Brain natriuretic peptide for cardiovascular events independent of left ventricular end-diastolic pressure

I read the recent publication by Rogers et al1 with great interest. Rogers et al assessed the prognostic value of brain natriuretic peptide (BNP) for cardiovascular events independent of left ventricular end-diastolic pressure (LVEDP) and reached the conclusion that plasma BNP level was not a is not just a prognostic surrogate for elevated LV filling pressure.1 Indeed, the clinical value of plasma BNP relating to LV function is still a topic to be studied. Recently, Oyamada et al2 reported that plasma BNP value did not have a significant association with the LVEDP. Oyamada et al showed that tissue Doppler imaging combined with pulsed-wave Doppler echocardiography has a better clinical usefulness.2 Indeed, the BNP has no underlying biological process relating to LVEDP. Nevertheless, the use of BNP has its limitation in laboratory concern due to the problem of false positive that can be the result of both preanalytical and analytical interferences in the laboratory process.3