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The Scientific World Journal
Volume 2013, Article ID 784670, 10 pages
http://dx.doi.org/10.1155/2013/784670
Review Article

The Role of Natriuretic Peptides for the Diagnosis of Left Ventricular Dysfunction

Department of Internal Medicine and Metabolic Diseases, Cardiology Section, Le Scotte Hospital, 53100 Siena, Italy

Received 17 June 2013; Accepted 20 August 2013

Academic Editors: X. Ai, Y. Wang, and Y. Yang

Copyright © 2013 Alberto Palazzuoli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Natriuretic peptides (NPs) are entered in current guidelines for heart failure (HF) diagnosis and management because of their high specificity and sensibility in screening patients with acute dyspnea. Due to their availability and relatively low cost, they became the first step examinations in HF patients evaluation at hospital admission together with clinical and chest radiography examination. NPs are released following any cardiac haemodynamic stress due to volume or pressure overload and should be considered as a mirror of cardiac condition helping in recognizing patients with poor outcome. Moreover, the exact role of NPs in early HF stages, in isolated diastolic dysfunction, and in general population is questioned. Several promising reports described their potential role; however, the wide cut-off definition, inclusion criteria, and intrinsic measurement biases do not actually consent to their clinical application in these settings. A multimodality strategy including both NPs and imaging studies appears to be the best strategy to define the cardiac dysfunction etiology and its severity as well as to identify patients with higher risk. In this review, we describe the current and potential role of NPs in patients with asymptomatic cardiac insufficiency, evaluating the requirement to obtain a better standardization for imaging as for laboratory criteria.