The Role of B-Type Natriuretic Peptide Testing in Guiding Outpatient Heart Failure Treatment

Heart Failure (J Fang, Section Editor)

Opinion statement

While heart failure (HF) treatment guidelines exist, there are significant gaps in their implementation owing in part to the lack of objective data to help guide clinicians in their medical decision-making. B-type natriuretic peptide (BNP) and its amino-terminal equivalent (NT-proBNP) are objective markers of HF prognosis, are useful to monitor response to treatment in outpatients with HF, and may have a role in “guiding” HF care as well. Successful BNP or NT-proBNP guided HF treatment requires regular attempts to reach and maintain target values (BNP ≤ 125 pg/mL or NT-proBNP ≤ 1000 pg/mL). This may be achieved through lifestyle modifications, exercise programs, medication adjustments, and therapeutic interventions shown to reduce morbidity and mortality in HF patients. Failure to achieve biomarker targets portends a worse prognosis, proportional to the lowest achieved natriuretic peptide concentration; in those with significant biomarker “nonresponse,” prognosis is poor, and alternative therapeutic strategies should be considered.


Biomarkers Natriuretic peptide Heart failure Management Prognosis Outpatient Pharmacotherapy Cardiac resynchronization Therapy Exercise 

References and Recommended Reading

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Division of CardiologyMassachusetts General HospitalBostonUSA

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