What is Heart Failure?
Heart failure (HF) is a diagnosis made on clinical grounds, requiring at its simplest only a clinical history and physical examination findings, although, of course, certain investigations can help, especially imaging to assess left ventricular (LV) mechanical function. Unlike cancer, or even myocardial infarction (MI), there is no pathological or biochemical test that is either sufficient or necessary to diagnose HF. Natriuretic peptides (B-type natriuretic peptide [BNP] or N-terminal-proBNP) are the closest tests we have to fulfilling this role, and although multiple studies have used elevated NPs as a diagnostic threshold, a guide to therapy or as an inclusion criterion for clinical trial entry, none has become established as an essential diagnostic test for HF.