Natriuretic peptides. What should a practitioner know?
DOI: 10.32364/2587-6821-2025-9-1-5
T.M. Uskach1,2
1Acad. E.I. Chazov National Medical Research Center of Cardiology, Moscow, Russian Federation
2Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
Natriuretic peptides (NP), first off, the brain natriuretic peptide (BNP) and the N-terminal fragment of the brain natriuretic propeptide (NT-proBNP), play an important role in diagnosis, treatment control, and prognosis in patients with heart failure (HF). Specific threshold levels of NP are common to verify a diagnosis of HF. However, various HF-related comorbidities complicate interpretation of NP test results. In addition, drug therapy has a significant impact on laboratory markers of HF.
Aim: to describe NP role in HF management. Study data related to specific alteration of NP levels in patients with obesity, atrial fibrillation, and various left ventricular ejection fraction, as well as those related to an impact of HF therapy on the NP levels are reported. It is emphasized that the NP test data should be interpreted considering the clinical picture, other diagnostic data, and patient's attributes invalidating the test results.
Keywords: heart failure, natriuretic peptides, diagnosis, prognosis, drug therapy.
For citation: Uskach T.M. Natriuretic peptides. What should a practitioner know? Russian Medical Inquiry. 2025;9(1):35–42 (in Russ.). DOI: 10.32364/2587-6821-2025-9-1-5
Tatiana M. Uskach — Dr. Sc. (Med.), Professor, Leading Scientific Officer, Department of Myocardial Diseases and Heart Failure, Acad. E.I. Chazov National Medical Research Center of Cardiology, 15A, Academician Chazov str., Moscow, 121552, Russian Federation; Professor of Cardiology Department, Russian Medical Academy of Continuous Professional Education; 2/1, Barrikadnaya str., Moscow, 125993, Russian Federation; ORCID iD 0000-0003-4318-0315
Contact information: Tatiana M. Uskach, e-mail: tuskach@mail.ru
Financial Disclosure: the author has no a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 27.01.2025.
Revised 19.02.2025.
Accepted 14.03.2025.
References
1. Heidenreich P.A., Bozkurt B., Aguilar D. et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/ American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022;79(17):e263–e421. DOI: 10.1016/j.jacc.2021.12.012
2. McDonagh T.A., Metra M., Adamo M. et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42:3599–726. DOI: 10.1093/eurheartj/ehab368
3. Галявич А.С., Терещенко С.Н., Ускач Т.М. и др. Хроническая сердечная недостаточность. Клинические рекомендации 2024. Российский кардиологический журнал. 2024;29(11):6162. DOI: 10.15829/1560-4071-2024-6162Galyavich A.S., Tereshchenko S.N., Uskach T.M. et al. 2024 Clinical practice guidelines for Chronic heart failure. Russian Journal of Cardiology. 2024;29(11):6162 (in Russ.). DOI: 10.15829/1560-4071-2024-6162
4. Maisel A., Mueller C., Kirkwood A. et al. State of the art: using natriuretic peptide levels in clinical practice. Eur J Heart Fail. 2008;10:824–839. DOI: 10.1016/j.ejheart.2008.07.014
5. Emdin M., Passino C., Prontera C. et al. Comparison of brain natriuretic peptide (BNP) and amino-terminal ProBNP for early diagnosis of heart failure. Clin Chem. 2007;53(7):1289–1297. DOI: 10.1373/clinchem.2006.080234
6. Mueller C., McDonald K., De Boer R.A. et al.; Heart Failure Association of the European Society of Cardiology. Heart Failure Association of the European Society of Cardiology practical guidance on the use of natriuretic peptide concentrations. Eur J Heart Fail. 2019;21(6):715–731. DOI: 10.1002/ejhf.1494
7. Hendricks S., Dykun I., Balcer B. et al. Higher BNP/NT-pro BNP levels stratify prognosis equally well in patients with and without heart failure: a meta-analysis with more than 89.000 patients. ESC Heart Fail. 2022;9(5):3198–3209. DOI: 10.1002/ehf2.14019
8. Gong F.F., Campbell D.J., Prior D.L. Non-invasive cardiac imaging and the prediction of heart failure progression in preclinical stage A/B subjects. JACC Cardiovasc Imag. 2017;10:1504–1519. DOI: 10.1016/j.jcmg.2017.11.001
