The emerging role of natriuretic peptides in the diagnosis and treatment of decompensated heart failure.
B-type natriuretic peptide (BNP) is a cardiac neurohormone and is released as prepro BNP and then enzymatically cleaved to the N-terminal proBNP (NT-proBNP) and BNP upon ventricular myocyte stretch. Blood measurements of BNP and NT-proBNP have been used to identify patients with heart failure (HF). Clinical considerations for these tests include their half-lives in plasma, dependence on renal function for clearance, interpretation of their units of measure, and the rapid availability of the test results. The BNP assay is currently used as a diagnostic and prognostic aid in HF. In general, a BNP level below 100 pg/mL excludes acutely decompensated HF. Recombinant, human BNP (nesiritide) is an approved intravenous treatment for acute, decompensated HF. This paper reviews the literature concerning the use of this peptide as a diagnostic test and as an intravenous therapy.
Gallagher
Michael J
MJ
Division of Clinical Nutrition and Preventive Medicine, William Beaumont Hospital, 4949 Coolidge Highway, Royal Oak, MI 48073, USA.
McCullough
Peter A
PA
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D006334:Heart Function Tests; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain; D045265:Natriuretic Peptides / Q000378:metabolism* / Q000627:therapeutic use*; D009419:Nerve Tissue Proteins / Q000378:metabolism* / Q000627:therapeutic use*; D011379:Prognosis; D011498:Protein Precursors / Q000378:metabolism* / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
D015415:Biomarkers; D045265:Natriuretic Peptides; D009419:Nerve Tissue Proteins; D011498:Protein Precursors; C063382:prepro-brain natriuretic peptide; D020097:Natriuretic Peptide, Brain