Table 5. Selected Causes of Elevated Natriuretic Peptide
Concentrations
Cardiac
• HF, including RV syndromes
• ACS
• Heart muscle disease, including LVH
• Valvular heart disease
• Pericardial disease
• AF
• Myocarditis
• Cardiac surgery
• Cardioversion
Noncardiac
• Advancing age
• Anemia
• Renal failure
• Pulmonary causes: obstructive sleep
apnea, severe pneumonia, pulmonary
hypertension
• Critical illness
• Bacterial sepsis
• Severe burns
• Toxic-metabolic insults, including
cancer chemotherapy and
envenomation
Table 6. Recommendations for Biomarkers in HF
Biomarker, Application
Setting
COR
LOE
I
A
I
A
Natriuretic Peptides
Diagnosis or exclusion of HF
Ambulatory, acute
Prognosis of HF
Ambulatory, acute
Achieve GDMT
Ambulatory
IIa
B
Guidance for acute decompensated HF
therapy
Acute
IIb
C
I
A
Biomarkers of Myocardial Injury
Additive risk stratification
Acute, ambulatory
Biomarkers of Myocardial Fibrosis
Additive risk stratification
Ambulatory
IIb
B
Acute
IIb
A
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