BNP in CHF: guide to diagnosis, not to treatment
Can we use the level of BNP (brain natriuretic peptide) as a marker of adequacy of CHF treatment? i.e. if it’s high, it means the CHF is not well managed and if it’s normal, the management is optimal? Masoud Shahrokhi, MD, West Vancouver, BC
You ask a very important question. BNP is best utilized when the diagnosis of heart failure is not clear — often in the emergency room. A very high value is suggestive of heart failure and a very low value essentially rules out the diagnosis. There were trials looking at BNP as a tool to predict the best management of CHF, but unfortunately’ these didn’t reveal a good clear answer. Currently BNP isn’t recommended for this indication.