9. Taylor C.J., Moore J., O'Flynn N. Diagnosis and management of chronic heart failure: NICE guideline upd ate 2018. Br J Gen Pract. 2019;69:265–226. DOI: 10.3399/bjgp19X702665
10. Welsh P., Campbell R.T., Mooney L. et al. Reference Ranges for NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) and Risk Factors for Higher NT-proBNP Concentrations in a Large General Population Cohort. Circ Heart Fail. 2022;15:e009427. DOI: 10.1161/CIRCHEARTFAILURE.121.009427
11. Wilson Tang W.H., Girod J.P., Lee M.J. et al. Plasma B-Type Natriuretic Peptide Levels in Ambulatory Patients With Established Chronic Symptomatic Systolic Heart Failure. Circulation. 2003;108(24):2964–2966. DOI: 10.1161/01.CIR.0000106903. 98196.B6
12. Lundgren M., Ridefelt P., Karlsson M. et al. Interlaboratory variation for NT-proBNP among Swedish laboratories in an external quality program 2011–2021. Clin Chem Lab Med. 2023;61(9):1643–1651. DOI: 10.1515/cclm-2023-0051
13. Balion C., Don-Wauchope A., Hill S. et al. Use of Natriuretic Peptide Measurement in the Management of Heart Failure [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. Report No.: 13(14)-EHC118-EF. PMID: 24404625
14. Tang W.H.W. B-type natriuretic peptide: a critical review. Congest Heart Fail. 2007;13(1):48–52. DOI: 10.1111/j.1527-5299.2007.05622.x
15. Geng Z., Huang L., Song M., Song Y. N-terminal pro-brain natriuretic peptide and cardiovascular or all-cause mortality in the general population: A meta-analysis. Sci Rep. 2017;7:41504. DOI: 10.1038/srep41504
16. Van Veldhuisen D.J., Linssen G.C.M., Jaarsma T. et al. B-type natriuretic peptide and prognosis in heart failure patients with preserved and reduced ejection fraction. J Am Coll Cardiol. 2013;61(14):1498–1506. DOI: 10.1016/j.jacc.2012.12.044
17. Lam C.S.P., Gamble G.D., Ling L.H. et al. Mortality associated with heart failure with preserved vs. reduced ejection fraction in a prospective international multi-ethnic cohort study. Eur Heart J. 2018;39(20):1770–1780. DOI: 10.1093/eurheartj/ehy005
18. Edelmann F., Wachter R., Schmidt A.G. et al. Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. JAMA. 2013;309(8):781–791. DOI: 10.1001/jama.2013.905
19. Solomon S.D., Zile M., Pieske B. et al. The angiotensin receptor neprilysin inhibitor LCZ696 in heart failure with preserved ejection fraction: a phase 2 double-blind randomised controlled trial. Lancet. 2012;380(9851):1387–1395. DOI: 10.1016/S0140-6736(12)61227-6
20. Zile M.R., Claggett B.L., Prescott M.F. et al. Prognostic implications of changes in N-terminal Pro-B-type natriuretic peptide in patients with heart failure. J Am Coll Cardiol. 2016;68(22):2425–2436. DOI: 10.1016/j.jacc.2016.09.931
21. Schmitt W., Rühs H., Burghaus R. et al. NT-proBNP Qualifies as a Surrogate for Clinical End Points in Heart Failure. Clin Pharmacol Ther. 2021;110(2):498–507. DOI: 10.1002/cpt.2222
22. Jehn S., Mahabadi A.A., Pfohl C. et al. BNP and NT-proBNP Thresholds for the Assessment of Prognosis in Patients Without Heart Failure. JACC. 2023;2(10):100688. DOI: 10.1016/j.jacadv.2023.100688
23. Suthahar N., Meems L.M.G., Groothof D. et al. Relationship between body mass index, cardiovascular biomarkers and incident heart failure. Eur J Heart Fail. 2021;23(3):396–402. DOI: 10.1002/ejhf.2102
24. Horwich T.B., Hamilton M.A., Fonarow G.C. B-type natriuretic peptide levels in obese patients with advanced heart failure. J Am Coll Cardiol. 2006;47:85–90. DOI: 10.1016/j.jacc.2005.08.050
25. Frankenstein L., Remppis A., Nelles M. et al. Relation of N-terminal pro-brain natriuretic peptide levels and their prognostic power in chronic stable heart failure to obesity status. Eur Heart J. 2008;29:2634–2640. DOI: 10.1093/eurheartj/ehn388
26. Suthahar N., Meijers W.C., Ho J.E. et al. Sex-specific associations of obesity and N-terminal pro-B-type natriuretic peptide levels in the general population. Eur J Heart Fail. 2018;20:1205–1214. DOI: 10.1002/ejhf.1209
