The natriuretic peptides BNP and NT-proBNP are synthesized and released dependent of wall tension in the atria and ventricles. The determination of these peptides in a rapid test makes two markers available that closely correlate with the severity of heart failure. Systolic as well as diastolic left ventricular dysfunction are recorded, but a clear differentiation cannot be made by marker determination. Particularly important is the high negative predictive value and the certainty with which heart failure can be excluded when the plasma level is normal. Besides the diagnostic assistance, natriuretic peptides have a high and above all independent value to assess the prognosis of heart failure, acute coronary syndromes and partially of atrial fibrillation. It is possibile to optimize the therapy of heart failure according to the plasma level.
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