Can increased BNP levels cause dyspnea and edema?

Question

Hello doctor,

I am a 49-year-old female who has been pacemaker-dependent for several years due to cardiomyopathy, with an ejection fraction (EF) of 30 percent, BNP (brain natriuretic peptide) of 186 pg/mL, and a cardiac event that resulted in elevated troponin levels. Eventually, I was switched to a biventricular pacemaker or defibrillator. I had an echo last week (three months post-implant) and was pleased to hear that my EF is now 50 percent. However, I continue to experience edema and dyspnea frequently, and my BNP has increased to 490 pg/mL. Can you help me understand what this means?

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Although your ejection fraction is now 50 percent, your BNP (brain natriuretic peptide) level is elevated, which explains the edema and dyspnea you are experiencing. An increased BNP indicates higher fluid retention and pressure in your heart, leading to these symptoms. This suggests that you are still dealing with heart failure. It is very positive that your pacemaker was upgraded to a biventricular device. In my practice, we often use a more aggressive combination of beta-blockers and ACE (angiotensin-converting enzyme) inhibitors in similar cases.

I sincerely wish you a swift recovery.

Best regards.

Answer 2

Hello,

Welcome back to icliniq.com.

This will depend on different factors like if you have arrhythmias, the response to current treatment, etc. Normally the higher the BNP, the higher the chance of sudden cardiac death but, a bi-ventricular pacemaker helps reduce that chance. So, the prognosis can be determined only by a combination of various factors.

Best regards.