Natriuretic Peptides
Lori B. Daniels, MD* and
Alan S. Maisel, MD, FACC
Division of Cardiology, University of California at San Diego, and the Division of Cardiology, Veteran’s Affairs San Diego Healthcare System, San Diego, California.
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Figure 1 BNP Levels by ACC/AHA Heart Failure Stages
B-type natriuretic peptide (BNP) rises with age over the course of a lifetime but generally stays under 20 pg/ml in the absence of left ventricular dysfunction or structural heart disease. B-type natriuretic peptide >100 pg/ml is the cutoff for diagnosing congestive heart failure in symptomatic patients. Stage A = risk factors; Stage B = asymptomatic structural heart disease; Stage C = symptomatic heart failure; Stage D = refractory heart failure. ACC = American College of Cardiology; AHA = American Heart Association.
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Figure 2 BNP Cut-Points for 90% Sensitivity
B-type natriuretic peptide (BNP) cut-points for 90% sensitivity in diagnosing congestive heart failure in patients with dyspnea, on the basis of body mass index (BMI) subgroup. Specificity at the 90% sensitivity level shown was at least 70% for all 3 groups. Data from the Breathing Not Properly Multinational Study; figure adapted from Daniels et al. (55).
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