Role of brain natriuretic peptide in the diagnosis and management of heart failure: current concepts.
BACKGROUND
Progression of heart failure is related to ventricular remodeling, a process associated to neurohormonal activation. Brain natriuretic peptide (BNP), a member of the natriuretic peptide family, has recently emerged as an important neurohormone in the pathophysiology of heart failure.


METHODS
In this update, some of the recent advances on the role of BNP in heart failure are summarized. In particular, the role of BNP in diagnosis of heart disease, as a prognostic marker of cardiovascular events and as a possible guide to optimize heart failure therapy is discussed.


RESULTS
Recent results from 4,300 patients enrolled in the Valsartan Heart Failure Trial (Val-HeFT) confirmed that BNP is the strongest predictor of outcome in heart failure, when compared to other neurohormones and clinical markers. The current use of BNP in the screening and diagnosis of heart failure and its possible future roles are presented.


CONCLUSIONS
In recent years, there has been an impressive accumulation of data supporting an important role of BNP as a diagnostic and prognostic marker of heart failure. Development of rapid, accurate and affordable diagnostic methods will allow the routine monitoring of BNP in a wide spectrum of settings, from general practice to controlled clinical trials.
Latini
Roberto
R
Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
Masson
Serge
S
de Angelis
Noeleen
N
Anand
Inder
I
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000502:physiology*; D011379:Prognosis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D020257:Ventricular Remodeling / Q000502:physiology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D015415:Biomarkers; D020097:Natriuretic Peptide, Brain