Nikhil Prasad Fact checked by:Thailand Medical News Team Jul 06, 2026 58 minutes ago
Medical News: Common Heart Biomarkers Are Proving Valuable Beyond Heart Failure
A growing body of research suggests that natriuretic peptides—blood markers traditionally used to diagnose heart failure—could become important tools in intensive care units (ICUs). A new narrative review found that these biomarkers not only help assess stress on the heart but also provide valuable information about critically ill patients suffering from conditions such as sepsis, acute respiratory distress syndrome (ARDS), shock, kidney injury, pulmonary embolism, and severe COVID-19.
A new review finds natriuretic peptides are becoming valuable tools for diagnosing, monitoring, and predicting outcomes in
critically ill ICU patients
The review was conducted by researchers from the Department of Internal Medicine at Augusta University, Georgia, McMaster University in Ontario, Canada, AbbVie in North Chicago, Illinois, and Phoebe Health in Albany, Georgia.
Looking Beyond Heart Failure
Natriuretic peptides include B-type natriuretic peptide (BNP) and its inactive companion molecule, N-terminal pro-B-type natriuretic peptide (NT-proBNP). These substances are released by the heart whenever its muscle is stretched or placed under increased pressure. While doctors have relied on these tests for years to diagnose and monitor heart failure, researchers now believe they have a much broader role in the care of critically ill patients.
After reviewing 24 published studies involving adult ICU patients, the researchers found consistent evidence that BNP and NT-proBNP can assist doctors in identifying hidden cardiac stress, estimating the severity of illness, monitoring changes in a patient's condition, and predicting the likelihood of serious complications.
Helping Doctors Solve Difficult ICU Cases
Patients admitted to intensive care often develop multiple organ problems simultaneously, making diagnosis extremely challenging. The review found that natriuretic peptide measurements can help doctors distinguish between breathing difficulties caused by heart dysfunction and those caused by severe lung disease or inflammation.
The biomarkers also provide useful information when evaluating patients with different forms of shock, including septic shock and cardiogenic shock. When interpreted alongside echocardiography, lung ultrasound, and other bedside assessments, these blood tests help physicians better understand whether the heart is struggling, whether excess fluid is accumulating, and how aggressively treatment should be adjusted.
Importantly, the researchers emphasize that natriuretic peptides should never replace careful clinical assessment. Instead, they are most valuable as part of a comprehensive evaluation using imaging studies, physical examination, and other laboratory tests.
High Levels Often Signal Greater Risk
One of the review's most important findings was the strong relationship between elevated natriuretic peptide levels and poor clinical outcomes.
Across multiple studies, patients with higher BNP or NT-proBNP concentrati
ons were more likely to develop acute kidney injury, require prolonged mechanical ventilation, remain in the ICU longer, and face an increased risk of death. Similar associations were reported in patients with sepsis, ARDS, postoperative cardiac complications, pulmonary embolism, and severe COVID-19.
The researchers also noted that repeated measurements may provide more useful information than a single test. Falling BNP levels may indicate that treatment is reducing stress on the heart, while persistently elevated or rising levels can suggest ongoing cardiovascular strain or worsening illness.
In this
Medical News report, it is important to note that BNP and NT-proBNP are not disease-specific markers. Numerous conditions common in intensive care—including kidney dysfunction, advanced age, systemic inflammation, mechanical ventilation, right-sided heart strain, and even obesity—can influence their levels. This means doctors must always interpret test results within the broader clinical picture rather than relying on a single laboratory value.
Future of ICU Monitoring
The review also highlights several emerging biomarkers—including soluble ST2, galectin-3, high-sensitivity troponin, cardiotrophin-1, mid-regional pro-adrenomedullin, adrenomedullin, renin, and dipeptidyl peptidase-3—that may eventually complement natriuretic peptides. Researchers believe combining multiple biomarkers with bedside ultrasound could significantly improve the early detection of cardiovascular stress and help personalize treatment strategies for critically ill patients.
Conclusion
The review demonstrates that natriuretic peptides have evolved far beyond their traditional use in diagnosing heart failure. When combined with imaging, hemodynamic monitoring, and careful clinical assessment, BNP and NT-proBNP can help physicians identify hidden cardiac dysfunction, assess disease severity, monitor treatment response, and predict outcomes in a wide variety of critical illnesses. However, the authors stress that these biomarkers should be viewed as valuable decision-support tools rather than standalone diagnostic tests. They also emphasize the need for future large multicenter studies to establish ICU-specific diagnostic thresholds and determine whether biomarker-guided treatment strategies can further improve patient management and outcomes.
The study findings were published in the peer reviewed Journal of Clinical Medicine.
https://www.mdpi.com/2077-0383/15/13/5244
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https://www.thailandmedical.news/news/predicting-heart-failure-outcomes-with-biomarkers
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