27. Manh T.H., Anh D.D., Viet T.L. Effect of body mass index on N-terminal pro-brain natriuretic peptide values in patients with heart failure. Egypt Heart J. 2023;75(1):75. DOI: 10.1186/s43044-023-00401-1
28. Nadruz W. Jr, Claggett B.L., McMurray J.J. et al. Impact of Body Mass Index on the Accuracy of N-Terminal Pro-Brain Natriuretic Peptide and Brain Natriuretic Peptide for Predicting Outcomes in Patients With Chronic Heart Failure and Reduced Ejection Fraction: Insights From the PARADIGM-HF Study (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial). Circulation. 2016;134:1785–1787. DOI: 10.1161/CIRCULATIONAHA.116.024976
29. Richards M., Di Somma S., Mueller C. et al. Atrial fibrillation impairs the diagnostic performance of cardiac natriuretic peptides in dyspneic patients. JACC Heart Fail. 2013;1:192–199. DOI: 10.1016/j.jchf.2013.02.004
30. McMurray J.J., Packer M., Desai A.S. et al. PARADIGM-HF Investigators and Committees. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371:993–1004. DOI: 10.1056/NEJMoa140907760
31. Anker S.D., Butler J., Filippatos G. et al. EMPEROR-Preserved Trial Investigators. Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med. 2021;385:1451–1461. DOI: 10.1056/NEJMoa2107038
32. Solomon S.D., Vaduganathan M., Claggett B.L. et al. Baseline characteristics of patients with HF with mildly reduced and preserved ejection fraction: DELIVER trial. JACC Heart Fail. 2022;10:184–197. DOI: 10.1016/j.jchf.2021.11.006
33. Solomon S.D., Vaduganathan M., Claggett B.L. et al. Sacubitril/valsartan across the spectrum of ejection fraction in heart failure. Circulation. 2020;141:352–361. DOI: 10.1161/CIRCULATIONAHA.119.044586
34. Pitt B., Pfeffer M.A., Assmann S.F. et al. TOPCAT Investigators. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014;370:1383–1392. DOI: 10.1056/NEJMoa1313731
35. McMurray J.J.V., Solomon S.D., Inzucchi S.E. et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2019;381(21):1995–2008. DOI: 10.1056/NEJMoa1911303
36. Packer M., Anker S.D., Butler J. et al. EMPERORReduced Trial Investigators. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020;383:1413–1424. DOI: 10.1056/NEJMoa2022190
37. Morello A., Lloyd-Jones D.M., Chae C.U. et al. Association of atrial fibrillation and aminoterminal pro-brain natriuretic peptide concentrations in dyspneic subjects with and without acute heart failure: results from the ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) study. Am Heart J. 2007;153(1):90–97. DOI: 10.1016/j.ahj.2006.10.005
38. Gould P.A., Gula L.J., Bhayana V. et al. Characterization of cardiac brain natriuretic peptide release in patients with paroxysmal atrial fibrillation undergoing left atrial ablation. Circ Arrhythmia Electrophysiol. 2010;3:18–23. DOI: 10.1161/CIRCEP.108.831586
39. Werhahn S.M., Becker C., Mende M. et al. NT-proBNP as a marker for atrial fibrillation and heart failure in four observational outpatient trials. ESC Heart Failure. 2022;9:100–109. DOI: 10.1002/ehf2.13703
40. Brady P.F., Chua W., Nehaj F. et al. Interactions Between Atrial Fibrillation and Natriuretic Peptide in Predicting Heart Failure Hospitalization or Cardiovascular Death. J Am Heart Assoc. 2022;11:e022833. DOI: 10.1161/JAHA.121.022833
41. Anjan V.Y., Loftus T.M., Burke M.A. et al. Prevalence, clinical phenotype, and outcomes associated with normal B-type natriuretic peptide levels in heart failure with preserved ejection fraction. Am J Cardiol. 2012;110:870–876. DOI: 10.1016/j.amjcard.2012.05.014
42. Bishu K., Deswal A., Chen H.H. et al. Biomarkers in acutely decompensated heart failure with preserved or reduced ejection fraction. Am Heart J. 2012;164:763–770.e3. DOI: 10.1016/j.ahj.2012.08.014
43. Van Veldhuisen D.J., Linssen G.C.M., Jaarsma T. et al. B-type natriuretic peptide and prognosis in heart failure patients with preserved and reduced ejection fraction. J Am Coll Cardiol. 2013;61:1498–1506. DOI: 10.1016/j.jacc.2012.12.044
