BNP 1800

[Mightnot]

I have atrial fibrillation and my BNP tests that indicate risk of heart failure was 800 and is now 1700. The stats I have looked at are grim eg 80+% chance of death within 10 years and 50% for 5 years ( at around 2000 BNP near my numbers). Does anyone know if there is a treatment to lower BNP to under 300 the safe limit or is there a surgical/medicinal treatment that could be used? thanks M

[CDreamer]

it’s the heart failure which needs to be treated. What is your treatment plan? Do you know the cause of your heart failure?

My husband was in HF in 2017-18, AF was treated and his QOL improved over the following few years. At 90 still fit and active.

I would suggest you stop reading the stats and getting anxious and start questioning your doctors as to treatment plan and prognosis.

Stats are simply numbers and what you don’t know in those stats are the huge numbers of variables such as the number who smoke, drink alcohol, don’t exercise etc etc.

First - Look after your body and it will look after you.

[Mightnot in reply to CDreamer]

thanks - agreed - but getting medical help on nhs is a worry. NHS website says with my numbers of BNP I need to see someone within 2 weeks but in my experience the wait time can be months. The referral went to the hospital today.

[Mightnot in reply to Mightnot]

I could go private but that is for the consultation only as the treatment etc could be too expensive privately.

[CDreamer in reply to Mightnot]

Agreed but what many of us have found is that purely having that consultation helps because you have information. You can have a consultation and then ask to be treated on NHS list as long as the doctor you see is a consultant in the NHS and also has a private practice. It’s worth investigating IF you are told it will be months. If you are considered a priority or you symptoms worsen you will be seen quickly, least that’s my experience with friends who have similar.

Uncertainty brings a sense of insecurity which sends anxiety through the roof so getting some certainty back really does help, once you have a plan to work to.

Good luck.

[Desanthony in reply to Mightnot]

If you can go privately for the consultation then do as the Dr/consultant you see will be able to put you on to his NHS list higher up the list as you are no longer waiting for your first consultation with them and you would have the treatment on the NHS.

[Mightnot in reply to Desanthony]

thanks for the reply - I will see one but the soonest is a couple of weeks so far and I might know when the nhs appointment is. Once I saw a private cardiologist and then the appointment for the nhs one came a few weeks later and the same for a scan so I could have saved money so that is a factor.

[Buffafly in reply to Mightnot]

If you really need urgent treatment you’ll get it in a reasonable time - that’s my experience. I asked to see a dermatologist privately because I didn’t want to wait but my GP suggested I go for an NHS referral. Had a call today for an appointment in two weeks. I’d wait to see if an appointment comes through I think.

[Desanthony in reply to Mightnot]

Yes I know love it when it works like that. If its an urgent appointment you should get it through within a few weeks anyway. We have found that some of the private hospitals around here have at least a month if not 2 months wait but others you can get an appointment this week - which I have just done!

[Ppiman in reply to CDreamer]

Excellent advice. Heart failure is likely what we all fear and yet two people I know with it are doing surprisingly well.

I guess that most HF is in the elderly population, too, who often have other comorbidity, thus making it difficult to know just what was the final cause of their demise.

Steve

[Mightnot in reply to Ppiman]

I have done a lot of research - Im in my early 50s so when you see the % mortality rate for HD it is a worry for me as people depend on me if that make sense

[Ppiman in reply to Mightnot]

Yes, it does make a lot of sense and I feel for you. There are various kinds of heart failure, I gather. CHF is the one the statistics are calculated for, I would think.

It’s an odd condition that isn’t well understood. Why some people get it and not others, why some suffer more than others and the exact mechanisms involved seem still to elude doctors. I’ve also read that treatment is a great deal better these days so that also might affect any statistics.

Steve

[oscarfox49]

Have you actually had a proper diagnosis of heart failure though, as opposed to just the high BNP reading? I am in a very similar position but both my researches on the web and my local doctor said it was not abnormal for AF to elevate BNP readings considerably (the protein is produced because the heart is struggling to beat properly) but that is not necessarily heart failure. He told me he had asked for the reading just to set a monitoring point against which to judge any increase in BNP levels later.

What does your cardiologist say?

