Assays of which of the following i bomarkers is most commonly used in the diagnosis of Hea failure:
Correct Answer: Brain Natriuretic Peptide (BNP)
Description: Answer is a (BNP) BNP is the most commonly used biomarker used in the diagnosis of Hea failure. Levels of Brain Natriuretic Peptide (BNP), Endothelin -I (ET-1), Atrial Natriuretic Peptide (ANP) and Adrenomedullin are all increased in Hea Failure. BNP has scored over others in prognostic, diagnostic, and therapeutic values and has also a found place in the guidelines for the diagnosis of congestive hea failure. Assays of BNP are commercially available and used clinically for screening and diagnosis of hea failure, to predict severity of condition and estimate prognosis. Brain natriuretic peptide (BNP) is a neuro-hormone released from ventricular myocytes in response to myocytes stress. It is released as a pro-hormone and cleaved into N-terminal (NT) pro-BNP and BNP. It causes vasodilation, diuresis, and natriuresis and decreases activity of Sympathetic Nervous System (SNS) and Renin-angiotensinAldosterone System (RAAS). Both BNP and NT-pro-BNP have prognostic value in hea failure. Those with higher values on admission do worse and those whose values decrease after treatment fare better. Out of BNP and NT-pro -BNP, NT-pro-BNP is superior to BNP in predicting hospitalisation and death in hea failure. BNP /NT-pro-BNP Assays: It helps in screening patients at risk of development of hea failure (Diabetics and asymptomatic coronary aery disease) It helps in deciding whether hea failure is the cause of dyspnoea in the emergency depament (A very low BNP or NT-pro-BNP helps exclude a cardiac cause of dyspnoea) It has prognostic value in hea failure (Those with higher values on admission do worse and those whose values decrease after treatment fare better) Out of BNP and NT-pro-BNP, NT-pro-BNP is superior to BNP in predicting hospitalisation and death in hea failure. Note: At present serial measurement of BNP are not recommended as a guide for Hea Failure Therapy
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