Awareness, access, and adoption of natriuretic peptides for diagnosis of heart failure

Bayes-Genis A. Petrie M.C. Moura B. Chioncel O. Volterrani M. Adamo M. Rakisheva A. Savarese G. Tocchetti C.G. Metra M. Rosano G.
February 2025 John Wiley and Sons Inc

ESC Heart Failure
2025 #12 Issue 1 54 - 59 pp.

Aims: This survey investigates natriuretic peptide (NP) testing in community and hospital settings, assessing awareness, accessibility, and utilization. Methods and results: This investigator-initiated survey, conceived within the HFA of the European Society of Cardiology, comprised 14 questions. It underwent validation and pilot testing to ensure question readability and online system functionality. The survey was accessible for 87 days, from 5 April 2023 to 1 July 2023 via a web platform. There were 751 healthcare professionals across 99 countries who responded. Of them, 92.5% had access to NPs testing in hospital whereas 34.3% had no access to NTproBNP in community settings. Access to point of care NP testing was uncommon (9.6%). Public insurance fully covered NPs testing in 31.0% of cases, with private insurance providing coverage in 37.9%. The majority (84.0%) of participants believed that the medical evidence supporting NPs testing was strong, and 54.7% considered it cost-effective. Also, 35.8% found access, awareness, and adoption to be in favour of NPs testing both in hospital and community settings. Strategies to optimize NP testing involved regular guideline updates (57.9%), prioritizing NPs testing for dyspnoea assessment (36.4%), and introducing clinician feedback mechanisms (21.2%). Notably, 40% lacked a community-based HF diagnostic pathway for referring high-NP patients for echocardiography and cardiology evaluation. Conclusions: This survey reveals NP awareness, access, and adoption across several countries. Highlighting the importance of community-based early heart failure diagnosis and optimizing HF diagnostic pathways remains a crucial, unmet opportunity to improve patient outcomes.

Access , Adoption , Awareness , Natriuretic peptides , Primary care

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Heart Institute, Hospital Unbiversitari Germasn Trias i Pujol, Universitat Autonoma de Barcelona, CIBERCV, Carretera del Canyet s/n 08916, Badalona, Spain
School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
Armed Forces Hospital, Faculty of Medicine, University of Porto, Porto, Portugal
Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’, Bucharest, Romania
University of Medicine Carol Davila, Bucharest, Romania
Cardio Pulmonary Department, IRCCS San Raffaele, Rome, Italy
Exercise Science and Medicine, San Raffaele Open University, Rome, Italy
Cardiology and Cardiac Catheterization Laboratory, Cardio-Thoracic Department, Civil Hospitals, Brescia, Italy
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
Department of Cardiology, Scientific Institution of Cardiology and Internal Diseases, Almaty, Kazakhstan
Department of Medicine, Karolinska Institutet, and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden
Cardio-Oncology Unit, Department of Translational Medical Sciences (DISMET), Center for Basic and Clinical Immunology Research (CISI), Interdepartmental Center of Clinical and Translational Sciences (CIRCET), Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Naples, Italy
IRCCS San Raffaele, Rome, Italy

Heart Institute
School of Cardiovascular and Metabolic Health
Armed Forces Hospital
Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’
University of Medicine Carol Davila
Cardio Pulmonary Department
Exercise Science and Medicine
Cardiology and Cardiac Catheterization Laboratory
Department of Medical and Surgical Specialties
Department of Cardiology
Department of Medicine
Cardio-Oncology Unit
IRCCS San Raffaele

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