Role of B-type natriuretic peptide (BNP) in heart failure

Introduction: Early clinical diagnosis of heart failure (HF) is challenging because the signs and symptoms are neither sensitive nor specific for diagnosis. B-type natriuretic peptide (BNP), a cardiac neurohormone is a useful biomarker for patients with HF. Objectives: The purpose of this review is to evaluate the role of BNP in HF as a diagnostic, prognostic, and therapeutic marker in both outpatient care and urgent care settings. Methodology: An extensive literature review was conducted for this study. Findings: Determination of BNP is particularly useful as a rule-out test for suspected cases of HF in patients with dyspnoea. HF is very unlikely in patients with levels of BNP <100 pg/mL whereas BNP levels >400 pg/mL strongly support the diagnosis of HF. Elevated level of BNP indicates a worse prognosis in patients with HF. Conclusion: Although, it is recommended in the diagnostic pathways of guidelines for HF, it is not well established to recommend measurement of BNP to titrate HF medications because of lack of enough evidence. It requires further in-depth research.