Natriuretic Peptides (BNP and Amino-terminal proBNP)
Author: Larry Bernstein, M.D., Triplex Consulting (see Reviewers/Authors page)
Revised: 12 December 2010, last major update December 2010
Copyright: (c) 2003-2010, PathologyOutlines.com, Inc.
● Brain natriuretic peptide (BNP), now known as B-type natriuretic peptide (also BNP), is a 32 amino acid polypeptide secreted by the cardiac ventricles in response to excessive stretching of cardiomyocytes (Wikipedia)
● BNP was originally identified in extracts of porcine brain, although in humans it is produced mainly in the cardiac ventricles
● BNP is co-secreted with a 76 amino acid N-terminal fragment (NT-proBNP), which is biologically inactive
● Evaluation of dyspneic patient with suspected congestive heart failure, regardless of renal function (J Am Coll Cardiol 2006;47:91)
● B-type natriuretic peptide levels are higher in patients with congestive heart failure than in dyspnea from other causes (J Am Coll Cardiol 2002;39:202, N Engl J Med 2004;350:647)
● NT-proBNP measurement is a valuable addition to standard clinical assessment for the identification and exclusion of acute CHF in the emergency department setting (Am J Cardiol 2005;95:9480)
● Reduces misdiagnosis of congestive heart failure, which occurs 50% to 75% of the time
● NT-proBNP is superior to BNP for predicting mortality and morbidity for heart failure (Clin Chem 2006;52:1528), and coexisting renal disease and heart failure (Clin Chem 2007;53:1511)
● BNP levels below 100 pg/mL indicate no heart failure
● Determination of endogenous BNP with the AxSYM assay using frozen plasma samples may not be valid after 1 day, but NT-proBNP as measured by the Elecsys assay may be stored at -20 degrees C for at least four months without a relevant loss of the immunoreactive analyte (Clin Chem Lab Med 2004;42:942)
● Clin Chem 2007;53:1928,
Am J Kidney Dis 2005;46:610,
Eur J Heart Fail 2004;6:269
End of Clinical Chemistry > Cardiac-related tests > Natriuretic Peptides (BNP and Amino-terminal proBNP)
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