Abstrait

Natriuretic peptides in heart failure

Kimberly D Tran, Niraj V Parekh and Alan S Maisel

Congestive heart failure (CHF) is the leading cause of adult hospitalization in the USA, and despite advancements in treatment, the disease remains a major clinical challenge. The primary symptom of CHF is dyspnea; however, it is often difficult to distinguish between cardiac and other unrelated causes of this symptom. The synthesis, storage and release of B‑type natriuretic peptide (BNP) from the ventricular myocytes is strongly induced during acute episodes of ventricular-wall tension or stretch. Thus, BNP levels can be easily measured and have proven extremely useful at the point of care and can be used to differentiate cardiac from pulmonary etiologies of dyspnea. In addition to its diagnostic utility, it also has prognostic value and may help guide the treatment of patients with CHF. For these reasons, natriuretic peptides have established themselves in recent years as cornerstones in the diagnosis, treatment and prognosis of patients with heart failure, and it is likely that future algorithms will incorporate BNP levels and other clinical indicators to guide critical-care physicians in making management decisions for their CHF patients.