The natriuretic peptides in cardiovascular medicine

Curr Probl Cardiol. 2004 Dec;29(12):707-69. doi: 10.1016/j.cpcardiol.2004.07.002.


Within the last five years, assay systems for measurement of plasma levels of brain natriuretic peptide (BNP) have been approved as a diagnostic aid for heart failure (HF). Similarly, nesiritide, a recombinant form of human BNP, has been approved for the treatment of acutely decompensated HF. Both BNP as a diagnostic test and a therapeutic modality are rapidly becoming integrated into clinical practice. The purpose of this review is to provide a brief overview of the physiology of the natriuretic peptides relevant to their informed clinical use. The current literature regarding the utility of measuring BNP for the diagnosis and management of HF is reviewed and practical recommendations regarding the interpretation of BNP levels are offered. The clinical literature regarding the use of recombinant BNP for the treatment of HF is reviewed, underscoring current gaps in our knowledge regarding the indications for and benefits of this novel agent.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Atrial Natriuretic Factor / physiology
  • Cardiomegaly / physiopathology
  • Diuresis / physiology
  • Heart Failure / diagnosis*
  • Heart Failure / drug therapy*
  • Heart Failure / mortality
  • Humans
  • Kidney / drug effects
  • Myocardial Infarction / blood
  • Natriuresis / physiology
  • Natriuretic Agents* / blood
  • Natriuretic Agents* / pharmacology
  • Natriuretic Agents* / physiology
  • Natriuretic Agents* / therapeutic use
  • Natriuretic Peptide, Brain* / blood
  • Natriuretic Peptide, Brain* / pharmacology
  • Natriuretic Peptide, Brain* / physiology
  • Natriuretic Peptide, Brain* / therapeutic use
  • Natriuretic Peptide, C-Type / physiology
  • ROC Curve
  • Survival Analysis
  • Treatment Outcome
  • Vasodilation / physiology
  • Ventricular Remodeling


  • Natriuretic Agents
  • Natriuretic Peptide, Brain
  • Natriuretic Peptide, C-Type
  • Atrial Natriuretic Factor