Brain natriuretic peptide--the biological marker in the diagnosis of overt congestive heart failure and myocardial ischemia (original) (raw)

Brain natriuretic peptide (BNP) is one of the cardiac peptide hormones that are involved in water and electrolyte homeostasis in heart failure. There are two mechanisms for increased BNP gene expression: cardiomyocyte stretching and neurohormonal activation. Many recent studies reported an increase in BNP gene expression with elevated plasma concentrations of BNP/NT-proBNP and its precursor, proBNP, in overt heart failure as well as in myocardial ischemia or acute coronary syndrome. In addition, the elevated plasma concentrations of BNP and NT-proBNP are a prognostic marker of morbidity, mortality and later development of heart failure in patients with acute coronary syndrome. In the management of children with congenital heart disease the role of BNP as a diagnostic tool is less evident. This review summarizes recently known facts about the role of BNP in the diagnosis, management and prognosis of congestive heart failure, myocardial ischemia and congenital heart disease (Ref. 33)....