From the Guidelines
You should consult a cardiologist if your BNP level is 137 pg/mL, as this value is mildly elevated and may indicate early heart failure or other cardiac issues that warrant medical attention. The elevation of BNP suggests that your heart is under some strain, as this hormone is released when the heart's chambers are stretched due to increased pressure or volume 1. According to the 2017 ACC/AHA/HFSA focused update, natriuretic peptide biomarker–based screening, such as BNP testing, can be useful in preventing the development of left ventricular dysfunction or new-onset heart failure in patients at risk 1.
Key Considerations
- BNP levels have been shown to parallel the clinical severity of heart failure, and elevated levels may indicate disease progression or worsening symptoms 1.
- The use of BNP measurements to guide the titration of drug doses has not been shown conclusively to improve outcomes more effectively than achievement of the target doses of drugs shown in clinical trials to prolong life 1.
- A BNP level of 137 pg/mL is mildly elevated, and further evaluation is necessary to determine the underlying cause and develop an appropriate treatment plan.
Next Steps
- Schedule an appointment with your doctor within the next few days for proper evaluation.
- In the meantime, monitor for symptoms like shortness of breath, swelling in your legs or ankles, fatigue, or chest discomfort.
- Limit sodium intake, maintain proper hydration without overhydrating, and avoid excessive physical exertion until you've been evaluated.
- Your doctor may order additional tests, such as an echocardiogram, to assess your heart function and determine the best course of treatment.
From the Research
BNP Levels and Cardiac Disease
- B-type natriuretic peptide (BNP) is elevated in states of increased ventricular wall stress, and is commonly used to rule out congestive heart failure (CHF) in dyspneic patients 2.
- A BNP level of 80 pg/mL is useful in diagnosing heart failure in symptomatic patients without a history of heart failure 3.
- BNP levels are influenced by age, gender, and body mass index (BMI), and can be elevated in a variety of clinical settings, including cardiac and non-cardiac diseases 2.
Diagnostic Utility of BNP
- BNP measurement is superior to two-dimensional echocardiographic determination of ejection fraction in identifying CHF, regardless of the threshold value 4.
- The sensitivity of BNP > or = 100 pg/mL for the diagnosis of CHF is 89%, and specificity is 73% 4.
- BNP levels correlate linearly with LV systolic dysfunction as well as with impaired degree of diastolic dysfunction 5.
BNP Levels and Consultation
- Given a BNP level of 137, it is likely that consultation of cards (cardiology) is warranted, as this level is above the threshold for diagnosing heart failure 3, 4.
- However, BNP levels should be interpreted in the context of individual patient comorbidities and clinical presentation, as they can be elevated in a variety of clinical settings 2, 6.