Monitoring the response to pharmacologic therapy in patients with stable chronic heart failure: is BNP or NT-proBNP a useful assessment tool?

Clin Biochem. 2008 Mar;41(4-5):266-76. doi: 10.1016/j.clinbiochem.2007.10.006. Epub 2007 Oct 16.

Abstract

Objectives: B-type natriuretic peptides are biomarkers of heart failure (HF) that can decrease following treatment. We sought to determine whether B-type natriuretic peptide (BNP) or N-terminal proBNP (NT-proBNP) concentration changes occurred in parallel to changes in other measures of heart failure following treatment.

Methods: We conducted a systematic review of the literature for studies that assessed B-type natriuretic peptide measurements in treatment monitoring of patients with stable chronic heart failure. Selected studies had to include at least three consecutive measurements of BNP or NT-proBNP.

Results: Of 4338 citations screened, only 12 met all of the selection criteria. The selected studies included populations with a wide range of heart failure severity and therapy. BNP and NT-proBNP decreased following treatment in nine studies and was associated with improvement in clinical measures of HF.

Conclusions: There was limited data to support using BNP or NT-proBNP to monitor therapy in patients with HF.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review
  • Systematic Review

MeSH terms

  • Chronic Disease
  • Heart Failure / diagnosis*
  • Heart Failure / drug therapy*
  • Heart Failure / metabolism
  • Humans
  • Monitoring, Physiologic / methods
  • Natriuretic Peptide, Brain / analysis*
  • Peptide Fragments / analysis*
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain