NTproBNP is a very useful test in heart failure. However, often it is overused, as the diagnosis of heart failure should be a clinical one.
Here are the scenarios where it may be useful:
Useful = ambulatory patients with dyspnoea– in the diagnosis of HF, esp. in clinical uncertainty
Useful = establishing prognosis
May be useful = achieving optimal dosing in select clinically euvolaemicpatients
Not well established = serial measurement to reduce hospitalization
BNP can be elevated by conditions other than heart failure
advanced age
renal failure
anaemia
Pulmonary – obstructive sleep apnoea, pneumonia, pulmonary hypertension
Diabetes
Critical illness
Sepsis
Burns
Toxic-metabolic insults
BNP can be falsely low because of
Overweight, obesity
Author: Andrew To