44. Verbrugge F.H., Omote K., Reddy Y.N.V. et al. Heart failure with preserved ejection fraction in patients with normal natriuretic peptide levels is associated with increased morbidity and mortality. Eur Heart J. 2022;43(20):1941–1951. DOI: 10.1093/eurheartj/ehab911
45. Santosa Y.P., Tjandrawati A., Noormartany et al. Comparison of Pro B-natriuretic Peptide in Hypertensive Patients with and without Diastolic Dysfunction. Acta Med Indones. 2008;40(1):19–23. PMID: 18326895
46. Knebel F., Eddicks S., Schimke I. et al. Myocardial tissue Doppler echocardiography and N-terminal B-type natriuretic peptide (NT-proBNP) in diastolic and systolic heart failure. Cardiovasc Ultrasoud. 2008;6:45. DOI: 10.1186/1476-7120-6-45
47. Buckley L.F., Canada J.M., Del Buono M.G. et al. Low NT-proBNP levels in overweight and obese patients do not rule out a diagnosis of heart failure with preserved ejection fraction. ESC Heart Fail. 2018;5(2):372–378. DOI: 10.1002/ehf2.12235
48. Bozkurt B., Coats A.J., Tsutsui H. et al. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure. J Card Fail. 2021;S1071-9164(21)00050-6. Online ahead of print. DOI: 10.1016/j.cardfail.2021.01.022
49. Kittleson M.M., Panjrath G.S., Amancherla K. et al. 2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction. J Am Coll Cardiol. 2023;81(18):1835–1878. DOI: 10.1016/j.jacc.2023.03.393
50. Mohebi R., Liu Y., Myhre P.L. et al. Heart failure phenotypes according to natriuretic peptide trajectory following initiation of sacubitril/valsartan. J Am Coll Cardiol HF. 2023;11:855–858. DOI: 10.1016/j.jchf.2023.03.006
51. Maddox T.M., Januzzi J.L. Jr, Allen L.A. et al. 2024 ACC expert consensus decision pathway for treatment of heart failure with reduced ejection fraction: a report of the American College of Cardiology Solution. Se t Oversight Committee. J Am Coll Cardiol. 2024;83(15):1444–1488. DOI: 10.1016/j.jacc.2023.12.024
52. Januzzi J.L., Butler J., Fombu E. et al. Rationale and methods of the prospective study of biomarkers, symptom improvement, and ventricular remodeling during sacubitril/valsartan therapy for heart failure (PROVE-HF). Am Heart J. 2018;199:130–136. DOI: 10.1016/j.ahj.2017.12.021
53. Karlström P., Alehagen U., Boman K. et al. Brain natriuretic peptide-guided treatment does not improve morbidity and mortality in extensively treated patients with chronic heart failure: responders to treatment have a significantly better outcome. Eur J Heart Fail. 2011;13:1096–1103. DOI: 10.1093/eurjhf/hfr078
54. Ibrahim N.E., Januzzi J.L.Jr. The future of biomarkerguided therapy for heart failure after the guiding evidence based therapy using biomarker intensified treatment in heart failure (GUIDE-IT) study. Curr Heart Fail Rep. 2018;15:37–43. DOI: 10.1007/s11897-018-0381-0
55. Daubert M.A., Adams K., Yow E. et al. NT-proBNP goal achievement is associated with significant reverse remodelings and improved clinical outcomes in HFrEF. J Am Coll Cardiol HF. 2019;7:158–168. DOI: 10.1016/j.jchf.2018.10.014
56. Januzzi J.L. Jr, Camacho A., Pina I.L. et al. Reverse cardiac remodeling and outcome after initiation of sacubitril/valsartan. Circ Heart Fail. 2020;13:e006946. DOI: 10.1161/CIRCHEARTFAILURE.119.006946
57. Weiner R.B., Baggish A.L., Chen-Tournoux A. et al. Improvement in structural and functional echocardiographic parameters during chronic heart failure therapy guided by natriuretic peptides:mechanistic insights from the ProBNP Outpatient Tailored Chronic Heart Failure (PROTECT) study. Eur J Heart Fail. 2013;15:342–351. DOI: 10.1093/eurjhf/hfs180
58. Desai A.S., Solomon S.D., Shah A.M. et al. Effect of sacubitril-valsartan vs enalapril on aortic stiffness in patients with heart failure and reduced ejection fraction: a randomized clinical trial. JAMA. 2019;322:1077–1084. DOI: 10.1001/jama.2019.12843
59. Januzzi J.L. Jr, Prescott M.F., Butler J. et al. Association of change in N-terminal pro-b-type natriuretic peptide following initiation of sacubitril-valsartan treatment with cardiac structure and function in patients with heart failure with reduced ejection fraction. JAMA. 2019;322:1085–1095. DOI: 10.1001/jama.2019.12821