[Mightnot in reply to oscarfox49]

Hi, you make a good point. I spoke to my general practitioner, who mentioned my BNP levels increasing from 800 to 1800, indicating potential heart failure. I'm scheduled to see a cardiologist soon to clarify. From what I've researched about the BNP test, it measures a hormone produced by the left ventricle when it's not functioning properly, which could lead to symptoms. However, I haven't experienced noticeable symptoms recently, possibly due to medication managing water retention and arrhythmia. I'll discuss this further with the cardiologist. When I was first diagnosed I had breathlessness, fluid build up in the feet and ankles and other signs of heart failure and the doctor said this was separate to the atrial fibrillation. My meetings with cardiologists have mainly been focussed on the atrial fibrillation part and they just skip over the 800 BNP ( that was the figure) but now it is 1800 then they might address it and I will do that eitherway. I hope it is the AF causing the increased BNP as around 2000 BNP the prognosis is grim. Thanks for the reply

[oscarfox49 in reply to Mightnot]

When I did my 'researches' on line, I did discover a report saying that the presence of AF often made BNP an unreliable guide to heart failure diagnosis. The BNP test is often used to diagnose AF too. Unfortunately I didn't note down the location of the report I found.

I must admit I have none of the other symptoms like swollen feet and ankles though I suffer from quite a bit of breathlessness when walking and climbing a slope. I have my next blood test in June and will see what have happened to my BNP levels since the last test a year ago. Incidentally my level was 2 255 ng/L last June.

A very worrying time and I hope your cardiologist can sort out the best treatment for you and put your mind at rest. None of us should think about mortality statistics as they are misleading and can just spoil our quality lives by worrying about things which may never happen.

[Ppiman in reply to oscarfox49]

I think that’s well said. I’ma writing type and envy people who aren’t. It’s my experience that the internet often paints a different and often worse picture from the one I get told by the specialist I have seen.

Steve

[Mightnot]

Update - I had a private consulation with a cardiologist I saw on the phone. He said that 1) lose more weight 2) ablation is a good choice and I don't need to go onto amiodaran first or be in normal heat rate for 6 months 3) he suggested looking up sotalol which have much milder and rare side effect than amiodaran which has 50% chance of having some significant side effects 4) he said that wegovy would not interact with current medication and weight loss is a priorty 5) if I dont hear from the nhs in the next week or so then I will pay for an ecocardiogram from him and he can arrange this very quickly privately 6) he doesn't suggest a private cardioversion as not cost effective privately.7) finally he said the the BNP of 1700 may not be heart failure and could be due to atrial fibrillation. Question - anyone used sotalol and has anyone had experience of any of the above treatments/procedures?

[Mightnot]

This is an update to my original post in this thread. I'm 55 years old and I've had atrial fibrillation for a year. I've undergone two cardioversions, and the last one lasted for about 10 weeks. For the past 10 weeks, I've been in atrial fibrillation all the time. I'm still waiting to see the doctors at the hospital, so I saw a consultant. These are my options:

1. Just live with it and take /increase bisoprolol up to 15mg from 10mg

2. Keep taking my flecainide and get another cardioversion, although that might be a waste of time according to the consultant.

3. Stop taking flecainide and switch to amiodarone, then get another cardioversion. Hopefully, the amiodarone can keep me in regular rhythm and then I can have ablations. The first cardioversion is like a trial run, and the second one is to fix the problem. This might keep me in regular rhythm for a few years.

4 an option I thought of was just having the ablation straightaway, but each one of the doctors I’ve seen have said I must be out of a regular rhythm for six months before they consider the ablation. However people on here have said that they’ve had the ablation without being in regular rhythm. So this option for my own option which I will ask when I see them NHS, but I’m pretty sure they’re going to strongly suggest route, three

The doctor mentioned that on a amiodaran dose of about six months to a year, not long-term use, amiodarone should be fine and is a very effective drug. However, I'm really afraid of the toxicity of amiodarone. I've read about it online, and some posts mention its toxic effects on the thyroid and other issues, including the rare "blue man" syndrome, which sounds horrific.

Does anyone have experience with this drug or been through a similar situation before? If so, I would appreciate some feedback. At the moment, I'm considering taking amiodarone, but when you read the side effects of most drugs, they sound concerning. This one, in particular, seems quite severe. I've read scientific literature indicating a 50% chance of experiencing one of the serious side effects, whereas with many other medicines, the chances are much lower, like one in 10,000. These potential side effects are nasty, and while I'm not dying, I wonder if I could just live with my current condition.

When I’m not in regular rhythm, and when I’m in atrial fibrillation, I have about 20% less energy and vigor, but it's not totally debilitating like some people experience. They can't get out of bed or off the sofa, whereas I can still walk a few miles. I just don't feel as well.