Role of BNP and NT-proBNP in clinical application
10.3760/cma.j.issn.1009-9158.2012.10.002
- VernacularTitle:关注BNP与NT-proBNP的临床应用
- Author:
Hui YUAN
- Publication Type:Journal Article
- Keywords:
Natriuretic peptide,brain;
Peptide fragments;
Heart failure;
Dyspnea;
Coronary disease;
Prognosis
- From:
Chinese Journal of Laboratory Medicine
2012;35(10):870-873
- CountryChina
- Language:Chinese
-
Abstract:
The precursor of B-type natriuretic peptide (proBNP) is cleaved by a specific enzyme into the biologically active BNP and biologically inactive N-terminal fragment (NT-proBNP).Plasma BNP and NT-proBNP concentrations are affected by gender,age,obesity (higher BMI) and renal function.BNP is primary metabolized by clearance receptors,NT-proBNP is suggested by renal excretion,so plasma concentrations of NT-proBNP are more affected by renal function than that of BNP.The differential diagnosis of acute dyspnea and acute heart failure (AHF) is one of the most important clinical applications of BNP and NT-proBNP.Two cut-off points were used:a lower one with a high negative predictive value to reliably exclude acute heart failure (AHF) as the cause of acute dyspnoea (rule-out cutoff value),and a second higher one with a high positive predictive value to rule in AHF as the cause of dyspnoea (rule-in cutoff value).The rule-in cutoff values of NT-proBNP divided into three levels according to the age,these cutoff values apply irrespective of gender,obesity and renal function,but the rule-in cutoff point of BNP need to be corrected by obesity and renal function.In addition,BNP/NT-proBNP has been shown to provide diagnosis,prognosis and therapy-guiding information in chronic heart failure and coronary heart disease.
