title: Low plasma levels of brain natriuretic peptide in severe acute heart failure: merely a case?
abstract: Brain natriuretic peptide (BNP) is commonly used for diagnosis and prognosis of patients with congestive heart failure (HF). High levels of BNP are associated with high probability of cardiogenic dyspnea and higher risk of subsequent cardiovascular events. We describe a case of acute HF (worsening chronic HF) in a 74-year-old male with low plasma BNP levels on admission, in whom a rapid and consistent increase in the marker's concentration occurred after administration of diuretics and vasodilators, despite a prompt clinical and hemodynamic improvement. Reports of cardiogenic dyspnea with moderate increase or normal plasma levels of BNP have been recently published: does this signify a pitfall for BNP as a useful diagnostic and prognostic tool? Clinical implications of our observation are discussed, and we conclude that neurohumoral biomarkers do not obviate the need for a careful physical and instrumental examination of patient.
authors: Loretta
authors: L
authors: Brentana
authors: Pier Luigi
authors: PL
authors: Temporelli
authors: Ugo
authors: U
authors: Corrà
authors: Marinella
authors: M
authors: Gattone
authors: Massimo
authors: M
authors: Pistono
authors: Alessandro
authors: A
authors: Imparato
authors: Marco
authors: M
authors: Gnemmi
authors: Pantaleo
authors: P
authors: Giannuzzi
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011859:Radiography
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain