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This book has been produced based on original research findings. The levels of natriuretic peptides have a direct relation with severity of left ventricular dilatation and thus with severity of heart failure which is otherwise assessed by echocardiography. The objective of this research was to assess the level of NT-ProBNP in patients with different grades of heart failure and compare it with Left Ventricular Ejection Fraction obtained on echocardiography. brain natriuretic peptide (BNP), a biologically active peptide, has become a potential diagnostic aid to identify patients with elevated ventricular filling pressure who are likely to exhibit signs and symptoms of heart failure. It is released from cardiac myocytes in response to increased stretch resulting from cardiac dilatation or hypertrophy as occurs in heart failure. BNP is cleaved from proBNP alongwith the hormonally inactive peptide NT-ProBNP. BNP acts to reduce the adverse stimulus of stretch by causing both arterial and veno-dilatation and reduction in blood volume through natriuresis, and suppression of secretion of renin and aldosterone. NT-ProBNP is biologically inactive and its measurement has an advantage over BNP due to its longer half life and wider dynamic range. Elevation of BNP and NTproBNP indicates left ventricular systolic dysfunction or diastolic dysfunction associated with elevated wall stress, or myocardial hypertrophy. Postgraduate Medical Complex, Lahore, Pakistan & Faculty of Medicine and Health Sciences, Universti Sultan Zainal Abidin, Malaysia.

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