Understanding the medical value of NT-proBNP for patients with heart failure
A complex syndrome
HF is defined as the heart’s inability to deliver an adequate amount of blood to the body’s tissues and organs. It is a complex clinical syndrome with a progressing abnormality in cardiac structure and/or function.
Because the clinical condition worsens over months or years, it is often termed chronic heart failure (CHF). Major heart associations (such as the New York Heart Association, the American College of Cardiology and the American Heart Association) each use a four-stage scale to gauge the severity of the condition.
An abnormal ECG can indicate that structural changes have occurred in the heart affecting chamber volumes, ventricular systolic and diastolic function, wall thickness and valve function. However, when patients with vague symptoms of suspected HF are referred for an ECG it can often reveal normal or near-normal cardiac structure.
The value of NT-ProBNP
Neurohormonal changes (NT-proBNP and BNP levels in blood) on the other hand, can be detected in the early stages of the disease, yielding a high sensitivity for ventricular stress and strain. That’s why current guidelines recommend measuring NT-proBNP and BNP levels to help with the diagnosis of CHF – in addition to an ECG.
In therapy of HF patients, NT-proBNP levels provide valuable prognostic information and guidance in relation to symptoms. It appears that progressive titration of HF therapy to achieve target BNP or NT-proBNP concentrations will lead to a reduction in HF-related or all-cause mortality together with a reduction in the time patients spend in hospital.