Although heart failure may be diagnosed readily in its advanced stages, it may be
difficult to diagnose clinically in its early stages. Thus, there is a critical need
for an inexpensive, simple, rapid, and objective test for heart failure. Such measurements
could be performed at the point-of-care or in a centralized laboratory if rapid turn-around
time could be achieved that is comparable to that for the cardiac troponins. Measurement
of the fragments of the biologically-active B-type natriuretic peptide (BNP), proBNP,
or the inactive N-terminal fragment (NT-proBNP) likely fulfill this need and are the
subject of this article. BNP measurements can be performed on whole blood or EDTA
plasma by using the United States Food and Drug Administration (FDA)–approved point-of-care
Biosite (San Diego, California) Triage BNP fluorescence immunoassay. Roche Diagnostics
(Indianapolis, Indiana) has developed an FDA-approved Elecsys electrochemiluminescent
assay for NT-proBNP. The electrochemiluminescent assay is a double-antibody, sandwich
capture assay. NT-proBNP amino acids 1 through 20 contain the epitope that is identified
by the capture antibody, whereas amino acids 39 through 50 contain the epitope that
is identified by the detection antibody.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.
Content published before 2002 is available via pay-per-view purchase only.
Subscribe:
Subscribe to Clinics in Laboratory MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Brain natriuretic peptide, diagnosis and management of congestive heart failure.Point of Care. 2002; 4: 246-252
- Long-term trends in the incidence of and survival with heart failure.N Engl J Med. 2002; 347: 1397-1402
- Heart failure—an epidemic of uncertain proportions.N Engl J Med. 2002; 347: 1442-1444
- New epidemiologic perspectives concerning mild-to-moderate heart failure.Am J Med. 2001; 110: 6S-13S
- Laboratory markers of CHF. Advance/Laboratory 2002.Merion Publishers, King of Prussia (PA)2002
- One year temporal pattern of neurohumoral factors and natriuretic peptides compared with clinical variables in patients with dilated cardiomyopathy.Minerva Cardioangiol. 2002; 50: 661-665
- The Denolin lecture. Congestive heart failure: a half century perspective.Eur Heart J. 2001; 22: 825-836
- Aldosterone in congestive heart failure.N Engl J Med. 2001; 345: 1689-1697
- B-type natriuretic peptide–a window to the heart.N Engl J Med. 2002; 347: 158-159
- Natriuretic peptides in assessment of left-ventricular dysfunction.Scand J Clin Lab Invest Suppl. 1999; 230: 132-142
- Pathophysiological and clinical relevance of circulating levels of cardiac natriuretic hormones: are they merely markers of cardiac disease?.Clin Chem Lab Med. 2002; 40: 752-760
- Measurement and importance of plasma brain natriuretic peptide and related peptides.Ann Clin Biochem. 2001; 38: 83-93
- The role of the circulation in processing pro-brain natriuretic peptide (proBNP) to amino-terminal BNP and BNP-32.Peptides. 1997; 18: 1475-1481
- Quantification of pro-B-type natriuretic peptide and its products in human plasma by use of an analysis independent of precursor processing.Clin Chem. 2002; 48: 1035-1042
- N-terminal pro-brain natriuretic peptide after myocardial infarction: a marker of cardio-renal function.Hypertension. 2002; 39: 99-104
- Molecular forms of human brain natriuretic peptide in plasma.Clin Chim Acta. 2002; 316: 129-135
- Circulating natriuretic peptide concentrations in patients with end-stage renal disease: role of brain natriuretic peptide as a biomarker for ventricular remodeling.Mayo Clin Proc. 2001; 76: 1111-1119
- Assessment of the stability of N-terminal pro-brain natriuretic peptide in vitro: implications for assessment of left ventricular dysfunction.Clin Sci (Lond). 1999; 97: 255-258
- Guidelines for the diagnosis and treatment of chronic heart failure.Eur Heart J. 2001; 22: 1527-1560
- The natural history of congestive heart failure: the Framingham study.N Engl J Med. 1971; 285: 1441-1446
- An analysis of physicians' reasons for prescribing long-term digitalis therapy in outpatients.J Chronic Dis. 1985; 38: 733-739
- Validity of clinical diagnosis of heart failure in primary health care.Eur Heart J. 1991; 12: 315-321
