NT pro-BNP (Brain Natriuretic Peptide)

General Information

ProBNP may be used as an aid in the diagnosis of patients suspected of having heart failure.

Left ventricular dysfunction can occur as a part of coronary heart disease, arterial hypertension, valvular disease and primary myocardial disease. If the left ventricular dysfunction remains untreated and is progressive, the potential for mortality is high, e.g. due to sudden cardiac death.

Chronic cardiac insufficiency is a clinical syndrome caused by impairment of the cardiac pumping function.

In subjects with left ventricular dysfunction, serum and plasma concentrations of BNP increase, as does the concentration of the putatively inactive amino-terminal fragment, NT-proBNP. ProBNP, comprising 108 amino acids, is secreted mainly by the ventricle and, in this process, is cleaved into physiologically active BNP (77-108) and the N-terminal fragment NT-proBNP (1-76).

Studies indicate that NT-proBNP can be used in diagnostic and prognostic applications. The concentration of NT-proBNP in serum or plasma correlates with the prognosis of the left ventricular dysfunction. Fisher, et al. found that congestive heart failure patients with NT-proBNP values above median had a one year mortality rate of 53% compared to 11% in patients below median. In the GUSTO IV study, which involved more than 6800 patients, it was shown that NT-proBNP was the strongest independent predictor of one-year mortality in patients with acute coronary syndrome. The test is also useful in assigning symptoms to cardiac or non-cardiac causes, and helps to identify subjects with left ventricular dysfunction.