60. Ibrahim N.E., McCarthy C.P., Shrestha S. et al. Effect of neprilysin inhibition on various natriuretic peptide assays. J Am Coll Cardiol. 2019;73:1273–1284. DOI: 10.1016/j.jacc.2018.12.063
61. Myhre P.L., Prescott M.F., Murphy S.P. et al. Early B-Type natriuretic peptide change in HFrEF patients treated with sacubitril/valsartan: a pooled analysis of EVALUATE-HF and PROVE-HF. J Am Coll Cardiol HF. 2022;10:119–128. DOI: 10.1016/j.jchf.2021.09.007
62. Langenickel T.H., Dole W.P. Angiotensin receptorneprilysin inhibition with LCZ696: a novel approach for the treatment of heart failure. Drug Discov Today: Ther Strateg. 2012;9:e131–e139. DOI: 10.2147/VHRM.S55630
63. Mair J., Lindahl B., Giannitsis E. et al. Biomarker Study Group of the European Society of Cardiology Acute Cardiovascular Care Association.Will sacubitril-valsartan diminish the clinical utility of B-type natriuretic peptide testing in acute cardiac care? Eur Heart J Acute Cardiovasc Care. 2017;6:321–328. DOI: 10.1177/2048872615626355
2. McDonagh T.A., Metra M., Adamo M. et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42:3599–726. DOI: 10.1093/eurheartj/ehab368
3. Галявич А.С., Терещенко С.Н., Ускач Т.М. и др. Хроническая сердечная недостаточность. Клинические рекомендации 2024. Российский кардиологический журнал. 2024;29(11):6162. DOI: 10.15829/1560-4071-2024-6162Galyavich A.S., Tereshchenko S.N., Uskach T.M. et al. 2024 Clinical practice guidelines for Chronic heart failure. Russian Journal of Cardiology. 2024;29(11):6162 (in Russ.). DOI: 10.15829/1560-4071-2024-6162
4. Maisel A., Mueller C., Kirkwood A. et al. State of the art: using natriuretic peptide levels in clinical practice. Eur J Heart Fail. 2008;10:824–839. DOI: 10.1016/j.ejheart.2008.07.014
5. Emdin M., Passino C., Prontera C. et al. Comparison of brain natriuretic peptide (BNP) and amino-terminal ProBNP for early diagnosis of heart failure. Clin Chem. 2007;53(7):1289–1297. DOI: 10.1373/clinchem.2006.080234
6. Mueller C., McDonald K., De Boer R.A. et al.; Heart Failure Association of the European Society of Cardiology. Heart Failure Association of the European Society of Cardiology practical guidance on the use of natriuretic peptide concentrations. Eur J Heart Fail. 2019;21(6):715–731. DOI: 10.1002/ejhf.1494
7. Hendricks S., Dykun I., Balcer B. et al. Higher BNP/NT-pro BNP levels stratify prognosis equally well in patients with and without heart failure: a meta-analysis with more than 89.000 patients. ESC Heart Fail. 2022;9(5):3198–3209. DOI: 10.1002/ehf2.14019
8. Gong F.F., Campbell D.J., Prior D.L. Non-invasive cardiac imaging and the prediction of heart failure progression in preclinical stage A/B subjects. JACC Cardiovasc Imag. 2017;10:1504–1519. DOI: 10.1016/j.jcmg.2017.11.001
9. Taylor C.J., Moore J., O'Flynn N. Diagnosis and management of chronic heart failure: NICE guideline upd ate 2018. Br J Gen Pract. 2019;69:265–226. DOI: 10.3399/bjgp19X702665
10. Welsh P., Campbell R.T., Mooney L. et al. Reference Ranges for NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) and Risk Factors for Higher NT-proBNP Concentrations in a Large General Population Cohort. Circ Heart Fail. 2022;15:e009427. DOI: 10.1161/CIRCHEARTFAILURE.121.009427
11. Wilson Tang W.H., Girod J.P., Lee M.J. et al. Plasma B-Type Natriuretic Peptide Levels in Ambulatory Patients With Established Chronic Symptomatic Systolic Heart Failure. Circulation. 2003;108(24):2964–2966. DOI: 10.1161/01.CIR.0000106903. 98196.B6
12. Lundgren M., Ridefelt P., Karlsson M. et al. Interlaboratory variation for NT-proBNP among Swedish laboratories in an external quality program 2011–2021. Clin Chem Lab Med. 2023;61(9):1643–1651. DOI: 10.1515/cclm-2023-0051
13. Balion C., Don-Wauchope A., Hill S. et al. Use of Natriuretic Peptide Measurement in the Management of Heart Failure [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. Report No.: 13(14)-EHC118-EF. PMID: 24404625
