The general consensus about testing
of BNP and proBNP is that, the testing should be performed to confirm the
diagnosis of CHF in patients with a suspected diagnosis of CHF but presenting
with ambiguous clinical features e.g. dyspnea which may be caused by COPD and
cardiac failure. It is also used to monitor CHF patients following therapy.
It is also
used to monitor CHF patients following therapy. BNP and NT-proBNP are used to
identify patients with moderate to severe CHF and risk stratification of CHF
and those with ACS. NPs increases in other conditions of volume overload – thus
non specific. Used in risk stratification in CHF, ACS along with troponin
measurement. Proposed for screening purpose considering risk factors
q BNP usually
>100 pg/mL in CHF.
The NT-proBNP (1-2 hr T1/2)
fragment is not cleared via receptor mediated process but
predominantly by
kidney. So, NT-proBNP is more sensitive to changes in renal function.
Since BNP is released by ventricles
during stress condition, this can provide sensitive marker for changes in
ventricular physiology. It is Proposed for screening purpose in high risk
groups.
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