A rapid bedside test for B-type peptide predicts treatment outcomes in patients admitted for decompensated heart failure: a pilot study

Abstract

In patients admitted with decompensated CHF, changes in BNP levels during treatment are strong predictors for mortality and early readmission. The results suggest that BNP levels might be used successfully to guide treatment of patients admitted for decompensated CHF.

The diagnostic and prognostic value of brain natriuretic peptides in adults with a systemic morphologically right ventricle or Fontan-type circulation

“…This is an important finding, as in acquired heart disease with acute heart failure, a lower as well as a declining BNP concentration is associated with a better outcome [17,18].…”

Does B-type Natriuretic Peptide Level Predict Outcome After Arterial Switch Operation ?

“…However, it is clear that it increases in various pathologic states; particularly those involved in increased cardiac chamber wall stretch and expanded fluid volume as heart failure, renal failure, primary hyperaldosteronism, and in reduced peptide clearance as in renal failure 11,12 . Furthermore some studies indicated that BNP seems to have clinical utility in terms of excluding the diagnosis of heart failure in patients with symptoms of breathlessness or fluid retention and may provide prognostic information about those with heart failure or other cardiac diseases [13][14][15][16][17][18] Also, there is some evidence that it may be useful for monitoring heart failure therapies [19][20] .…”

B‐type natriuretic peptide measurement in heart failure

“…14,42,[61][62][63][64][65] Harrison et al reported on a cohort of 325 emergency room patients with dyspnea, showing that an initial BNP level > 480 pg/ml had a high discriminatory power to predict all-cause 6-month mortality. 66 Koglin et al also examined the relation of BNP levels with survival and showed that levels correlated strongly with heart failure survival scores (a well-validated prediction model for CHF survival).…”

“…These studies , who showed that patients who died during the first year after hospitalization for CHF had markedly higher BNP levels, and that the ability of BNP to predict adverse outcomes compared favorably with known prognostic indicators such as norepinephrine level, wedge pressure, and LV function. 41 The utility of serial BNP measurement for defining prognosis was tested by Cheng et al 14 They followed 72 patients admitted with CHF with serial measurements of BNP and looked at a primary endpoint of death or 30-day readmission. There was a mean New York Heart Association (NYHA) class of 3.6 on admission, and 42% were placed on intravenous inotropic therapy.…”

“…12 Initial studies revealed that BNP levels improve clinicians' ability to diagnose CHF in the emergency room and are important predictors of death or readmission following hospital discharge for CHF. 13,14 Other studies have shown improved outcomes in patients with CHF managed by BNP-guided therapy compared with those managed by history and physical examination. 15 This paper reviews the basic physiology of BNP in the natural history of CHF, details the existing literature, and explains the various clinical settings in which BNP measurement may be used.…”