14. Tang W.H.W. B-type natriuretic peptide: a critical review. Congest Heart Fail. 2007;13(1):48–52. DOI: 10.1111/j.1527-5299.2007.05622.x
15. Geng Z., Huang L., Song M., Song Y. N-terminal pro-brain natriuretic peptide and cardiovascular or all-cause mortality in the general population: A meta-analysis. Sci Rep. 2017;7:41504. DOI: 10.1038/srep41504
16. Van Veldhuisen D.J., Linssen G.C.M., Jaarsma T. et al. B-type natriuretic peptide and prognosis in heart failure patients with preserved and reduced ejection fraction. J Am Coll Cardiol. 2013;61(14):1498–1506. DOI: 10.1016/j.jacc.2012.12.044
17. Lam C.S.P., Gamble G.D., Ling L.H. et al. Mortality associated with heart failure with preserved vs. reduced ejection fraction in a prospective international multi-ethnic cohort study. Eur Heart J. 2018;39(20):1770–1780. DOI: 10.1093/eurheartj/ehy005
18. Edelmann F., Wachter R., Schmidt A.G. et al. Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. JAMA. 2013;309(8):781–791. DOI: 10.1001/jama.2013.905
19. Solomon S.D., Zile M., Pieske B. et al. The angiotensin receptor neprilysin inhibitor LCZ696 in heart failure with preserved ejection fraction: a phase 2 double-blind randomised controlled trial. Lancet. 2012;380(9851):1387–1395. DOI: 10.1016/S0140-6736(12)61227-6
20. Zile M.R., Claggett B.L., Prescott M.F. et al. Prognostic implications of changes in N-terminal Pro-B-type natriuretic peptide in patients with heart failure. J Am Coll Cardiol. 2016;68(22):2425–2436. DOI: 10.1016/j.jacc.2016.09.931
21. Schmitt W., Rühs H., Burghaus R. et al. NT-proBNP Qualifies as a Surrogate for Clinical End Points in Heart Failure. Clin Pharmacol Ther. 2021;110(2):498–507. DOI: 10.1002/cpt.2222
22. Jehn S., Mahabadi A.A., Pfohl C. et al. BNP and NT-proBNP Thresholds for the Assessment of Prognosis in Patients Without Heart Failure. JACC. 2023;2(10):100688. DOI: 10.1016/j.jacadv.2023.100688
23. Suthahar N., Meems L.M.G., Groothof D. et al. Relationship between body mass index, cardiovascular biomarkers and incident heart failure. Eur J Heart Fail. 2021;23(3):396–402. DOI: 10.1002/ejhf.2102
24. Horwich T.B., Hamilton M.A., Fonarow G.C. B-type natriuretic peptide levels in obese patients with advanced heart failure. J Am Coll Cardiol. 2006;47:85–90. DOI: 10.1016/j.jacc.2005.08.050
25. Frankenstein L., Remppis A., Nelles M. et al. Relation of N-terminal pro-brain natriuretic peptide levels and their prognostic power in chronic stable heart failure to obesity status. Eur Heart J. 2008;29:2634–2640. DOI: 10.1093/eurheartj/ehn388
26. Suthahar N., Meijers W.C., Ho J.E. et al. Sex-specific associations of obesity and N-terminal pro-B-type natriuretic peptide levels in the general population. Eur J Heart Fail. 2018;20:1205–1214. DOI: 10.1002/ejhf.1209
27. Manh T.H., Anh D.D., Viet T.L. Effect of body mass index on N-terminal pro-brain natriuretic peptide values in patients with heart failure. Egypt Heart J. 2023;75(1):75. DOI: 10.1186/s43044-023-00401-1
28. Nadruz W. Jr, Claggett B.L., McMurray J.J. et al. Impact of Body Mass Index on the Accuracy of N-Terminal Pro-Brain Natriuretic Peptide and Brain Natriuretic Peptide for Predicting Outcomes in Patients With Chronic Heart Failure and Reduced Ejection Fraction: Insights From the PARADIGM-HF Study (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial). Circulation. 2016;134:1785–1787. DOI: 10.1161/CIRCULATIONAHA.116.024976
29. Richards M., Di Somma S., Mueller C. et al. Atrial fibrillation impairs the diagnostic performance of cardiac natriuretic peptides in dyspneic patients. JACC Heart Fail. 2013;1:192–199. DOI: 10.1016/j.jchf.2013.02.004
30. McMurray J.J., Packer M., Desai A.S. et al. PARADIGM-HF Investigators and Committees. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371:993–1004. DOI: 10.1056/NEJMoa140907760
31. Anker S.D., Butler J., Filippatos G. et al. EMPEROR-Preserved Trial Investigators. Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med. 2021;385:1451–1461. DOI: 10.1056/NEJMoa2107038
