B-type natriuretic peptide (BNP) is a small protein secreted by the ventricles of the heart in response to excessive stretching of the heart muscles cells (myocytes). BNP is secreted into the blood when your heart is working hard. The N-terminal fragment of BNP is a highly sensitive marker for cardiac dysfunction.

An elevated NT-proBNP level frequently indicates the presence of an underlying cardiac disorder. It can even identify people with structural heart disease and cardiac dysfunction before symptoms begin.^1-5 Even relatively low levels of NT-proBNP may be considered an index of increased cardiovascular risk since NT-proBNP abnormalities correlate well with development of progressive atherosclerosis.⁶

Instructions

Fasting is not required for this test. Take all medications as prescribed.

Note

BNP and NT-proBNP levels decrease in most people who are taking drug therapies for heart failure; such as angiotensin-converting enzyme (ACE) inhibitors, beta blockers, and diuretics. BNP and NT-proBNP also increase with increasing age and decreasing renal function. Additionally, NT-proBNP has been found to be more sensitive and specific than BNP.

References

1. Paget, V., Legedz, L., Gaudebout, N., Girerd, N., Bricca, G. et al. (2011). N-terminal pro-brain natriuretic peptide: a powerful predictor of mortality in hypertension. Hypertension 57(4), 702-709.
2. Kistorp, C., Raymond, I., Pedersen, F., Gustafsson, F., Faber, J. et al. (2005). N-terminal pro-brain natriuretic peptide, C-reactive protein, and urinary albumin levels as predictors of mortality and cardiovascular events in older adults. JAMA 293(13), 1609-1616.
3. Omland, T., Sabatine, M.S., Jablonski, K.A., Rice, M.M., Hsia, J. et al. (2007). Prognostic value of B-Type natriuretic peptides in patients with stable coronary artery disease: the PEACE Trial. J Am Coll Cardiol 50(3), 205-214.
4. McKie, P.M., Rodeheffer, R.J., Cataliotti, A., Martin, F.L., Urban, L.H. et al. (2006). Amino-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide: biomarkers for mortality in a large community-based cohort free of heart failure. Hypertension 47(5), 874-880.
5. de Antonio, M., Lupon, J., Galan, A., Vila, J., Urrutia, A. et al. (2012). Combined use of high-sensitivity cardiac troponin T and N-terminal pro-B type natriuretic peptide improves measurements of performance over established mortality risk factors in chronic heart failure. Am Heart J 163(5), 821-828.
6. Seino Y, Ogawa A, Yamashita T et al. Application of NT-proBNP and BNP measurements in cardiac care: a more discerning marker for the detection and evaluation of heart failure. Eur J Heart Fail 2004 March 15;6(3):295-300.