- N-terminal prohormone of brain natriuretic peptide
-
The N-terminal prohormone of brain natriuretic peptide (NT-proBNP) is a 76 amino acid N-terminal fragment of brain natriuretic peptide.
Both BNP and NT-proBNP levels in the blood are used for screening, diagnosis of acute congestive heart failure (CHF) and may be useful to establish prognosis in heart failure, as both markers are typically higher in patients with worse outcome.[1] The plasma concentrations of both BNP and NT-proBNP are also typically increased in patients with asymptomatic or symptomatic left ventricular dysfunction.[2]
Blood levels
Upper limit (95th percentile) of blood ranges
for NT-proBNP in healthy peopleSex Age Limit
in pg/mLMale < 45 yrs 90[3] 45-54 yrs 140[3] 55-64 yrs 180[3] 65-74 yrs 230[3] > 75 yrs 850[3] Females < 45 yrs 180[3] 45-54 yrs 190[3] 55-64 yrs 230[3] 65-74 yrs 350[3] > 75 yrs 620[3] Interpretation Age Range Congestive heart failure likely <75years > 125 pg/mL[4] >75 years >450pg/mL[4] There is no level of BNP that perfectly separates patients with and without heart failure.[5]
In screening for congenital heart disease in pediatric patients, an NT-proBNP cut-off value of 91 pg/mL could differentiate an acyanotic heart disease (ACNHD) patient from a healthy patient with a sensitivity of 84% and specificity of 42%.[6] On the other hand, an NT-proBNP cut-off value of 318 pg/mL is more appropriate in differing patients with congenital nonspherocytic hemolytic disease (CNHD) from healthy patients, with 94% sensitivity and 97% specificity.[6] An NT-proBNP value of 408 pg/mL has been estimated to be 83% sensitive and 57% specific in differentiating patients with ACNHD from patients with CNHD.[6]
See also
References
- ^ Bhalla V, Willis S, Maisel AS (2004). "B-type natriuretic peptide: the level and the drug--partners in the diagnosis of congestive heart failure". Congest Heart Fail 10 (1 Suppl 1): 3–27. doi:10.1111/j.1527-5299.2004.03310.x. PMID 14872150.
- ^ Atisha D, Bhalla MA, Morrison LK, Felicio L, Clopton P, Gardetto N, Kazanegra R, Chiu A, Maisel AS (September 2004). "A prospective study in search of an optimal B-natriuretic peptide level to screen patients for cardiac dysfunction". Am. Heart J. 148 (3): 518–23. doi:10.1016/j.ahj.2004.03.014. PMID 15389242.
- ^ a b c d e f g h i j The University of Iowa (UIHC) > Department of Pathology > LABORATORY SERVICES HANDBOOK > N-terminal-pro-BNP Showing 95th percentiles. Epic Lab Code: LAB649. Updated: 10/27/2009
- ^ a b Page 220 in: Lee, Mary Ann (2009). Basic Skills in Interpreting Laboratory Data. Amer Soc of Health System. ISBN 1-58528-180-8.
- ^ Maisel A, Krishnaswamy P, Nowak R, McCord J, Hollander J, Duc P, Omland T, Storrow A, Abraham W, Wu A, Clopton P, Steg P, Westheim A, Knudsen C, Perez A, Kazanegra R, Herrmann H, McCullough P (2002). "Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure". N Engl J Med 347 (3): 161–7. doi:10.1056/NEJMoa020233. PMID 12124404.
- ^ a b c Screening for Congenital Heart Disease with NT-proBNP: Results By Emmanuel Jairaj Moses, Sharifah A.I. Mokhtar, Amir Hamzah, Basir Selvam Abdullah, and Narazah Mohd Yusoff. Laboratory Medicine. 2011;42(2):75-80. © 2011 American Society for Clinical Pathology
Categories:- Medicine stubs
- Peptide hormones
Wikimedia Foundation. 2010.
