In recent years there has been growing interest in the development of new
diagnostic tools and particularly in laboratory tests for the identification of
heart failure (HF) patients. Because of the rise in HF occurrence, it is
necessary to use simple and reliable method to recognize those patients at risk
before the onset of the clinical symptoms. To date HF diagnosis remains
difficult: its symptoms and signs are often non specific as well as being poor
sensitive indicators for HF severity. Throughout the last 10 years published
literature has highlighted a boom in the use of biomarkers for HF. Both B-type
and N-terminal pro-B-type natriuretic peptides have demonstrated specific role in
heart failure diagnosis, as well as risk assessment. A single determination of
BNP at any time during the development of chronic heart failure (CHF) provides a
clinically useful tool to establish the outcome. Renal dysfunction is often
associated with heart failure and predicts adverse clinical outcomes. Many
studies have recently suggested the clinical use of serum neutrophil
gelatinase-associated lipocalin (NGAL) levels in patients admitted to the
hospital for acute HF can be used to estimate the risk of early worsening renal
function. This could be potentially applied in clinical practice for early
identification of renal dysfunction development in patients with HF. NGAL levels
appear also to predict renal dysfunction in patients with chronic HF and
preserved renal function. For all these reasons, BNP and NGAL are two emerging
tools useful for diagnosis and prognosis in HF. The combination of two laboratory
biomarkers could potentially identify patients with more elevated risks of both
cardiac hemodynamic impairment and kidney dysfunction
