When you have symptoms of heart failure, such as fatigue and shortness of breath, a BNP test can help your doctor determine whether it’s heart failure or pneumonia. BNP blood tests lead to an accurate diagnosis of heart failure about 90% of the time. BNP levels can also help your doctor determine your outlook after heart failure.
Full Answer
What is a BNP test for heart failure?
If your doctor orders a BNP test, you are probably showing symptoms of heart failure. The test measures a hormone called “brain natriuretic peptide.” During heart failure, pressure builds up in the chambers of your heart and creates BNP. When the heart works harder and doesn’t pump blood well, it releases this hormone in large amounts.
What are the treatments for high BNP levels in heart failure?
Your doctor may prescribe ACE inhibitors, beta blockers, or diuretics to help. Other factors that you may or may not be able to control could also keep BNP levels up, such as: The BNP test is only one way to monitor heart failure. Another blood test, called ANP, measures atrial natriuretic peptide, which is a hormone like BNP.
Is proBNP a good indicator of CHF?
BNP was shown to have a high negative predictive value in ruling out CHF. Additionally, the level of BNP correlated with the severity of disease as assessed by the NYHA CHF classification. 7 In November 2002, Roche Diagnostics (Indianapolis, IN) received FDA clearance to market the Elecsys® proBNP assay.
What are BNP levels and why do they matter?
BNP levels can also help your doctor determine your outlook after heart failure. Generally, a higher level means a worse outcome. As levels drop, however, you’ll start to feel better and breathe easier, and your outlook will get better, too. After diagnosis, additional BNP tests can:
How does BNP diagnosis heart failure?
The best way to diagnose and treat these patients is unclear. BNP increases when cardiac myocytes are strained; therefore, BNP is an effective method for detecting heart failure with or without systolic dysfunction.
Can BNP be used to monitor heart failure?
The 2010 NICE guideline on the management of chronic heart failure recommends that BNP (or its derivative N-terminal pro-Btype natriuretic peptide, NTproBNP) is measured in people with suspected heart failure who have no history of heart attack.
How do you measure BNP?
A BNP test is done by drawing blood from a vein in your arm using a hypodermic needle. This process is known as venipuncture. A machine then measures levels of BNP or another heart hormone, called N-terminal-pro BNP (NT-pro-BNP), in the blood sample. The results from the test are usually ready in 15 to 20 minutes.
What diagnosis can be used for BNP?
1. BNP measurements are used to distinguish cardiac cause of acute dyspnea from pulmonary or other non-cardiac causes. 2. BNP is particularly useful in distinguishing decompensated CHF from exacerbated chronic obstructive pulmonary disease (COPD) in a symptomatic patient with combined CHF and COPD.
How accurate is BNP in diagnosing heart failure?
In general, the diagnostic accuracy is approximately 90% at the cut-off value of BNP (100 pg/mL) or NT-proBNP (162 pmol/L).
What is BNP test for heart?
Brain natriuretic peptide (BNP) test is a blood test that measures levels of a protein called BNP that is made by your heart and blood vessels. BNP levels are higher than normal when you have heart failure.
Why is BNP important?
Why Is a BNP Blood Test Needed? BNP levels help your doctor figure out if you have heart failure or something else that has similar symptoms such as shortness of breath. The test also shows if your heart failure has worsened. It'll help your doctor decide what treatments you need and if you need to be hospitalized.
What is the function of BNP?
B-type natriuretic peptide (BNP) belongs to a family of protein hormones called natriuretic peptides. These natriuretic peptides have an important role in regulating the circulation. They act on blood vessels, causing them to dilate, or widen. They also work on the kidneys, causing them to excrete more salt and water.
How do you interpret BNP results?
BNP levels go up when the heart cannot pump the way it should. A result greater than 100 pg/mL is abnormal. The higher the number, the more likely heart failure is present and the more severe it is. Sometimes other conditions can cause high BNP levels.
How do you collect a BNP?
Do not collect in glass. Collect in a plastic lavender-top (EDTA) tube. Centrifuge and transfer the plasma into a LabCorp PP transpak frozen purple tube with screw cap (LabCorp N° 49482). Freeze within 24 hours and maintain frozen until tested.
Why do doctors measure BNP?
Measuring BNP levels in the blood through a blood test can help doctors to determine whether a patient’s shortness of breath is due to heart failure, or to some other cause .
Why is the BNP test used?
BNP tests can also be used to monitor the severity of heart failure once diagnosed.
Why is BNP important?
BNP helps to regulate the body’s salt and fluid content, and reduces blood pressure . In patients who have heart failure, BNP levels tend to become greatly elevated during episodes of worsening shortness of breath.
Why is BNP important in heart failure?
When the heart works harder and doesn’t pump blood well, it releases this hormone in large amounts. BNP widens your blood vessels to help improve circulation. That’s why higher levels may be a sign of heart failure.
What is the blood test for BNP?
Another blood test, called ANP, measures atrial natriuretic peptide, which is a hormone like BNP. The larger, more powerful chambers in the lower portion of your heart produce BNP. The upper chambers produce ANP. Doctors may confirm your results with other blood tests, a chest X-ray, an electrocardiogram, or an echocardiogram.
What is the NT-proBNP test?
The NT-proBNP blood test measures brain natriuretic peptide to detect heart failure. If your doctor orders a BNP test, you are probably showing symptoms of heart failure. The test measures a hormone called “brain natriuretic peptide.”. During heart failure, pressure builds up in the chambers of your heart and creates BNP.
