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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]
There is no level of BNP that perfectly separates patients with and without heart failure. [14]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%. [15]
[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.
Stage A Defined as: At high risk for heart failure but without structural heart disease (defects in the heart from aging, injury, infection, or heart defect at birth), or symptoms of heart failure.
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.
Pro-brain natriuretic peptide: This is increased in patients with heart failure. It has been approved as a marker for acute congestive heart failure. Patients with < 80 have a much higher rate of symptom-free survival within a year. Generally, pt with CHF will have > 100.
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