Natriuretic peptides (NPs) are released from the heart in response to haemodynamic stimuli including atrial stretch and NT-proBNP has diagnostic and prognostic value in patients with acute and chronic heart failure, with high specificity and well validated cut-off values.
As the population ages and co-morbidities increase, HF prevalence, related hospital admissions and mortality are expected to continue rising.3 Diagnostic uncertainty is often high after initial evaluation of dyspnoeic patients, as the clinical presentation and physical findings associated with HF are common and non- specific. Early NT-proBNP testing has an important role in diagnosis, allowing clinicians to identify patients with a high risk of HF and refer them promptly for echocardiography when appropriate.
There is an evolving role for NT-proBNP testing in guiding individualised HF management decisions such as timing of hospital discharge, and monitoring of outpatients to detect early evidence of decompensation, with a view to optimising therapy and reducing re-admissions. Clinical guidelines reflect the evidence for the utility of NT-proBNP testing in the acute and chronic HF settings, with some differences between Australian and European guidelines and reimbursement, which may present a practical barrier in some circumstances.
This educational activity was developed by MdBriefCase, with funding from Roche Diagnostics.