Type B natriuretic peptide (Pro-BNP)

General Information

NT-proBNP     N-Terminal Pro B-type natriuretic peptide

According to the latest definition, heart failure is a condition whose development is related to structural or functional pathology of the cardiovascular system. The condition includes at least one of the following symptoms/signs: increased serum natriuretic factor levels, presence of hemodynamic and/or imaging evidence of pulmonary or congestive heart failure, at rest or with exercise.

Diagnosing heart failure at an early stage is often difficult, because the symptoms expressed at this stage: dyspnea (shortness of breath), weakness and peripheral edema - are non-specific signs. Diagnosis is even more complicated in elderly and obese people. Ultrasound examination of the heart is the most common method at this time. Cardiac biomarkers provide an opportunity to diagnose the disease at an early stage.

The clinical significance of natriuretic peptides has long been established. They are a family of molecules represented by ANP-A type (ventricle), BNP-B type (brain) and CNP-C type natriuretic peptides. Their role is to maintain the homeostasis of circulating blood. ANP and BNP affect water-electrolyte balance.

The A-type natriuretic peptide ANP is rapidly released into the circulation, whereas the B-type is produced as precursors (pre-pro-BNP and pro-BNP) and released from the ventricular myocardium after prolonged parietal (ventricular wall) stress. (The parietal stress is the force against the heart cells).

PRO-BNP breaks down into biologically active form – BNP-B type natriuretic peptide and inactive NT-probnp.

It has been established that BNP (and consequently NT-pro-BNP) correlates with left ventricular failure.

The heart's pump function is quantified by estimating the left ventricular ejection fraction. It is defined as the ratio of the stroke volume at the end of diastole (relaxation of the ventricle) to the volume of blood retained in the left ventricle.

A normal ejection fraction is 50-65%, and less than 50% is indicative of heart damage.

Determination of natriuretic peptide, including NT-proBNP, is a biomarker for the assessment of heart failure. An increase in indicators indicates an increase in heart failure and an increase in the risk of death.

Referral norms

Data under <18 years have no clinical value

18-44 years old - 44 pg/ml

45-54 years old - 58 pg/ml

65-74 years old - 161 pg/ml

> 75 pg/ml above 346 years old

When is the survey conducted?

Determination of N-terminal pro-B-type natriuretic peptide is important in the diagnostics of conditions such as:

• Prediction of chronic heart failure
• Monitoring of chronic heart failure treatment
• Risk assessment of patients with acute coronary syndrome
• Screening for asymptomatic ventricular failure
• Evaluation of patients with pulmonary embolic diseases
• Cardiovascular disease risk assessment in patients with type 2 diabetes mellitus
• Determining the risk of atrial fibrillation
• Determination of stroke risk score

Preliminary preparation: it is not necessary

Study sample: Venous blood