32. Solomon S.D., Vaduganathan M., Claggett B.L. et al. Baseline characteristics of patients with HF with mildly reduced and preserved ejection fraction: DELIVER trial. JACC Heart Fail. 2022;10:184–197. DOI: 10.1016/j.jchf.2021.11.006
33. Solomon S.D., Vaduganathan M., Claggett B.L. et al. Sacubitril/valsartan across the spectrum of ejection fraction in heart failure. Circulation. 2020;141:352–361. DOI: 10.1161/CIRCULATIONAHA.119.044586
34. Pitt B., Pfeffer M.A., Assmann S.F. et al. TOPCAT Investigators. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014;370:1383–1392. DOI: 10.1056/NEJMoa1313731
35. McMurray J.J.V., Solomon S.D., Inzucchi S.E. et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2019;381(21):1995–2008. DOI: 10.1056/NEJMoa1911303
36. Packer M., Anker S.D., Butler J. et al. EMPERORReduced Trial Investigators. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020;383:1413–1424. DOI: 10.1056/NEJMoa2022190
37. Morello A., Lloyd-Jones D.M., Chae C.U. et al. Association of atrial fibrillation and aminoterminal pro-brain natriuretic peptide concentrations in dyspneic subjects with and without acute heart failure: results from the ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) study. Am Heart J. 2007;153(1):90–97. DOI: 10.1016/j.ahj.2006.10.005
38. Gould P.A., Gula L.J., Bhayana V. et al. Characterization of cardiac brain natriuretic peptide release in patients with paroxysmal atrial fibrillation undergoing left atrial ablation. Circ Arrhythmia Electrophysiol. 2010;3:18–23. DOI: 10.1161/CIRCEP.108.831586
39. Werhahn S.M., Becker C., Mende M. et al. NT-proBNP as a marker for atrial fibrillation and heart failure in four observational outpatient trials. ESC Heart Failure. 2022;9:100–109. DOI: 10.1002/ehf2.13703
40. Brady P.F., Chua W., Nehaj F. et al. Interactions Between Atrial Fibrillation and Natriuretic Peptide in Predicting Heart Failure Hospitalization or Cardiovascular Death. J Am Heart Assoc. 2022;11:e022833. DOI: 10.1161/JAHA.121.022833
41. Anjan V.Y., Loftus T.M., Burke M.A. et al. Prevalence, clinical phenotype, and outcomes associated with normal B-type natriuretic peptide levels in heart failure with preserved ejection fraction. Am J Cardiol. 2012;110:870–876. DOI: 10.1016/j.amjcard.2012.05.014
42. Bishu K., Deswal A., Chen H.H. et al. Biomarkers in acutely decompensated heart failure with preserved or reduced ejection fraction. Am Heart J. 2012;164:763–770.e3. DOI: 10.1016/j.ahj.2012.08.014
43. Van Veldhuisen D.J., Linssen G.C.M., Jaarsma T. et al. B-type natriuretic peptide and prognosis in heart failure patients with preserved and reduced ejection fraction. J Am Coll Cardiol. 2013;61:1498–1506. DOI: 10.1016/j.jacc.2012.12.044
44. Verbrugge F.H., Omote K., Reddy Y.N.V. et al. Heart failure with preserved ejection fraction in patients with normal natriuretic peptide levels is associated with increased morbidity and mortality. Eur Heart J. 2022;43(20):1941–1951. DOI: 10.1093/eurheartj/ehab911
45. Santosa Y.P., Tjandrawati A., Noormartany et al. Comparison of Pro B-natriuretic Peptide in Hypertensive Patients with and without Diastolic Dysfunction. Acta Med Indones. 2008;40(1):19–23. PMID: 18326895
46. Knebel F., Eddicks S., Schimke I. et al. Myocardial tissue Doppler echocardiography and N-terminal B-type natriuretic peptide (NT-proBNP) in diastolic and systolic heart failure. Cardiovasc Ultrasoud. 2008;6:45. DOI: 10.1186/1476-7120-6-45
47. Buckley L.F., Canada J.M., Del Buono M.G. et al. Low NT-proBNP levels in overweight and obese patients do not rule out a diagnosis of heart failure with preserved ejection fraction. ESC Heart Fail. 2018;5(2):372–378. DOI: 10.1002/ehf2.12235
48. Bozkurt B., Coats A.J., Tsutsui H. et al. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure. J Card Fail. 2021;S1071-9164(21)00050-6. Online ahead of print. DOI: 10.1016/j.cardfail.2021.01.022
