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.

Diagnosing heart failure is often difficult due to the nonspecific nature of the 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 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 out-patient setting. We also coin the concept of "heart stress" when NT-proBNP levels are elevated in a asymptomatic patients with risk factors for heart failure (i.e diabetes, hypertension, CAD); 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 HF ultimately improving patient outcomes and reducing healthcare costs. This article is protected by copyright. All rights reserved.