Interpretation and use of natriuretic peptides in non-congestive heart failure settings

Shih Hung Tsai, Yen Yue Lin, Shi Jye Chu, Ching Wang Hsu, Shu Meng Cheng

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Natriuretic peptides (NPs) have been found to be useful markers in differentiating acute dyspneic patients presenting to the emergency department (ED) and emerged as potent prognostic markers for patients with congestive heart failure (CHF). The best-established and widely used clinical application of BNP and NT-proBNP testing is for the emergent diagnosis of CHF in patients presenting with acute dyspnea. Nevertheless, elevated NPs levels can be found in many circumstances involving left ventricular (LV) dysfunction or hypertrophy; right ventricular (RV) dysfunction secondary to pulmonary diseases; cardiac inflammatory or infectious diseases; endocrinology diseases and high output status without decreased LV ejection fraction. Even in the absence of significant clinical evidence of volume overload or LV dysfunction, markedly elevated NP levels can be found in patients with multiple comorbidities with a certain degree of prognostic value. Potential clinical applications of NPs are expanded accompanied by emerging reports regarding screening the presence of secondary cardiac dysfunction; monitoring the therapeutic responses, risk stratifications and providing prognostic values in many settings. Clinicians need to have expanded knowledge regarding the interpretation of elevated NPs levels and potential clinical applications of NPs. Clinicians should recognize that currently the only reasonable application for routine practice is limited to differentiation of acute dyspnea, rule-out-diagnostic-tests, monitoring of therapeutic responses and prognosis of acute or decompensated CHF. The rationales as well the potential applications of NPs in these settings are discussed in this review article.

Original languageEnglish
Pages (from-to)151-163
Number of pages13
JournalYonsei Medical Journal
Volume51
Issue number2
DOIs
Publication statusPublished - Mar 2010
Externally publishedYes

Fingerprint

Natriuretic Peptides
Heart Failure
Left Ventricular Dysfunction
Dyspnea
Right Ventricular Dysfunction
Endocrinology
Left Ventricular Hypertrophy
Routine Diagnostic Tests
Stroke Volume
Lung Diseases
Communicable Diseases
Hospital Emergency Service
Comorbidity
Heart Diseases
Therapeutics

Keywords

  • Acute coronary syndrome
  • Carbon monoxide intoxication
  • Cardiac dysrhythmia
  • Cirrhosis of liver
  • Hyperthyroidism
  • Natriuretic peptides
  • Pulmonary embolism
  • Pulmonary hypertension
  • Renal failure
  • Sepsis
  • Stroke

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Interpretation and use of natriuretic peptides in non-congestive heart failure settings. / Tsai, Shih Hung; Lin, Yen Yue; Chu, Shi Jye; Hsu, Ching Wang; Cheng, Shu Meng.

In: Yonsei Medical Journal, Vol. 51, No. 2, 03.2010, p. 151-163.

Research output: Contribution to journalArticle

Tsai, Shih Hung ; Lin, Yen Yue ; Chu, Shi Jye ; Hsu, Ching Wang ; Cheng, Shu Meng. / Interpretation and use of natriuretic peptides in non-congestive heart failure settings. In: Yonsei Medical Journal. 2010 ; Vol. 51, No. 2. pp. 151-163.
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