Natriuretic peptides (BNP or NT-proBNP) cannot be used to rule out diastolic dysfunction, as patients with relaxation abnormalities and mild or no symptoms may have normal peptide levels.
Can natriuretic peptides be used for the diagnosis of diastolic heart failure?
Natriuretic peptides are useful for detecting diastolic dysfunction in symptomatic patients but cannot be used to rule out the diagnosis in those with mild or no symptoms.
Abstract Many patients with heart failure have stiff hearts with an increased wall thickness and small volumes leading to diastolic dysfunction. Different definitions for diastolic heart failure have been proposed but today there is no generally accepted definition and there are few large controlled studies telling us how it should be managed. Natriuretic peptides (BNP or NT-proBNP) might be used to detect patients with diastolic dysfunction especially in those patients having a restrictive filling pattern or pseudo-normalised mitral flow pattern and in those, who are symptomatic. However, patients with relaxation abnormalities and mild symptoms or asymptomatic may have normal levels of the natriuretic peptides indicating no or only slight elevation of the left ventricular filling pressures. Thus low levels cannot be used as a rule out diagnosis of diastolic dysfunction.
Ulf Dahlström (Sat,) conducted a review in Diastolic Heart Failure. Natriuretic peptides (BNP or NT-proBNP) was evaluated. Natriuretic peptides (BNP or NT-proBNP) cannot be used to rule out diastolic dysfunction, as patients with relaxation abnormalities and mild or no symptoms may have normal peptide levels.