Monitoring the response to pharmacologic therapy in patients with stable chronic heart failure: is BNP or NT-proBNP a useful assessment tool?
OBJECTIVE
B-type natriuretic peptides are biomarkers of heart failure (HF) that can decrease following treatment. We sought to determine whether B-type natriuretic peptide (BNP) or N-terminal proBNP (NT-proBNP) concentration changes occurred in parallel to changes in other measures of heart failure following treatment.


METHODS
We conducted a systematic review of the literature for studies that assessed B-type natriuretic peptide measurements in treatment monitoring of patients with stable chronic heart failure. Selected studies had to include at least three consecutive measurements of BNP or NT-proBNP.


RESULTS
Of 4338 citations screened, only 12 met all of the selection criteria. The selected studies included populations with a wide range of heart failure severity and therapy. BNP and NT-proBNP decreased following treatment in nine studies and was associated with improvement in clinical measures of HF.


CONCLUSIONS
There was limited data to support using BNP or NT-proBNP to monitor therapy in patients with HF.
Balion
Cynthia M
CM
Hamilton Regional Laboratory Medicine Program, Hamilton, ON, Canada.
McKelvie
Robert S
RS
Reichert
Sonja
S
Santaguida
Pasqualina
P
Booker
Lynda
L
Worster
Andrew
A
Raina
Parminder
P
McQueen
Matthew J
MJ
Hill
Stephen
S
D002908:Chronic Disease; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods; D020097:Natriuretic Peptide, Brain / Q000032:analysis*; D010446:Peptide Fragments / Q000032:analysis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain