Heart failure & cardiomyopathiesResearch article
Cardiac biomarkers response under angiotensin receptor–neprilysin inhibitor: a sub-analysis of the NATRIUM-HF study
- sub-analysis of the NATRIUM-HF study
Authors' conclusion
In a controlled acute volume overload setting, BNP and NT-proBNP provide comparable information, but their short-term dynamics lag behind clinical decongestion. Routine serial NP measurements at very short time intervals are unlikely to add incremental clinical value in the early phase of acute HF.
Study context
- Population
- Ambulatory patients with heart failure (HF) with reduced ejection fraction receiving guideline-directed medical therapy who initiated S/Vambulatory patients with HFrEF who initiated S/V
- Participants
- 229 patients
- Comparison
- before and after S/V initiation
Main finding
As reported in the abstract
BNP and NT-proBNP concentrations across visits · after 2 and 3 months of treatment
BNP lower with S/V initiation
−8%, P = .009
NT-proBNP lower with S/V initiation
−35%, P < .001
Further findings
BNP and NT-proBNP during the acute protocol · 9-hour protocol
- BNP and NT-proBNP increased significantly over time (timepoint effect)
- P < 0.001
- visit-by-time interaction for BNP
- P = 0.17
- visit-by-time interaction for NT-proBNP
- P = 0.95
- BNP and NT-proBNP continued to rise during the 9-hour observation period despite marked natriuresis and improvement in clinical signs
- parallel trajectories before and after S/V initiation
Original publication
Cardiac biomarkers response under angiotensin receptor–neprilysin inhibitor: a sub-analysis of the NATRIUM-HF study. ESC Heart Fail. Published 16 March 2026. doi:10.1093/eschf/xvag075
Summarised from the published abstract; every number is checked against it