B-type natriuretic peptide (BNP) and N-terminal pro b-type natriuretic peptide (NT-proBNP)
- Is a polypeptide secreted from heat ventricles in response to ventricular volume expansion and pressure overload.
- The major source of BNP is the cardiac ventricles. Only a minimal amount of BNP is found storage granules. As such, its release is directly proportional to ventricular dysfunction.
- A BNP reliably predicts the presence or absence of left ventricular dysfunction on an echocardiogram. High levels indicated a high likelihood of HF. Low levels can rule out heart failure.
Characteristics that can produce to higher levels of NT-proBNP even in healthy individuals.
- Healthy female patients and those >65 years of age will have higher levels of NT-proBNP than younger male patients.
- NT-proBNP is negatively correlated with kidney function as measured by the eGFR) and albumin levels. Patients with a low GFR or a low level of albumin have higher NT-proBNP levels.
- Grip strength is negatively correlated with NT-proBNP as well.
Characteristics that can produce to higher levels of NT-proBNP even in healthy individuals.
- A higher BMI is associated with a lower NT-proBNP. The utility of NT-proBNP to rule out heart failure in obese patients is decreased.
Reference / Further Reading on BNP and Pro-BNP
https://labtestsonline.org/tests/bnp-and-nt-probnp
Heart Fail Rev 2014;19(4):439-451. Performance of BNP and NT-proBNP for diagnosis of heart failure in primary care patients: A systematic review.
N Engl J Med 2016;375(19):1868-1877. Heart failure with preserved ejection fraction.
J Nutr Health Aging 2016;20(9):937-943. Impact of protein nutritional status on plasma BNP in elderly patients.
Int J Cardiol 2017;228:599-604. Plasma levels of atrial and brain natriuretic peptides in apparently healthy subjects: Effects of sex, age, and hemoglobin concentration.
Am J Med 2001;111(4):274-279.