A test in context: Critical evaluation of natriuretic peptide testing in heart failure

Gary S. Francis, G. Michael Felker, W. H Wilson Tang

Research output: Contribution to journalReview articlepeer-review

41 Scopus citations


Circulating natriuretic peptide measurements have been used extensively over the past 15 years to diagnose and monitor patients with heart failure. We are still learning how complex the dynamics of natriuretic peptides can be in the interpretation of test results in individual patients. Although natriuretic peptide measurements are widely used in practice, there are questions regarding why these peptides may not necessarily track with blood volume or invasive hemodynamic measurements in individual patients. Interpretation of natriuretic peptide measurements will depend on many factors, including special patient populations, obesity, renal function, the state of congestion or decongestion, and whether patients are receiving specific therapies. Natriuretic peptide measurements have clearly revolutionized clinical care for patients with heart failure, but further research should provide insights to help use these measurements to individualize patient care beyond the current guidelines.

Original languageEnglish (US)
Pages (from-to)330-337
Number of pages8
JournalJournal of the American College of Cardiology
Issue number3
StatePublished - Jan 26 2016

Bibliographical note

Funding Information:
Dr. Felker (R01HL105448) and Dr. Tang (RO1HL103931) are supported by grants from the National Institutes of Health (NIH) related to this topic. Dr. Francis has served as a member of the Data and Safety Monitoring Boards of GUIDE-IT; National Heart, Lung, and Blood Institute (NIH), and the LCZ Program (Novartis); and has served as a consultant to Amgen. Dr. Felker received research grant support from NIH as well as Roche Diagnostics (related to natriuretic peptide–guided therapy). Dr. Tang has reported that he has no relationships relevant to the contents of this paper to disclose.

Publisher Copyright:
© 2016 American College of Cardiology Foundation.


  • BNP
  • NT-proBNP
  • biological markers
  • neprilysin


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