- Role of cardiac natriuretic peptide testing in heart failure.Clin Chem. 2002; 48: 977-978
- Brain natriuretic peptide blood levels in the differential diagnosis of dyspnea.Chest. 2001; 120: 2047-2050
- Evaluation of brain natriuretic peptide in the diagnosis of heart failure.Cardiology. 2000; 93: 19-25
- Comparative value of Doppler echocardiography and B-type natriuretic peptide assay in the etiologic diagnosis of acute dyspnea.J Am Coll Cardiol. 2002; 40: 1794-1800
- Comparative measurement of N-terminal pro-brain natriuretic peptide and brain natriuretic peptide in ambulatory patients with heart failure.Clin Chem Lab Med. 2002; 40: 761-763
- The amino-terminal portion of pro-brain natriuretic peptide (Pro-BNP) circulates in human plasma.Biochem Biophys Res Commun. 1995; 214: 1175-1183
- Immunoreactive amino-terminal pro-brain natriuretic peptide (NT-PROBNP): a new marker of cardiac impairment.Clin Endocrinol (Oxf). 1997; 47: 287-296
- Radioimmunoassay for N-terminal probrain natriuretic peptide in human plasma.Scand J Clin Lab Invest. 2001; 61: 33-42
- B-type natriuretic peptide measurements in diagnosing congestive heart failure in the dyspneic emergency department patient.Rev Cardiovasc Med. 2002; 3: S10-S17
- The potential of brain natriuretic peptide as a biomarker for New York Heart Association class during the outpatient treatment of heart failure.J Card Fail. 2002; 8: 149-154
- The impact of B-type natriuretic peptide levels on the diagnoses and management of congestive heart failure.Curr Opin Cardiol. 2002; 17: 340-345
- Validating aminoterminal BNP assays: a word of caution.Lancet. 1999; 353: 1068-1069
- Value of natriuretic peptides in assessment of patients with possible new heart failure in primary care.Lancet. 1997; 350: 1349-1353
- Plasma brain natriuretic peptide after long-term treatment for heart failure in general practice.Eur J Heart Fail. 2002; 4: 479-483
- Clinical criteria and biochemical markers for the detection of systolic dysfunction.J Card Fail. 2000; 6: 194-200
- Brain natriuretic peptide levels predict functional capacity in patients with chronic heart failure.J Am Coll Cardiol. 2002; 40: 718-722
- Clinical significance of blood brain natriuretic peptide level measurement in the detection of heart disease in untreated outpatients: comparison of electrocardiography, chest radiography and echocardiography.Circ J. 2002; 66: 122-126
- Plasma N-terminal pro-brain natriuretic peptide and the ECG in the assessment of left-ventricular systolic dysfunction in a high risk population.Eur Heart J. 1999 Dec; 20: 1736-1744
- Influence of hypertension, left ventricular hypertrophy, and left ventricular systolic dysfunction on plasma N terminal proBNP.Heart. 2000; 83: 278-282
- Plasma amino-terminal pro-brain natriuretic peptide: a novel approach to the diagnosis of cardiac dysfunction.J Card Fail. 2000; 6: 130-139
- Plasma N-terminal pro BNP and cardiotrophin-1 are elevated in aortic stenosis.Eur J Heart Fail. 2001; 3: 15-19
- Circulating N-terminal brain natriuretic peptide precursor and endothelin levels in patients with syndrome X and left bundle branch block with preserved systolic function.Int J Cardiol. 2001; 79: 25-30
- Detection of left ventricular enlargement and impaired systolic function with plasma N-terminal pro brain natriuretic peptide concentrations.Am Heart J. 2002; 143: 923-929
- The value of natriuretic peptides NT-pro-BNP and BNP for the assessment of left-ventricular volume and function. A prospective study of 150 patients.Dtsch Med Wochenschr. 2002; 127: 2605-2609
- Head-to-head comparison of N-terminal pro-brain natriuretic peptide, brain natriuretic peptide and N-terminal pro-atrial natriuretic peptide in diagnosing left ventricular dysfunction.Clin Chim Acta. 2001; 310: 193-197
- How to use natriuretic peptide levels for diagnosis and prognosis.Eur Heart J. 1999; 20: 1374-1375
- Doppler echocardiography-derived index of myocardial performance (TEI index): comparison with brain natriuretic peptide levels in various heart disease.Jpn Circ J. 2001; 65: 637-642
- Pregnancy-associated plasma protein A as a marker of acute coronary syndromes.N Engl J Med. 2001; 345: 1022-1029
