 previous article in this issue | next article in this issue  |
|
Document Details : Title: Natriuretic peptide hormones in congestive heart failure: challenges, clinical interpretation and review of studies Author(s): H. Alkhawam , M. El-Hunjul , J. Nguyen , R. Desai , U. Syed , T.J. Vittorio Journal: Acta Cardiologica Volume: 71 Issue: 4 Date: 2016 Pages: 417-424 DOI: 10.2143/AC.71.4.3159694 Abstract : The primary action of natriuretic peptide hormones is to assist the heart in responding to the status of volume overload and subsequent stretching of the ventricles. Many studies have been done in the past decades that proved how useful is measuring brain natriuretic peptide (BNP) levels in diagnosing acute dyspnoea due to heart failure (HF) and to rule out non-cardiac dyspnoea. The major focus was on determining the optimal BNP level cutoffs that would help physicians in diagnosing acute cardiac dyspnoea early. The heart produces two natriuretic peptide hormones: atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). The most important stimulus in the secretion and release of these hormones, is stretch in the cardiac myocyte, which activates proBNP gene leading to de novo myocyte peptide synthesis and secretion. The more stretch that occurs, the higher level of these hormones which correlates with the severity of symptoms and prognosis. ProBNP originates from pre-proBNP, which is secreted by the ventricular musculature after volume or pressure overload. ProBNP is then further cleaved into two molecules, the biologically active BNP and the biologically inert NT-proBNP. In this manuscript, we will briefly review the pathophysiology of heart failure, BNP pathophysiology, clinical interpretation and limitation and review the most significant studies of BNP to determine the sensitivity and specificity of BNP in HF patients. |
