B-type natriuretic peptide in the management of heart failure.

OBJECTIVE: To review the current literature on the use of B-type natriuretic peptide in the diagnosis and management of heart failure. DATA SOURCES: Literature search of PubMed was performed up to September 2007. STUDY SELECTION: Key words for the literature search were 'heart failure' and 'B-type natriuretic peptide'. DATA EXTRACTION: Original papers and review articles related to the use of B-type natriuretic peptide in the diagnosis and management of heart failure. DATA SYNTHESIS: Heart failure is common in Hong Kong, and is associated with significant morbidity and mortality. Heart failure is often misdiagnosed. B-type natriuretic peptide may be regarded as a quantitative marker of heart failure; its levels have good diagnostic accuracy and can be measured with a rapid and simple bed-side assay and are useful in the assessment of patients with acute dyspnoea. Factors, such as obesity and renal impairment, alter B-type natriuretic peptide levels. Measurement of B-type natriuretic peptide facilitates improved medical outcomes, is cost-effective, and constitutes a good prognostic indicator for death and cardiac events. CONCLUSIONS: Determination of B-type natriuretic peptide levels is useful in the assessment of patients with acute dyspnoea, to exclude or diagnose heart failure, to facilitate improved medical outcomes, and is cost-effective. In addition, it is a good long-term prognostic indicator and can be used to guide heart failure treatment.