Chemistry, toxicology & urinalysis

Organ specific


Natriuretic peptides (BNP and Amino-terminal proBNP)

Last author update: 1 December 2010
Last staff update: 6 April 2020

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PubMed Search: Natriuretic peptides [title]

Larry Bernstein, M.D.
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Cite this page: Bernstein L. Natriuretic peptides (BNP and Amino-terminal proBNP). website. Accessed February 6th, 2023.
Definition / general
  • 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 - Brain natriuretic peptide)
  • 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
Clinical features
  • 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)

Reference ranges
  • 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)
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