BNP levels rise in response to what condition?

• A. Decreased heart rate
• B. Increased ventricular filling pressures
• C. Liver congestion
• D. Renal failure

Answer: (B)

BNP is released by ventricular myocytes in response to increased stretch of the ventricular walls, which happens with elevated filling pressures and volume overload. This stretch stimulates BNP release, and the peptide then acts to reduce preload and afterload by promoting natriuresis, diuresis, and vasodilation. That’s why BNP levels rise with increased ventricular filling pressures. Decreased heart rate doesn’t directly trigger BNP release; liver congestion and renal failure can be associated with high BNP for different reasons (consequence or clearance), but the primary stimulus for BNP rise is the ventricular stretch from elevated filling pressures.