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European Heart Journal Advance Access originally published online on June 14, 2007
European Heart Journal 2007 28(14):1678-1682; doi:10.1093/eurheartj/ehm234
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

The potential to improve primary prevention in the future by using BNP/N-BNP as an indicator of silent ‘pancardiac’ target organ damage

BNP/N-BNP could become for the heart what microalbuminuria is for the kidney

Allan Struthers* and Chim Lang

Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK

Received 8 March 2007; revised 4 May 2007; accepted 10 May 2007; online publish-ahead-of-print 14 June 2007.

* Corresponding author. Tel: +44 1382 632180; fax: +44 1382 644972. E-mail address: a.d.struthers{at}dundee.ac.uk

Brain natriuretic peptide (BNP) or N-terminal pro-BNP (N-BNP) now appears to be the best independent predictor of cardiovascular mortality over and above the conventional ones like blood pressure. This may be because a high BNP/N-BNP is identifying any form of asymptomatic cardiac target organ damage (TOD) [especially silent ischaemia, left ventricular hypertrophy (LVH), left atrial dilatation/atrial fibrillation (LAD/AF) and LV systolic dysfunction (LVSD)]. There are strong hints that BNP/N-BNP will also identify those who are going to develop LVH, LAD/AF, and LVSD in a few years' time. Thus, the prospects are good that BNP/N-BNP could be used to identify ‘pancardiac’ TOD, even when it is silent and that this information could be ‘harnessed’ to improve primary prevention. BNP/N-BNP could become to the heart what microalbuminuria is to the kidneys, i.e. an indicator of early, silent TOD.

Key Words: Hypertension • Hypertrophy • Coronary circulation • Echocardiography • Other diagnostic testing • Heart failure • Congestive


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