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N-terminal prohormone of brain natriuretic peptide (NT-proBNP or BNPT) is a 76 amino acid long protein that is cleaved from the N-terminal end of the 108 amino acid long prohormone proBNP to release brain natriuretic peptide 32 (BNP, also known as B-type natriuretic peptide). [1] [2] [3] [4]
The main clinical utility of either BNP or NT-proBNP is that a normal level helps to rule out chronic heart failure in the emergency setting. An elevated BNP or NT-proBNP should never be used exclusively to "rule in" acute or chronic heart failure in the emergency setting due to lack of specificity [dubious – discuss]. [19]
[74] [6] [75] An elevated NT-proBNP or BNP is a specific test indicative of heart failure. Additionally, NT-proBNP or BNP can be used to differentiate between causes of dyspnea due to heart failure from other causes of dyspnea. If a myocardial infarction is suspected, various cardiac markers may be used.
B-type natriuretic peptide (BNP) and its pro hormone NT-proBNP are especially useful in diagnosing heart failure, as their levels in the blood increase along with the severity of the condition. [3] Rapid testing of BNP and NT-proBNP can also help distinguish between shortness of breath due to heart and lung-related causes.
This also applies to patients with elevated NT-proBNP levels and patients with atrial enlargement in cardiac ultrasound. Other causes: Arterial dissections, infection-related vasculopathies (esp. Varicella zoster virus), thrombophilia, cancer-related thrombosis, migraine, Fabry disease and other genetic, autoimmune or rheumatic causes.
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The biological half-life of BNP, however, is twice as long as that of ANP, and that of NT-proBNP is even longer, making these peptides better choices than ANP for diagnostic blood testing. In addition to the mammalian natriuretic peptides (ANP, BNP , CNP ), other natriuretic peptides with similar structure and properties have been isolated ...