B-type natriuretic peptide in the management of heart failure

JD Maurellet, PT Liu
Department of Surgery, Queen Mary Hospital, Pokfulam, Hong Kong

OBJECTIVE. To review the current literature on the use of B-type natriuretic peptide in the diagnosis and management of heart failure.

DATA SOURCES. Literature search of PubMed was performed up to September 2007.

STUDY SELECTION. Key words for the literature search were 'heart failure' and 'B-type natriuretic peptide'.

DATA EXTRACTION. Original papers and review articles related to the use of B-type natriuretic peptide in the diagnosis and management of heart failure.

DATA SYNTHESIS. Heart failure is common in Hong Kong, and is associated with significant morbidity and mortality. Heart failure is often misdiagnosed. B-type natriuretic peptide may be regarded as a quantitative marker of heart failure; its levels have good diagnostic accuracy and can be measured with a rapid and simple bed-side assay and are useful in the assessment of patients with acute dyspnoea. Factors, such as obesity and renal impairment, alter B-type natriuretic peptide levels. Measurement of B-type natriuretic peptide facilitates improved medical outcomes, is cost-effective, and constitutes a good prognostic indicator for death and cardiac events.

CONCLUSIONS. Determination of B-type natriuretic peptide levels is useful in the assessment of patients with acute dyspnoea, to exclude or diagnose heart failure, to facilitate improved medical outcomes, and is cost-effective. In addition, it is a good long-term prognostic indicator and can be used to guide heart failure treatment.

Hong Kong Med J 2008;14:216-9

Key words: Diagnosis; Heart failure; Natriuretic peptide, brain