Tuesday, November 13, 2012

Clinical utility of Brain Natriuretic Peptide (BNP)

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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