49. Kittleson M.M., Panjrath G.S., Amancherla K. et al. 2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction. J Am Coll Cardiol. 2023;81(18):1835–1878. DOI: 10.1016/j.jacc.2023.03.393
50. Mohebi R., Liu Y., Myhre P.L. et al. Heart failure phenotypes according to natriuretic peptide trajectory following initiation of sacubitril/valsartan. J Am Coll Cardiol HF. 2023;11:855–858. DOI: 10.1016/j.jchf.2023.03.006
51. Maddox T.M., Januzzi J.L. Jr, Allen L.A. et al. 2024 ACC expert consensus decision pathway for treatment of heart failure with reduced ejection fraction: a report of the American College of Cardiology Solution. Se t Oversight Committee. J Am Coll Cardiol. 2024;83(15):1444–1488. DOI: 10.1016/j.jacc.2023.12.024
52. Januzzi J.L., Butler J., Fombu E. et al. Rationale and methods of the prospective study of biomarkers, symptom improvement, and ventricular remodeling during sacubitril/valsartan therapy for heart failure (PROVE-HF). Am Heart J. 2018;199:130–136. DOI: 10.1016/j.ahj.2017.12.021
53. Karlström P., Alehagen U., Boman K. et al. Brain natriuretic peptide-guided treatment does not improve morbidity and mortality in extensively treated patients with chronic heart failure: responders to treatment have a significantly better outcome. Eur J Heart Fail. 2011;13:1096–1103. DOI: 10.1093/eurjhf/hfr078
54. Ibrahim N.E., Januzzi J.L.Jr. The future of biomarkerguided therapy for heart failure after the guiding evidence based therapy using biomarker intensified treatment in heart failure (GUIDE-IT) study. Curr Heart Fail Rep. 2018;15:37–43. DOI: 10.1007/s11897-018-0381-0
55. Daubert M.A., Adams K., Yow E. et al. NT-proBNP goal achievement is associated with significant reverse remodelings and improved clinical outcomes in HFrEF. J Am Coll Cardiol HF. 2019;7:158–168. DOI: 10.1016/j.jchf.2018.10.014
56. Januzzi J.L. Jr, Camacho A., Pina I.L. et al. Reverse cardiac remodeling and outcome after initiation of sacubitril/valsartan. Circ Heart Fail. 2020;13:e006946. DOI: 10.1161/CIRCHEARTFAILURE.119.006946
57. Weiner R.B., Baggish A.L., Chen-Tournoux A. et al. Improvement in structural and functional echocardiographic parameters during chronic heart failure therapy guided by natriuretic peptides:mechanistic insights from the ProBNP Outpatient Tailored Chronic Heart Failure (PROTECT) study. Eur J Heart Fail. 2013;15:342–351. DOI: 10.1093/eurjhf/hfs180
58. Desai A.S., Solomon S.D., Shah A.M. et al. Effect of sacubitril-valsartan vs enalapril on aortic stiffness in patients with heart failure and reduced ejection fraction: a randomized clinical trial. JAMA. 2019;322:1077–1084. DOI: 10.1001/jama.2019.12843
59. Januzzi J.L. Jr, Prescott M.F., Butler J. et al. Association of change in N-terminal pro-b-type natriuretic peptide following initiation of sacubitril-valsartan treatment with cardiac structure and function in patients with heart failure with reduced ejection fraction. JAMA. 2019;322:1085–1095. DOI: 10.1001/jama.2019.12821
60. Ibrahim N.E., McCarthy C.P., Shrestha S. et al. Effect of neprilysin inhibition on various natriuretic peptide assays. J Am Coll Cardiol. 2019;73:1273–1284. DOI: 10.1016/j.jacc.2018.12.063
61. Myhre P.L., Prescott M.F., Murphy S.P. et al. Early B-Type natriuretic peptide change in HFrEF patients treated with sacubitril/valsartan: a pooled analysis of EVALUATE-HF and PROVE-HF. J Am Coll Cardiol HF. 2022;10:119–128. DOI: 10.1016/j.jchf.2021.09.007
62. Langenickel T.H., Dole W.P. Angiotensin receptorneprilysin inhibition with LCZ696: a novel approach for the treatment of heart failure. Drug Discov Today: Ther Strateg. 2012;9:e131–e139. DOI: 10.2147/VHRM.S55630
63. Mair J., Lindahl B., Giannitsis E. et al. Biomarker Study Group of the European Society of Cardiology Acute Cardiovascular Care Association.Will sacubitril-valsartan diminish the clinical utility of B-type natriuretic peptide testing in acute cardiac care? Eur Heart J Acute Cardiovasc Care. 2017;6:321–328. DOI: 10.1177/2048872615626355
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