Fig. 35.1 BNP and heart failure
A good correlation has been made between increasing levels of BNP and functional class of NYHA classification as depicted in the Fig. 35.1.
BNP and NT-proBNP provide strong prognostic information, and elevated levels are associated with an unfavorable outcome (death, sudden cardiac death, readmission, or cardiac events) in patients with heart failure or asymptomatic left ventricular dysfunction [3, 4].
They are also useful for choosing optimal treatment and monitoring its effects in heart failure.
The current American College of Cardiology/American Heart Association (ACC/AHA) guidelines for managing heart failure have incorporated using natriuretic peptide levels in establishing the prognosis and disease severity of chronic heart failure.
In patients with severe heart failure BNP and NT-proBNP assays can be used in resynchronization therapy.
Both are also used as markers and to aid in prognosis in acute and stable coronary heart disease. Higher values are associated with worse outcomes .
In aortic stenosis, the levels indicate disease severity, progression, functional status, and also the optimum time for valve replacement after which the levels decline.
In atrial fibrillation, the levels are elevated and predict the success of cardioversion.
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