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B-Type Natriuretic Peptides and Echocardiographic Measures of Cardiac Structure and Function

University Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand

^_* Reprint requests and correspondence: Dr. Richard W. Troughton, University Department of Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand (Email: richard.troughton{at}cdhb.govt.nz).

Echocardiography and the B-type natriuretic peptides (BNPs) provide powerful incremental assessment of cardiac function, clinical status, and outcome across the spectrum of cardiac disease. There is strong evidence to support their integrated use in the diagnosis and management of cardiovascular disease. Amino-terminal pro-B-type natriuretic peptide (NT-proBNP) or BNP may guide more effective use of echocardiography in screening for asymptomatic left ventricular dysfunction; Doppler echocardiography improves the accuracy of heart failure diagnosis in the setting of intermediate BNP or NT-proBNP levels. Combined assessment of peptides and echocardiography provides more powerful stratification of risk across all stages of heart failure, and integrated use of both tests may identify subjects with valvular disease at greatest risk for progression and guide decision-making for timely intervention.

Key Words: natriuretic peptides • echocardiography • left ventricular function • Doppler echocardiography

Abbreviations and Acronyms   aa = amino acid   ADHF = acute decompensated heart failure   BNP = B-type natriuretic peptide   E/Ea = transmitral early filling velocity/early diastolic annular velocity   LVEDP = left ventricular end diastolic pressure   LVEF = left ventricular ejection fraction   LVH = left ventricular hypertrophy   NT-proBNP = amino-terminal pro-B-type natriuretic peptide   PCWP = pulmonary capillary wedge pressure   RV = right ventricle