National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: clinical utilization of cardiac biomarker testing in heart failure.

I. Overview of Heart Failure. . . . . . . . . . . . . . . . . . . . . . .e99 A. Context of Biochemical Marker Testing in Heart Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e99 B. Background and Definition of Terms . . . . . . . . . .e100 C. B-type Natriuretic Peptide (BNP) and AminoTerminal proB-Type Natriuretic Peptide (NT-proBNP) Metabolism and Measurement . . . .e100 II. Use of Biochemical Markers in the Initial Evaluation of Heart Failure . . . . . . . . . . . . . . . . . . . .e101 A. Diagnosis of Heart Failure. . . . . . . . . . . . . . . . . . .e101 1. BNP and NT-proBNP for Diagnosis of Acute Decompensated Heart Failure . . . . . . . . . . . . . .e102 2. BNP or NT-proBNP for Confirmation of the Heart Failure Diagnosis. . . . . . . . . . . . . . . . . . .e103 B. Risk Stratification of Heart Failure . . . . . . . . . . . .e103 1. Risk stratification of Patients With and Without Heart Failure Using BNP or NT-proBNP . . . . . . . . . . . . . . . . . . . . . . . . . . . .e103 2. Risk Stratification of Patients With Heart Failure Using Cardiac Troponin . . . . . . . . . . . .e104 III. Use of Biochemical Markers in Screening for Cardiac Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . .e104 A. BNP or NT-proBNP for Screening Heart Failure and Dysfunction . . . . . . . . . . . . . . . . . . .e104 B. Approaches for Screening for Cardiac Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e104 IV. Use of Biochemical Markers in Guiding Management of Heart Failure. . . . . . . . . . . . . . . . . .e105 A. Monitoring Therapy Using BNP or NT-proBNP Guidance. . . . . . . . . . . . . . . . . . . . .e105 V. References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e105