- Evaluation of human serum albumin cobalt binding assay for the assessment of myocardial ischemia and myocardial infarction.Clin Chem. 2003; 49: 581-585
- Diagnostic value of B-type natriuretic peptide concentrations in patients with acute myocardial infarction.Am J Cardiol. 1996; 78: 284-287
- Plasma brain natriuretic peptide concentrations predict survival after acute myocardial infarction.J Am Coll Cardiol. 1996; 27: 1656-1661
- Neuroendocrine prediction of left ventricular function and heart failure after acute myocardial infarction. The Christchurch Cardioendocrine Research Group.Heart. 1999; 81: 114-120
- The prognostic value of B-type natriuretic peptide in patients with acute coronary syndromes.N Engl J Med. 2001; 345: 1014-1021
- B-type natriuretic peptide and acute coronary syndromes.N Engl J Med. 2002; 346: 453-454
- Multimarker approach to risk stratification in non-ST elevation acute coronary syndromes: simultaneous assessment of troponin I, C-reactive protein, and B-type natriuretic peptide.Circulation. 2002; 105: 1760-1763
- Early recanalization and plasma brain natriuretic peptide as an indicator of left ventricular function after acute myocardial infarction.Am Heart J. 2002; 143: 790-796
- Increased plasma brain natriuretic peptide level as a guide for silent myocardial ischemia in patients with non-obstructive hypertrophic cardiomyopathy.J Am Coll Cardiol. 2002; 39: 1657-1663
- Plasma N-terminal pro-brain natriuretic peptide and adrenomedullin: new neurohormonal predictors of left ventricular function and prognosis after myocardial infarction.Circulation. 1998; 97: 1921-1929
- Plasma N terminal pro-brain natriuretic peptide and cardiotrophin 1 are raised in unstable angina.Heart. 2000; 84: 421-424
- Prognostic value of N-terminal pro-atrial and pro-brain natriuretic peptide in patients with acute coronary syndromes.Am J Cardiol. 2002; 89: 463-465
- N-terminal pro-B-type natriuretic peptide and long-term mortality in acute coronary syndromes.Circulation. 2002; 106: 2913-2918
- N-terminal pro brain natriuretic peptide on admission for early risk stratification of patients with chest pain and no ST-segment elevation.J Am Coll Cardiol. 2002; 40: 437-445
- Left ventricular remodeling in the first year after acute myocardial infarction and the predictive value of N-terminal pro brain natriuretic peptide.Am Heart J. 2002; 143: 696-702
- Plasma catecholamines and N-terminal proBNP in patients with acute myocardial infarction undergoing primary angioplasty. Relation to left ventricular function and clinical outcome.Z Kardiol. 2003; 92: 73-81
- N-terminal proBNP—the most cost effective way to identify post infarction left ventricular dysfunction?.Eur Heart J. 2000; 21: 1490-1492
- Plasma amino-terminal pro-brain natriuretic peptide levels in subjects presenting to the emergency department with suspected acute coronary syndrome: possible role in selecting patients for follow up?.Intern Med J. 2001; 31: 211-219
- A rapid test for B-type natriuretic peptide correlates with falling wedge pressures in patients treated for decompensated heart failure: a pilot study.J Card Fail. 2001; 7: 21-29
- Titration of vasodilator therapy in chronic heart failure according to plasma brain natriuretic peptide concentration: randomized comparison of the hemodynamic and neuroendocrine effects of tailored versus empirical therapy.Am Heart J. 1999; 138: 1126-1132
- Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations.Lancet. 2000; 355: 1126-1130
- BNP in hormone-guided treatment of heart failure.Trends Endocrinol Metab. 2002; 13: 151-155
- Brain natriuretic peptide-guided therapy for heart failure.Ann Med. 2001; 33: 422-427
- Biochemical detection of left-ventricular systolic dysfunction.Lancet. 1998; 351: 9-13
- Value of plasma B type natriuretic peptide measurement for heart disease screening in a Japanese population.Heart. 2002; 87: 131-135
- Plasma natriuretic peptides for community screening for left ventricular hypertrophy and systolic dysfunction: the Framingham Heart Study.JAMA. 2002; 288: 1252-1259
- Reliability of N-terminal pro-brain natriuretic peptide assay in diagnosis of heart failure: cohort study in representative and high risk community populations.BMJ. 2002; 324: 1498
