clinical and prognostic implications of natriuretic peptides in cardiovascular disease

ABSTRACT

several serum biomarkers with important diagnostic, therapeutic and/or prognostic implications in cardiovascular diseases [CVD] are being increasingly used in research as well as clinical arena nowadays. the list of these markers is expanding, and includes C -reactive protein, cardiac Eroponins, homocysteine, lipoprotein [a], lipoprotein-associated phospholipase A2 [Lp-PLA2], serum amyloid A [SAA], ischemia-modified albumin [IMA], soluble CD40, and natriuretic peptides. Most of these markers are related to atherosclerotic vascular disease, ischemic heart disease, and acute coronary syndromes, but the natriuretic peptides, especially brain-type natriuretic peptide [BNP], are used as biomarkers of left ventricular dysfunction and have assumed an important role in the diagnosis and treatment of heart failure. BNP is synthesized in the cardiac myocyte and its blood concentration increase in relation to increase in ventricular wall tension. Blood levels of BNP and its biologically inactive precursor, N-terminal pro BNP, can be measured by a commercially available rapid whole blood test. The physiology and clinical implications of BNP will be reviewed