The Use of B-type Natriuretic Peptide to Diagnose Congestive Heart Failure

Jeffery R Gray

doi:10.29074/ascls.19.4.214

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Jeffery R Gray, MT(ASCP)⇑
1. is Research Specialist in the Department of Pathology at the University of Maryland School of Medicine, Baltimore MD

Address for correspondence: Jeffery Gray MT(ASCP), Research Specialist, Department of Pathology, University of Maryland School of Medicine, 10 South Pine Street, MSTF 7th floor, Aug-65, Baltimore MD 21201-1192. (410) 706-7734, (410) 706-4486 (fax). jgray{at}som.umaryland.edu.

Extract

This paper explains the background and current use of B-type natriuretic peptide (BNP) assays to differentiate congestive heart failure (CHF) from other causes of dyspnea. With a large and growing elderly population, CHF is being diagnosed much more often in emergency rooms in the United States. Doctors need a way to quickly distinguish whether a patient with respiratory distress is suffering from cardiac insufficiency or another etiology. BNP is released from the ventricles in response cardiac overload from CHF or some other form of left ventricular systolic dysfunction. Therefore, the detection and measurement of BNP is a fast and accurate method of determining if CHF is the cause of a patient's breathing difficulties.

The maturing of the large baby-boomer population is leading to an increase in the number of congestive heart failure (CHF) and left ventricular systolic dysfunction (LVSD) cases throughout the United States. Many of these individuals will not be diagnosed until they arrive at an emergency room seeking treatment for breathing difficulties. Although these patients suffer from respiratory distress caused by cardiac insufficiency, this symptom is common to many other conditions and diseases. Even when CHF is suspected, it is difficult to evaluate and the diagnostic tests are non-specific. Therefore, physicians need a way to quickly distinguish this disease from other causes of dyspnea. Tests used to measure plasma levels of B-type natriuretic peptide (BNP) are becoming the preferred method of identifying CHF in dyspneic patients.¹

Normally found in the ventricles of the heart, the BNP precursor (proBNP)…

ABBREVIATIONS: ANP = atrial natriuretic peptide; BNP = B-type natriuretic peptide; CHF = congestive heart failure; CNP = C-type natriuretic peptide; COPD = chronic obstructive pulmonary disease; ECG = electrocardiography; LVSD = left ventricular systolic dysfunction; POCT = point of care testing; RAAS = renin-angiotensin aldosterone system.