• atrial fibrillation

The burden of heart failure (HF) has long been recognised by the medical community; politics and population in general now begin to be aware of this major public health issue. One of the challenges when dealing with HF is the clear identification of patients with the condition. The detection of such patients is crucial since we have several interventions that can change the trajectory of the disease and lead to better survival and quality of life.

HF suspicion is based on typical signs and symptoms that are easily recognised by clinicians. Current recommendations strongly suggest that these patients perform basic tests (12-lead ECG; natriuretic peptide measurement) in order to exclude HF as the underlying cause of such clinical findings.

There is now robust and extensive evidence that natriuretic peptides can help clinicians in the diagnosis of acute HF. Even when physicians are uncertain on the mechanism of acute dyspnoea (pulmonary vs cardiac), the knowledge of natriuretic peptide levels gives crucial information. In ambulatory patients, the evidence is not so strong. There are a number of individual characteristics (gender, weight and age), comorbid conditions and medications that can affect the performance of natriuretic peptides in ambulatory patients with suspected HF. The value of natriuretic peptides in the diagnosis of HF has been established in patients with both preserved ejection …