Diagnostic value of BNP in diastolic heart failure

Abstract

Diastolic heart failure affects approximately 40%-50% of patients presenting with signs and symptoms of heart failure. Brain natriuretic peptide (BNP) is a cardiac neurohormone secreted from ventricular myocytes in response to increased end-diastolic pressure or volume. Accumulating evidence showed that BNP concentrations are increased in heart failure, and it is especially important in the differential diagnosis of dyspnea. BNP concentrations are increased in diastolic heart failure, but they are typically lower in diastolic than that in systolic heart failure. BNP concentrations are correlated with the stage of diastolic dysfunction, being mild-moderately elevated among patients with evidence of impaired relaxation and highest among those with a restrictive filling pattern. In asymptomatic patients with mild degree of diastolic dysfunction BNP concentrations may be within normal range. In this review we discuss the diagnostic value of BNP in diastolic heart failure.