A REVIEW ON IMPORTANCE OF B-TYPE NATRIURETIC PEPTIDE IN DIAGNOSIS AND MANAGEMENT OF HEART FAILURE IN EMERGENCY DEPARTMENT
B. Parimala, B. Ragavendra Rao, Dr. Venkata Rohit Kumar Chandolu* and J. N. Suresh Kumar
ABSTRACT
Heart failure is the major and increasing cause of death and disability worldwide. Heart failure is often difficult to diagnose with the symptoms and physical findings. Identification of circulatory biomolecules that may provide new windows into the diagnosis and management of cardiovascular diseases. The natriuretic peptide plays an important role in diagnosis and management of heart diseases in present scenario. Misdiagnosis of congestive heart failure can be life threatening, because treatments for congestive heart failure are hazardous to patients with other conditions, such as chronic obstructive pulmonary disease. The natriuretic peptide consists of three peptides, the A type peptide (ANP: Released from atria), the B type peptide (BNP: Released from ventricles) and the C type peptide (CNP: released from endothelial cells). B-type natriuretic peptide is a neurohormone which is released directly from the ventricles in response to volume expansion and pressure overload. In patients with left ventricular dysfunction we can see the elevated levels of BNP. BNP levels are significantly higher in patients with dyspnea because of heart failure than from the cause. The B-type natriuretic peptide has very short half-life i.e. 22 min and thus reflects the current movement of ventricular overload. BNP is more accurate than the ejection fraction or ANP for predicting the diagnosis of congestive heart failure. BNP may distinguish the cardiac and non-cardiac causes of acute dyspnea in emergency department. To provide cost effective treatment for patients with congestive heart failure, rapid and accurate differentiation of congestive heart failure from another causes of dyspnea must be accomplished.
Keywords: Heart failure, Natriuretic peptides, Emergency department, Disability, Ejection fraction, Dyspnea.
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