Heart Failure and NT-proBNP

Heart failure is a global health issue affecting more than 26 million people worldwide. The prevalence of heart failure is increasing rapidly due to the ageing population and increasing number of obese persons.

NT-proBNP is a standard blood test for individuals suspected of having congestive heart failure (CHF) where measurements of NT-proBNP are used as an aid in the diagnosis and assessment of severity.

Brain natriuretic peptide (BNP)

Brain natriuretic peptide (BNP) is a hormone that is secreted by cardiomyocytes (cardiac muscle cells) in the heart ventricles in response to stretching caused by cardiac wall stress. BNP forms part of the natriuretic peptide family, along with the two other natriuretic peptides, ANP and CNP. Together, the natriuretic peptides promote urine secretion, relax the blood vessels, lower the blood pressure, and reduces the heart’s workload.

BNP and the N-terminal part of the BNP precursor molecule, NT-proBNP, are established, benchmark diagnostic and prognostic markers for myocardial function. BNP and NT-proBNP have high negative predictive values, and clinical guidelines recommend measuring either BNP or NT-proBNP to rule out heart failure. The clinical cut-off levels are low, however, the reference range for NT-proBNP vary with age and gender. Women have higher NT-proBNP levels than men, and the concentration of NT-proBNP also increases with age. The expected NT-proBNP can also be used to monitor treatment for patients with chronic heart failure, and for prognosis of heart failure.

BNP/NT-proBNP

Although both BNP and NT-proBNP have similar uses in the clinic, the molecules cannot be directly compared. BNP is the bioactive peptide and has a half-life of approximately 20 minutes, whereas NT-proBNP is biologically inactive and has a half-life of 1-2 hours. The concentration of NT-proBNP in blood is thus higher than the concentration of BNP. BNP is eliminated by contact with receptors in the liver, lung, kidney, and vascular endothelium and by the kidney. In contrast, NT-proBNP is only cleared by the kidneys and the elimination is therefore highly dependent on kidney function compared to BNP. NT-proBNP is more stable in vitro than BNP.

The ReLIA NT-proBNP  and BNP Immunoassay is CE-marked cleared. For more details on ReLIA NT-proBNP  and BNP Immunoassay products and prices please contact us at  marketing@ReLIAchina.com

References

[1] Paulo Bettencourt, PhD; Ana Azevedo, MD;Joana Pimenta, MD; Fernando Friǒes,MD;Susana Ferreira,PhD. N-Terminal-Pro-Brain Natriuretic Peptide Predicts Outcome After Hospital Discharge in Heart Failure Patients. Circulation 2004;1102:2168-2174.

[2] Charlotte Kragelund, M.D.,Bjorn Gronning,M.D.,Lars Kober,D.M.Sc.,Per Hildebrandt,D.M.Sc., and Rolf Steffensen,M.D. N-Terminal Pro-B-Type Natriuretic Peptide and Long-Term Mortality in Stable Coronary Heart Disease. N Engl J Med 2005;352:666-75.

[3] James L.Januzzi, Roland van Kimmenade, John Lainchbury, Antoni Bayes-Genis, Jordi Ordones, Miguel Santalo-Bel, Yigal M. Pinto, and Mark Richards. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients. European Heart Journal(2006)27,330-337.

[4] Yoko Hamada, Nobuaki Tanaka, Kazuya Murata. Significance of predischarge BNP on one-year outcome in decompensated heart failure—comparative study with echo-Doppler indexes[J]. 11(1):43-49.

[5] M Mukoyama, K Nakao, K Hosoda. Brain natriuretic peptide as a novel cardiac hormone in humans: Evidence for an exquisite dual natriuretic peptide system, atrial natriuretic peptide and brain natriuretic peptide[J]. Journal of Clinical Investigation, 1991, 87(4):1402-1412.

[6] Dolgin M . Obesity and B-type natriuretic peptide levels in heart failure[J]. Journal of the American College of Cardiology, 2005, 45(6):967; author reply 967.