The use of NT-proBNP in clinical practice

Abstract

Early detection of heart failure and the accurate diagnosis of heart failure remains a huge clinical challenge to family practitioners. ECGs and chest x-rays merely serve as baseline investigations and the diagnosis is eventually only confirmed by a two-dimensional echocardiogram coupled with Doppler-flow studies. Another biomarker of left ventricular dysfunction that could be added to the armamentarium of the generalist is the blood test proBNP, the precursor of brain natriuretic peptide (BNP). Studies have shown that, already in early phases of left-ventricular systolic dysfunction (asymptomatic left ventricular systolic dysfunction and diastolic dysfunction), BNP proved to be a good marker of both development of heart failure and prognosis. This article gives the generalist an approach to using proBNP in general practice for early detection of left ventricular dysfunction, exclusion of heart failure and prudent referral to the cardiologist.