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April 26, 2023European Journal of Heart Failure164 citations

Natriuretic Peptides: Role in the Diagnosis and Management of Heart Failure: A Scientific Statement from the Heart Failure Association of the European Society of Cardiology, Heart Failure Society of America and Japanese Heart Failure Society

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HTHiroyuki TsutsuiNANancy M. AlbertACAndrew J.S. Coats

Key Points

  • To provide a trilateral international expert consensus on the diagnostic, prognostic, and therapeutic applications of natriuretic peptides in heart failure management.
  • Convened an expert panel through the Trilateral Cooperation Project (HFA-ESC, HFSA, and JHFS).
  • Synthesized current clinical and basic science evidence across biomarker performance, peptide-guided therapy, and pharmacological applications including ARNIs.
  • Confirmed BNP and NT-proBNP as central biomarkers for the objective diagnosis, risk stratification, and trial endpoint evaluation in acute and chronic heart failure.
  • Summarized therapeutic modulation of natriuretic peptide pathways using agents such as carperitide, nesiritide, and angiotensin receptor–neprilysin inhibitors.
  • Outlined persistent clinical knowledge gaps and future research priorities for peptide-guided heart failure treatment.

Abstract

ABSTRACT Natriuretic peptides, brain (B-type) natriuretic peptide (BNP) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) are globally and most often used for the diagnosis of heart failure (HF). In addition, they can have an important complementary role in the risk stratification of its prognosis. Since the development of angiotensin receptor–neprilysin inhibitors (ARNIs), the use of natriuretic peptides as therapeutic agents has grown in importance. The present document is the result of the Trilateral Cooperation Project among the Heart Failure Association of the European Society of Cardiology, the Heart Failure Society of America and the Japanese Heart Failure Society. It represents an expert consensus that aims to provide a comprehensive, up-to-date perspective on natriuretic peptides in the diagnosis and management of HF, with a focus on the following main issues: (1) history and basic research: discovery, production and cardiovascular protection; (2) diagnostic and prognostic biomarkers: acute HF, chronic HF, inclusion/endpoint in clinical trials, and natriuretic peptide-guided therapy; (3) therapeutic use: nesiritide (BNP), carperitide (ANP) and ARNIs; and (4) gaps in knowledge and future directions.

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Cite This Study

Tsutsui et al. (2023) studied this question. Natriuretic peptides, especially BNP and NT-proBNP, are crucial for diagnosing heart failure and guiding therapy, particularly with the rise of angiotensin receptor-neprilysin inhibitors.

synapsesocial.com/papers/696fa532b84853cc293d7ffchttps://doi.org/10.1002/ejhf.2848
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