[The circulating NTproBNP level, a new biomarker for the diagnosis of heart failure in patients with acute shortness of breath].

22 Heart failure, which is now the main cause of inhospital death among patients over 65 years of age, is the only cardiovascular disease for which the rates of incidence and prevalence are increasing.1 In addition, it is the most costly cardiovascular disease in the industrialized world. Despite recent therapeutic advances, the prognosis of heart failure is poor, and patients suffer multiple recurrences and re-admissions to hospital. The ability to determine of levels of natriuretic peptides—biological indicators of the degree of stress to which the myocardium is subject—is a step forward in the management of these patients. Currently, the diagnosis of acute heart failure is based on patient clinical history, a physical examination, and the results of complementary tests (mainly echocardiography). However, some 25%-50% of patients that seek help at the emergency room for decompensated heart failure are initially diagnosed incorrectly; unfortunately, echocardiography is not always available in emergency rooms in Spain. New diagnostic tests are therefore required that help to confirm ventricular dysfunction in patients with dyspnea of uncertain origin. The rapid, correct diagnosis of heart failure allows the immediate start of intensive therapy, improving patient prognosis and reducing costs. As well as modulating the neurohormonal response seen in heart failure, the B-type natriuretic peptides could be diagnostically and prognostically useful biomarkers.2 The initial studies in this area investigated the usefulness of B-type natriuretic peptide (BNP), but more recent work has shown that the aminoterminal ED I TO R I A L S