How Natriuretic Peptides Can Be a Therapeutic Target for Heart Failure

When the heart’s internal pressure increases, the hormones B-type natriuretic peptide (BNP) and N-terminal (NT)-pro hormone BNP (NT-proBNP) are released and enter the bloodstream. Due to this increase in the blood system, it is a true indicator of cardiac anomalies, which then becomes a good indicator of heart disease. A normal level of NT-proBNP is <125pg/mL for patients 0-74 years of age and <450 pg/mL for patients 75+ years of age. The range consistent with heart failure is >450 pg/mL for patients younger than 50, and >900 pg/mL for patients 50+. A recent study concerning natriuretic peptides has determined that BNP may have another use as a target for heart therapy. Medicomp’s MCTs can give instant and accurate rate, rhythm, morphology, and P-wave analysis for patients who present with increased levels of BNP.

Blood plasma BNP is an indicative marker of ventricular disorders. Studies have shown that increased plasma BNP is a predictor of hospital readmission, morbidity, and mortality. Treatment of intracardiac pressure, noted by an increase in plasma BNP, includes drug therapy, implantable cardioverter-defibrillators (ICDs), and transplants. Because these medications and procedures are expensive and often delivered as a “one size fits all” answer to CVD, researchers have been pondering a quick, inexpensive predictor for pending and recurring heart disease. Long-term prognosis has a much higher prediction rate if BNP concentrations are taken into account. High BNP concentrations following treatment had a likely outcome of readmission for negative cardiac events while patients with a decrease in BNP quite often presented without any history of cardiac events following treatment.

BNP can also predict prognosis in patients who suffer from mild, asymptomatic, and minimally symptomatic left ventricular impairment. An aggressive treatment that rapidly reduces blood plasma levels of BNP, such as intensive diuretic and vasodilator treatment, may reduce symptoms, recurrence, and mortality in these patients. A small study of patients with chronic heart failure showed that titrating management using N-terminal BNP values rather than titrating ACE inhibitors and β blockers led to a reduction in cardiovascular events. A second study of 220 patients found that BNP-guided treatment reduced readmission by 54 percent as well as a recurrence of cardiovascular events.

Using natriuretic peptides as prognostic markers and therapeutic targets may increase patient outcomes and greatly reduce readmission. Serial testing of BNP after aggressive treatment can predict further heart failure. In fact, BNP testing has proven to be a better predictor than many other forms of treatment. BNP results are rapid – 15-minutes – and the test can be given at the patient’s bedside as a simple blood draw. Further studies are pending, and Medicomp will share news on this study along with others that focus on cardiovascular care. Contact Medicomp at 800-234-3278 (800-23HEART) to learn about our MCTs for your patients who require mobile cardiac monitoring, and read our blogs for the most up-to-date news in cardiac care and technology.

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