Elevated values in preeclampsia: diagnostic and prognostic role of NT-proBNP and ANP

The aim of this review is to summarize the current understanding of the cardiac dimension of preeclampsia as reflected in the PubMed database, and to provide a perspective on how NT-proBNP and ANP may play a role in the future management of this challenging condition. Preeclampsia is a condition characterized by hypertension that typically develops after the 20th week of gestation. The most widely accepted model explaining the underlying pathology posits that disease progression involves two stages: placental insufficiency in the first stage and a maternal systemic response in the second. In the complex pathogenesis of preeclampsia, impaired cardiovascular adaptation and the resulting myocardial stress have been increasingly recognized as critical components. In this context, N-terminal pro–brain natriuretic peptide (NT-proBNP) and atrial natriuretic peptide (ANP)—biological indicators of cardiomyocyte stress and hemodynamic load—warrant careful investigation for their potential clinical applications. Data were analyzed from studies indexed in the PubMed database that compared the cardiac biomarkers NT-proBNP and ANP, examined their roles, and reported related outcomes in the context of preeclampsia. NT-proBNP primarily serves as a marker of increased ventricular afterload, whereas ANP is more indicative of diastolic dysfunction and atrial stretch. The observation that both biomarkers are significantly elevated in patients with preeclampsia, correlate with disease severity, and have the potential to predict adverse maternal outcomes underscores their clinical relevance in this condition. Multiple studies have demonstrated that both NT-proBNP and ANP levels are significantly elevated in preeclamptic pregnancies compared with healthy normotensive controls.