Brain natriuretic peptide - Revision history

Danbot: Add Category:Labs

2026-03-22T06:43:58Z

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	[[Category:Cardiology]]		[[Category:Cardiology]]
			[[Category:Labs]]

Rossdonaldson1: /* Background */

2019-07-20T12:10:21Z

Background

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	*May be trended to gauge treatment response in acute decompensated CHF		*May be trended to gauge treatment response in acute decompensated CHF
	*May have false negative with isolated diastolic dysfunction		*May have false negative with isolated diastolic dysfunction
			*N-terminal proBNP is a biologically inert metabolite of proBNP

	===Indications for Use===		===Indications for Use===

Rossdonaldson1 at 12:09, 20 July 2019

2019-07-20T12:09:15Z

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	**Baseline BNP, cardiac troponin, or both should be measured upon hospital admission to determine prognosis in patients with acutely decompensated heart failure		**Baseline BNP, cardiac troponin, or both should be measured upon hospital admission to determine prognosis in patients with acutely decompensated heart failure

	==~~Values and Diagnosis~~==		==Interpretation==
	{{BNP value}}		{{BNP value}}

			==Special Patient Populations==

			===BNP In Obese Patients===
			*Visceral fat expansion leads to increased clearance of active natriuretic peptides<ref>Clerico A, Giannoni A, Vittorini S, Emdin M. The paradox of low BNP levels in obesity. Heart Fail Rev. 2011;17(1):81-96. doi:10.1007/s10741-011-9249-z.</ref>
			*Obese patients also frequently treated for hypertension or coronary artery disease which may also contribute to lower BNP levels

			====Interpretation====
			*In one study of 204 patients with acute CHF, an inverse relationship between BMI and BNP was noted. The standard cutoff of 100pg/mL resulted in a 20% false-negative rate<ref>Krauser DG, Lloyd-Jones DM, Chae CU, et al. Effect of body mass index on natriuretic peptide levels in patients with acute congestive heart failure: A ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) substudy. Am Heart J. 2005;149(4):744-750. doi:10.1016/j.ahj.2004.07.010.</ref>
			*Analysis of a subgroup of patients with documented BMI from the Breathing Not Properly study showed that a lower cutoff was more appropriate to maintain 90% sensitivity in obese and morbidly obese patients (54pg/mL)<ref>Daniels LB, Clopton P, Bhalla V, et al. How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure. Results from the Breathing Not Properly Multinational Study. Am Heart J. 2006;151(5):999-1005. doi:10.1016/j.ahj.2005.10.011.</ref>

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* Background */

2019-07-20T12:08:16Z

Background

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	*May be trended to gauge treatment response in acute decompensated CHF		*May be trended to gauge treatment response in acute decompensated CHF
	*May have false negative with isolated diastolic dysfunction		*May have false negative with isolated diastolic dysfunction

			===Indications for Use===
			*American College of Cardiology, American Heart Association, Heart Failure Society of America guidelines as of May 2017<ref>Yancy CW et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure.</ref>
			**BNP should be measured in patients presenting with dyspnea to help diagnose or exclude heart failure
			**BNP or nt-pro-BNP should be measured to determine prognosis or disease severity in chronic heart failure
			**Baseline BNP, cardiac troponin, or both should be measured upon hospital admission to determine prognosis in patients with acutely decompensated heart failure

	==Values and Diagnosis==		==Values and Diagnosis==

Rossdonaldson1: /* Background */

2019-07-20T12:07:38Z

Background

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	==Background==		==Background==
			*Biologically active metabolite of proBNP (released from ventricles in response to increased volume/pressure)
			*Utility is controversial and may not affect patient centered outcomes<ref>Carpenter CR et al. BRAIN NATRIURETIC PEPTIDE IN THE EVALUATION OF EMERGENCY DEPARTMENT DYSPNEA: IS THERE A ROLE? J Emerg Med. 2012 Feb; 42(2): 197–205.</ref>
			*May be trended to gauge treatment response in acute decompensated CHF
			*May have false negative with isolated diastolic dysfunction

			==Values and Diagnosis==
	{{BNP value}}		{{BNP value}}

Rossdonaldson1: /* Differential Diagnosis */

2019-07-20T12:05:10Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
	{{Elevated [[BNP]]}}		{{Elevated BNP}}

	==See Also==		==See Also==

Rossdonaldson1 at 12:04, 20 July 2019

2019-07-20T12:04:54Z

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	==Background==		==Background==
	{{BNP value}}		{{BNP value}}

			==Differential Diagnosis==
			{{Elevated [[BNP]]}}

	==See Also==		==See Also==

Rossdonaldson1 at 12:03, 20 July 2019

2019-07-20T12:03:09Z

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			==Background==
	{{BNP value}}		{{BNP value}}

Mholtz at 04:15, 6 July 2017

2017-07-06T04:15:41Z

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	==See Also==		==See Also==
	*[[Congestive heart failure]]		*[[Congestive heart failure]]
	*http://lifeinthefastlane.com/ccc/brain-natriuretic-peptide-bnp/

	==External Links==		==External Links==
	*[http://pemplaybook.org/podcast/big-labs-little-people-troponin-bnp-d-dimer-and-lactate/ Pediatric Emergency Playbook Podcast: Big Labs, Little People]		*[http://pemplaybook.org/podcast/big-labs-little-people-troponin-bnp-d-dimer-and-lactate/ Pediatric Emergency Playbook Podcast: Big Labs, Little People]
			*http://lifeinthefastlane.com/ccc/brain-natriuretic-peptide-bnp/

	==References==		==References==
	<references/>		<references/>

	[[Category:Cardiology]]		[[Category:Cardiology]]

Thoreczko: Podcast link

2016-12-20T16:02:56Z

Podcast link

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	*[[Congestive heart failure]]		*[[Congestive heart failure]]
	*http://lifeinthefastlane.com/ccc/brain-natriuretic-peptide-bnp/		*http://lifeinthefastlane.com/ccc/brain-natriuretic-peptide-bnp/

			==External Links==
			*[http://pemplaybook.org/podcast/big-labs-little-people-troponin-bnp-d-dimer-and-lactate/ Pediatric Emergency Playbook Podcast: Big Labs, Little People]

	==References==		==References==
	<references/>		<references/>
	[[Category:Cardiology]]		[[Category:Cardiology]]