Low plasma levels of brain natriuretic peptide in severe acute heart failure: Merely a case?

Abstract Brain natriuretic peptide (BNP) is commonly used for diagnosis and prognosis of patients with congestive heart failure (HF). High levels of BNP are associated with high probability of cardiogenic dyspnea and higher risk of subsequent cardiovascular events. We describe a case of acute HF (wo...

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Bibliographic Details
Published in:International journal of cardiology 2007-11, Vol.122 (3), p.e18-e20
Main Authors: Brentana, Loretta, Temporelli, Pier Luigi, Corrà, Ugo, Gattone, Marinella, Pistono, Massimo, Imparato, Alessandro, Gnemmi, Marco, Giannuzzi, Pantaleo
Format: Article
Language:English
Subjects:
Acute Disease
Acute heart failure
Aged
Aortic stenosis
Biomarkers - blood
Brain natriuretic peptide
Cardiovascular
Heart Failure - blood
Heart Failure - diagnosis
Heart Failure - diagnostic imaging
Humans
Male
Natriuretic Peptide, Brain - blood
Radiography
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Summary:Abstract Brain natriuretic peptide (BNP) is commonly used for diagnosis and prognosis of patients with congestive heart failure (HF). High levels of BNP are associated with high probability of cardiogenic dyspnea and higher risk of subsequent cardiovascular events. We describe a case of acute HF (worsening chronic HF) in a 74-year-old male with low plasma BNP levels on admission, in whom a rapid and consistent increase in the marker's concentration occurred after administration of diuretics and vasodilators, despite a prompt clinical and hemodynamic improvement. Reports of cardiogenic dyspnea with moderate increase or normal plasma levels of BNP have been recently published: does this signify a pitfall for BNP as a useful diagnostic and prognostic tool? Clinical implications of our observation are discussed, and we conclude that neurohumoral biomarkers do not obviate the need for a careful physical and instrumental examination of patient.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2006.11.085