- Recommendation ID
- NG106/3
- Question
The impact of atrial fibrillation on the natriuretic peptide threshold for diagnosing heart failure:- What is the optimal NT-proBNP threshold for the diagnosis of heart failure in people with atrial fibrillation?
- Any explanatory notes
(if applicable) Why this is important:- Atrial fibrillation is a common arrhythmia in the general population, and occurs in 30 to 40% of people with heart failure. Atrial fibrillation can raise the level of serum natriuretic peptides, including NT-proBNP, even in the absence of heart failure. This is complicated further in heart failure with preserved ejection fraction, in which 2 echocardiographic diagnostic criteria become unreliable (the left atrial volume and the tissue doppler imaging assessment of diastolic function).
These factors contribute to the complexity of the diagnosis and have a potential impact on the usual thresholds for NT-proBNP in people who have atrial fibrillation. This has been recognised in several ongoing randomised controlled trials of heart failure, which are using higher NT-proBNP thresholds for the diagnosis of heart failure in people with atrial fibrillation.
Source guidance details
- Comes from guidance
- Chronic heart failure in adults: diagnosis and management
- Number
- NG106
- Date issued
- September 2018
Other details
| Is this a recommendation for the use of a technology only in the context of research? | No |
| Is it a recommendation that suggests collection of data or the establishment of a register? | No |
| Last Reviewed | 30/09/2018 |