- NT-proBNP: a new diagnostic screening tool to differentiate between patients with normal and reduced left ventricular systolic function.Heart. 2003; 89: 150-154
- High levels of plasma brain natriuretic peptide and interleukin-6 after optimized treatment for heart failure are independent risk factors for morbidity and mortality in patients with congestive heart failure.J Am Coll Cardiol. 2000; 36: 1587-1593
- A rapid bedside test for B-type peptide predicts treatment outcomes in patients admitted for decompensated heart failure: a pilot study.J Am Coll Cardiol. 2001; 37: 386-391
- Prediction of outcome by neurohumoral activation, the six-minute walk test and the Minnesota Living with Heart Failure Questionnaire in an outpatient cohort with congestive heart failure.Eur Heart J. 2002; 23: 886-891
- Role of brain natriuretic peptide in risk stratification of patients with congestive heart failure.J Am Coll Cardiol. 2001; 38: 1934-1941
- Risk stratification using a combination of cardiac troponin T and brain natriuretic peptide in patients hospitalized for worsening chronic heart failure.Am J Cardiol. 2002; 89: 691-695
- B-type natriuretic peptide predicts sudden death in patients with chronic heart failure.Circulation. 2002; 105: 2392-2397
- Decreased plasma concentration of brain natriuretic peptide as a potential indicator of cardiac recovery in patients supported by mechanical circulatory assist systems.J Am Coll Cardiol. 2001; 38: 1942-1949
- The prognostic role of brain natriuretic peptides in hemodialysis patients.Am J Nephrol. 2002; 22: 437-444
- Increased circulating levels of natriuretic peptides predict future cardiac event in patients with chronic hemodialysis.Nephron. 2002; 92: 610-615
- Significance of brain natriuretic peptides in patients on continuous ambulatory peritoneal dialysis.Int J Mol Med. 2002; 10: 457-461
- Assessment of cardiotoxicity during haemopoietic stem cell transplantation with plasma brain natriuretic peptide.Bone Marrow Transplant. 2000; 26: 309-313
- Brain natriuretic peptide as a risk marker for incident hypertensive cardiovascular events.Hypertens Res. 2002; 25: 669-676
- Plasma levels of natriuretic peptide and echocardiographic parameters in patients with Duchenne's progressive muscular dystrophy.Pediatr Cardiol. 2002; 23: 160-166
- Plasma N-terminal pro-brain natriuretic peptide and adrenomedullin: prognostic utility and prediction of benefit from carvedilol in chronic ischemic left ventricular dysfunction. Australia-New Zealand Heart Failure Group.J Am Coll Cardiol. 2001; 37: 1781-1787
- Utility of a BNP as a marker for RV dysfunction in acute pulmonary embolism.J Am Coll Cardiol. 2002; 39: 2080
- Increased brain natriuretic peptide as a marker for right ventricular dysfunction in acute pulmonary embolism.Thromb Haemost. 2001; 86: 1193-1196
- Plasma brain natriuretic peptide as a noninvasive marker for efficacy of pulmonary thromboendarterectomy.Ann Thorac Surg. 2002; 74: 180-184
- Diagnostic value of plasma levels of brain natriuretic peptide in arrhythmogenic right ventricular dysplasia.Circulation. 1998; 98: 2433-2440
- Comparison of transthoracic Doppler echocardiography and natriuretic peptides in predicting mean pulmonary capillary wedge pressure in patients with chronic atrial fibrillation.J Am Soc Echocardiogr. 2001; 14: 1080-1087
- Drop in plasma brain natriuretic peptide levels after successful direct current cardioversion in chronic atrial fibrillation.Can J Cardiol. 2001; 17: 415-420
- High plasma brain natriuretic polypeptide level as a marker of risk for thromboembolism in patients with nonvalvular atrial fibrillation.Stroke. 2002; 33: 1005-1010
- Brain and atrial natriuretic peptide plasma concentrations in normal healthy children.Br J Biomed Sci. 1993; 50: 92-95
- Plasma brain natriuretic peptide concentrations in healthy children from birth to adolescence: marked and rapid increase after birth.Eur J Endocrinol. 1995; 133: 207-209
- Quantitative evaluation of the changes in plasma concentrations of cardiac natriuretic peptide before and after transcatheter closure of atrial septal defect.Acta Paediatr. 2002; 91: 649-652
- Plasma brain natriuretic peptide as a predictor of haemodynamically significant patent ductus arteriosus in preterm infants.Clin Sci (Lond). 2002; 103: 75-77
