use of cardiac and non-cardiac cardiotoxic drugs are some of the common factors causing HF [6]- [11].…”