Practical algorithms for early diagnosis of heart failure and heart stress using NT-proBNP: A clinical consensus statement from the Heart Failure Association of the ESC

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  • Antoni Bayes-Genis
  • Kieran F. Docherty
  • Mark C. Petrie
  • James L. Januzzi
  • Christian Mueller
  • Lisa Anderson
  • Biykem Bozkurt
  • Javed Butler
  • Ovidiu Chioncel
  • John G.F. Cleland
  • Ruxandra Christodorescu
  • Stefano Del Prato
  • Carolyn S.P. Lam
  • Brenda Moura
  • Rodica Pop-Busui
  • Petar Seferovic
  • Maurizio Volterrani
  • Muthiah Vaduganathan
  • Marco Metra
  • Giuseppe Rosano

Diagnosing heart failure is often difficult due to the non-specific nature of symptoms, which can be caused by a range of medical conditions. Natriuretic peptides (NPs) have been recognized as important biomarkers for diagnosing heart failure. This document from the Heart Failure Association examines the practical uses of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in various clinical scenarios. The concentrations of NT-proBNP vary according to the patient profile and the clinical scenario, therefore values should be interpreted with caution to ensure appropriate diagnosis. Validated cut-points are provided to rule in or rule out acute heart failure in the emergency department and to diagnose de novo heart failure in the outpatient setting. We also coin the concept of ‘heart stress’ when NT-proBNP levels are elevated in an asymptomatic patient with risk factors for heart failure (i.e. diabetes, hypertension, coronary artery disease), underlying the development of cardiac dysfunction and further increased risk. We propose a simple acronym for healthcare professionals and patients, FIND-HF, which serves as a prompt to consider heart failure: Fatigue, Increased water accumulation, Natriuretic peptide testing, and Dyspnoea. Use of this acronym would enable the early diagnosis of heart failure. Overall, understanding and utilizing NT-proBNP levels will lead to earlier and more accurate diagnoses of heart failure ultimately improving patient outcomes and reducing healthcare costs.

Original languageEnglish
JournalEuropean Journal of Heart Failure
Volume25
Issue number11
Pages (from-to)1891-1898
Number of pages8
ISSN1388-9842
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 European Society of Cardiology.

    Research areas

  • Heart failure, Natriuretic peptides, NT-proBNP

ID: 379160361