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The Impact Of Blood Tests On Heart Failure Management

Heart failure affects millions of patients and is a life-threatening condition with poor quality of life, hospitalization burden, and premature death. Based only on history and clinical evaluation only, diagnosis is challenging as symptoms are often difficult to interpret. Up to 50% of patients may be misdiagnosed, and this leads to adverse effects such as inadequate care and high costs to health care for the patient. Hence, additional tests and an accurate diagnosis is required to confirm the initial diagnosis and ensure the best management of patients. [1]

Diagnosis Of Heart Failure[2]

After assessing the patient’s medical history, the first step toward diagnosis starts. This includes electrocardiogram (ECG), a biomarker (blood test) for natriuretic peptides, and echocardiography to determine any structural and functional impairment of the heart (changes in heartbeat rhythm, pumping capacity, wall stress and thickness of the wall). Interpreting the findings of those tests helps to validate or exclude the diagnosis of heart failure.

Biomarkers: A test that objectively measures and evaluates normal biological processes, pathogenic processes, or pharmacologic responses to therapeutic intervention, in blood. 

Natriuretic peptides: Natriuretic peptides are hormones that are made by the heart when its wall is stretched.

NT-proBNP: N-terminal pro B type natriuretic peptide.

Natriuretic Peptides’ Role In Diagnosing Heart Failure[3]

For an additional and objective result in heart failure diagnosis and management, natriuretic peptides such as NT-proBNP are ideal. For example, in patients with suspected heart failure symptoms, NT-proBNP is released into the blood and can help to distinguish cardiac causes from non-cardiac causes, such as shortness of breath.

Testing natriuretic peptides, such as NT-proBNP, can help in the following situations:

  1. It assists in the diagnosis during an emergency, assesses the severity of the condition and the risk of adverse events. This can help doctors to decide whether to admit or discharge patients from the hospital.
  2. This test will assist in determining whether to refer a patient to the cardiologist for further review at the general practitioner’s office.
  3. In the longer term, this testing at the office of the cardiologist, or general practitioner, helps doctors monitor the progression of the disease and work on long-term heart failure management.
  4. If a patient has higher NT-proBNP levels beyond a certain threshold level in their blood, it will help the doctor in the diagnosis of heart failure.
  5. If a patient experiences high levels of NT-proBNP in his or her blood over the long term and regardless of medication taken, then the prognosis (clinical outlook) is impaired. Moreover, NT-proBNP can be used over time to track heart failure and to assess which patients are stable or progressing and which are declining and are at high risk of hospitalization or death.

Having a complete clinical picture with the right objective information helps doctors to make the best decisions to support patients in treating heart failure.

References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5494150/
  2. https://www.mayoclinic.org/diseases-conditions/heart-failure/diagnosis-treatment/drc-20373148
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600257/
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