Usefulness of brain natriuretic peptide and N-terminal pro-brain natriuretic peptide in the elderly

B-type natriuretic peptide and N-terminal pro-brain natriuretic peptide are biomarkers secreted both in response to myocardial stretch and increased ventricular wall stress. They are now largely used in cardiovascular disease in adults, especially as diagnostic and prognostic tools. This article aims at synthesizing existing data concerning the usefulness of natriuretic peptides in elderly patients. With aging, co-morbidities such as renal failure are common and lead to an increase in circulating concentrations of natriuretic peptides. Nevertheless, their usefulness is relevant in geriatric practice. Their role has been well established in heart failure, not only in diagnosis, using two thresholds to decrease misclassification, but also in prognosis. In the future, natriuretic peptides could be used as prognosis tools in acute coronary syndrome, in cardiovascular risk assessment or in management of heart valve disease. However, further investigations in elderly people are needed before validating these indications in routine geriatric practice. (C) 2008 Elsevier Masson SAS. All rights reserved.