1120 | wileyonlinelibrary.com/journal/cep Clin Exp Pharmacol Physiol. 2020;47:1120–1133. © 2020 John Wiley & Sons Australia, Ltd Received: 6 November 2019 | Revised: 3 February 2020 | Accepted: 19 February 2020 DOI: 10.1111/1440-1681.13290 REVIEW ARTICLE The therapeutic effect of B-type natriuretic peptides in acute decompensated heart failure Martin Caprnda 1 | Anthony Zulli 2 | Haaris A. Shiwani 3 | Peter Kubatka 4,5 | Slavomira Filipova 6 | Vanda Valentova 5,7 | Katarina Gazdikova 8,9 | Ioana Mozos 10,11 | Andrius Berukstis 12 | Aleksandras Laucevicius 12 | Ivan Rihacek 13 | Jozef Dragasek 14 | Robert Prosecky 15 | Emmanuel E. Egom 16,17 | Robert Staffa 18 | Peter Kruzliak 15,18 | Vladimir Krasnik 19 1 First Department of Internal Medicine, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia 2 Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia 3 Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Trust, Lancaster, UK 4 Department of Medical Biology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia 5 Division of Oncology, Department of Experimental Carcinogenesis, Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia 6 Department of Cardiology, National Institute of Cardiovascular Diseases and Slovak Medical University, Bratislava, Slovakia 7 Independent Researcher, Mosjøen, Norway 8 Department of Nutrition, Faculty of Nursing and Professional Health Studies, Slovak Medical University, Bratislava, Slovakia 9 Department of General Medicine, Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia 10 Department of Functional Sciences, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania 11 Center for Translational Research and Systems Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania 12 Clinic of Heart and Vessel Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania 13 Second Department of Internal Medicine, Faculty of Medicine, Masaryk University and St, Anne´s University Hospital, Brno, Czech Republic 14 First Department of Psychiatry, Faculty of Medicine, Luis Pasteur University Hospital, Pavol Jozef Safarik University, Kosice, Slovakia 15 Department of Internal Medicine, Brothers of Mercy Hospital, Brno, Czech Republic 16 Egom Clinical & Translational Research Services Ltd, Dartmouth, NS, Canada 17 Jewish General Hospital and Lady Davis Research Institute, Montreal, QC, Canada 18 Second Department of Surgery, Faculty of Medicine, St. Anne´s University Hospital, Masaryk University, Brno, Czech Republic 19 Department of Ophthalmology, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia Caprnda and Zulli are co-first authors and share equal authorship. The peer review history for this article is available at https://publons.com/publon/10.1111/1440-1681.13290 Correspondence Dr. Peter Kruzliak, Department of Chemical Drugs, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Palackeho tr. 1/1946, 612 42 Brno, Czech Republic. Email: kruzliakpeter@gmail.com Dr. Katarina Gazdikova, Department of Nutrition, Faculty of Nursing and Professional Health Studies, Slovak Medical University, Limbova 12, 833 03 Bratislava, Slovakia. Email: katarina.gazdikova@szu.sk Abstract B-type natriuretic peptide (BNP) exhibits roles in natriuresis and diuresis, making it an ideal drug that may aid in diuresing a fluid-overloaded patient with poor or worsening renal function. Several randomized clinical trials have tested the hypothesis that infu- sions of pharmacological doses of BNP to acute heart failure (HF) patients may en- hance decongestion and preserve renal function in this clinical setting. Unfortunately, none of these have demonstrated beneficial outcomes. The current challenge for BNP research in acute HF lies in addressing a failure of concept and a reluctance to abandon an ineffective research model. Future success will necessitate a detailed