- Plasma levels of natriuretic peptides in relation to doxorubicin-induced cardiotoxicity and cardiac function in children with cancer.Med Pediatr Oncol. 2001; 37: 4-9
- Plasma concentrations of N-terminal pro-brain natriuretic peptide in control children from the neonatal to adolescent period and in children with congestive heart failure.Pediatrics. 2002; 110: E76
- Cardiac troponin I and N-terminal pro-brain natriuretic peptide in umbilical artery blood in relation to fetal heart rate abnormalities during labor.Pediatr Cardiol. 2001; 22: 393-396
- Evaluation of a new, rapid bedside test for quantitative determination of B-type natriuretic peptide.Clin Chem. 2001; 47: 591-594
- Rapid bedside measurement of brain natriuretic peptide in patients with chronic heart failure.Int J Cardiol. 2002; 86: 143-149
- Utility of B-natriuretic peptide as a rapid, point-of-care test for screening patients undergoing echocardiography to determine left ventricular dysfunction.Am Heart J. 2001; 141: 367-374
- Utility of B-type natriuretic peptide in the diagnosis of congestive heart failure in an urgent-care setting.J Am Coll Cardiol. 2001; 37: 379-385
- Utility of a rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea.J Am Coll Cardiol. 2002; 39: 202-209
- A rapid B-type natriuretic peptide assay accurately diagnoses left ventricular dysfunction and heart failure: a multicenter evaluation.Am Heart J. 2002; 144: 834-839
- Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure.N Engl J Med. 2002; 347: 161-167
- B-type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from Breathing Not Properly (BNP) Multinational Study.Circulation. 2002; 106: 416-422
- Utility of B-natriuretic peptide in detecting diastolic dysfunction: comparison with Doppler velocity recordings.Circulation. 2002; 105: 595-601
- Usefulness of B-type natriuretic peptide levels in predicting hemodynamic perturbations after heart transplantation despite preserved left ventricular systolic function.Am J Cardiol. 2002; 90: 1326-1329
- B-type natriuretic peptide (BNP) levels: diagnostic and therapeutic potential.Rev Cardiovasc Med. 2001; 2: S13-S18
- Circulating levels of cardiac natriuretic peptides (ANP and BNP) measured by highly sensitive and specific immunoradiometric assays in normal subjects and in patients with different degrees of heart failure.J Endocrinol Invest. 1998; 21: 170-179
- Plasma brain natriuretic peptide concentration: impact of age and gender.J Am Coll Cardiol. 2002; 40: 976-982
Roche Diagnostics. Product insert 03121640. Indianapolis (IN); 2003.
- Plasma levels of adrenomedullin and atrial and brain natriuretic peptides in the general population: their relations to age and pulse pressure.Hypertens Res. 2002; 25: 887-892
- Interpretation of plasma brain natriuretic peptide concentrations may require adjustment for patient's age.Ann Clin Biochem. 2002; 39: 151-153
- Stability of B-type natriuretic peptide levels during exercise in patients with congestive heart failure: implications for outpatient monitoring with B-type natriuretic peptide.Am Heart J. 2002; 143: 406-411
- Circulating brain natriuretic peptide values in healthy men before and after exercise.Metabolism. 2002; 51: 1423-1426
- B-type natriuretic peptide is related to left ventricular mass in hypertensive patients but not in athletes.Cardiology. 2002; 98: 113-115
- A new, fast and reliable radioimmunoassay of brain natriuretic peptide in human plasma. Reference values in healthy subjects and in patients with different diseases.Scand J Clin Lab Invest. 1997; 57: 529-540
- Degradation of human brain natriuretic peptide (BNP) by contact activation of blood coagulation system.Clin Chim Acta. 2001; 305: 181-186
- BNP in the diagnosis of heart failure.Advance/Laboratory. 2003; 12: 63-72
- Increased brain natriuretic peptide and atrial natriuretic peptide plasma concentrations in dialysis-dependent chronic renal failure and in patients with elevated left ventricular filling pressure.Clin Investig. 1994; 72: 430-434
- The effect of aortic valve replacement on N-terminal natriuretic propeptides in patients with aortic stenosis.Clin Cardiol. 2002; 25: 174-180
Article info
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
