Role of brain natriuretic peptide in the diagnosis and management of heart failure: Current concepts

Background: Progression of heart failure is related to ventricular remodeling, a process associated to neurohormonal activation. Brain natriuretic peptide (BNP), a member of the natriuretic peptide family, has recently emerged as an important neurohormone in the pathophysiology of heart failure. Methods: In this update, some of the recent advances on the role of BNP in heart failure are summarized. In particular, the role of BNP in diagnosis of heart disease, as a prognostic marker of cardiovascular events and as a possible guide to optimize heart failure therapy is discussed. Results: Recent results from 4,300 patients enrolled in the Valsartan Heart Failure Trial (Val-HeFT) confirmed that BNP is the strongest predictor of outcome in heart failure, when compared to other neurohormones and clinical markers. The current use of BNP in the screening and diagnosis of heart failure and its possible future roles are presented. Conclusion: In recent years, there has been an impressive accumulation of data supporting an important role of BNP as a diagnostic and prognostic marker of heart failure. Development of rapid, accurate and affordable diagnostic methods will allow the routine monitoring of BNP in a wide spectrum of settings, from general practice to controlled clinical trials.