What is the purpose of a BNP test?
BNP blood tests lead to an accurate diagnosis of heart failure about 90% of the time.
What are the factors that can keep BNP levels up?
Other factors that you may or may not be able to control could also keep BNP levels up, such as: High blood pressure. An overactive thyroid. High levels of the stress hormone cortisol. Certain rare tumors.
What happens when your BNP levels drop?
As levels drop, however, you’ll start to feel better and breathe easier, and your outlook will get better, too. After diagnosis, additional BNP tests can: Show how well your treatment is working. Let doctors know when it is safe for you to leave the hospital.
What tests can confirm heart disease?
Doctors may confirm your results with other blood tests, a chest X-ray, an electrocardiogram, or an echocardiogram. These tests can provide more details about the condition of your heart. References. (c)2019 WebMD, LLC.
What does BNP mean in heart failure?
Your results will indicate if your BNP levels are high enough to suspect a diagnosis of heart failure. If you already have a diagnosis of heart failure, the results can help your doctor find out whether heart failure treatments are helping treat it. Generally, BNP levels below 100 picograms per milliliter (pg/mL) are considered normal.
Why does BNP help with congestive heart failure?
When you have congestive heart failure, your heart can’t pump blood properly throughout your body because the walls of your heart chambers, known as the ventricles, become too weak.
What is BNP blood test?
A B-type natriuretic peptide (BNP) blood test measures the levels of the BNP hormone in your blood. BNP and another heart hormone called atrial natriuretic peptide (ANP) work together to keep your veins and arteries widened, or dilated. This allows your blood to easily pass through and prevents clots from forming.
How long does it take to get a BNP test?
A machine then measures levels of BNP or another heart hormone, called N-terminal-pro BNP (NT-pro-BNP), in the blood sample. The results from the test are usually ready in 15 to 20 minutes.
What does high BNP mean?
If high BNP levels indicate heart failure, your doctor will let you know what steps you need to take to prevent complications of this condition. See your doctor regularly to monitor your BNP levels if needed. Follow any instructions your doctor gives you to maintain your best heart health.
What causes a BNP test to be elevated?
nausea or having no appetite. A BNP test can also help rule out heart failure. Other conditions can cause elevated BNP levels, including lung or kidney conditions and obesity.
How to manage heart failure?
Improving your heart health can help reduce the effects of heart failure and other heart conditions. Consider these heart-healthy steps and ways to manage heart failure: 1 If you smoke, talk with your doctor about setting up a quit plan. 2 Stop consuming alcohol altogether, or drink fewer alcoholic beverages. 3 If you have overweight or obesity, work with your doctor to create a sustainable weight management plan. 4 Manage stress through practices such as yoga or meditation. 5 Exercise more often than not. Aim for at least 150 minutes of exercise a week. 6 Get 7 to 9 hours of sleep a night.
Differential Diagnosis
Diagnosis of CHF is difficult because CHF symptoms are non-specific. Preliminary diagnosis is based strictly on clinical symptoms such as fatigue, shortness of breath (dyspnea), edema-peripheral and pulmonary, tachycardia, rales and heart sounds.
Staging of Heart Failure
As with most pathologies, staging of the severity of heart failure is based primarily on clinical parameters ranging from less to most severe. The major classification system is the New York Heart Association (NYHA). The classification increases in severity from Class I to Class IV. The critical variables for each class are shown in Fig. 1.
Circulating Marker of CHF
B-type natriuretic peptide (BNP) is one of three natriuretic peptides. Atrial natriuretic peptide (ANP) and BNP originate in the cardiac myocytes, while C-type natriuretic peptide (CNP) originates in the endothelial cells. These peptides are characterized by a common 17 amino acid ring structure with a disulfide bond between two cysteine residues.
Commercial Assays for BNP and NT-proBNP
Within the past 15 years, numerous retrospective and prospective clinical studies have demonstrated that BNP can be used for a wide range of clinical applications related to heart failure, including diagnosis, monitoring and prognosis.6 While the original work was performed by investigators with “home brew” research assays, the introduction of the first commercial assay for BNP in 1993 by Shionogi & Co.
Clinical Applications of BNP
BNP levels have been shown to correlate to hemodynamic parameters associated with cardiac function and may serve as a surrogate for a number of cumbersome and expensive testing procedures, including echocardiography for determination of LVEF, pulmonary capillary wedge pressure (PCWP), and cardiac imaging.
Correlation with NYHA Classifications
In a study by Maisel et al of 1,586 patients (mean age 64 years) presenting to an emergency department with acute dyspnea (shortness of breath), BNP levels utilizing the Biosite Triage assay were shown to directly correlate with the New York Heart Association (NYHA) classifications for heart disease.10 Class I patients had a mean BNP level of 150 pg/mL; Class II, 250; Class III, 550; and Class IV, 900.
Correlation with Left Ventricular Systolic Dysfunction (LVSD)
In a study by McDonagh et al, BNP levels were shown to be useful in the detection of asymptomatic LVSD. 11 LVSD was defined as a LVEF <30 percent as measured by echocardiography. In this study of 1,653 asymptomatic individuals, mean BNP levels were significantly higher in the group with LVSD than in patients with LVEF of >30 percent.
What is a BNP and NT proBNP?
Beyond their guideline-supported use to identify patients with decompensated HF in both inpatient and outpatient venues, BNP and NT-proBNP provide powerful risk stratification across the entire range of HF stages. In this regard, NPs are additive to clinical judgment for prognostication and supplement or supersede other means of assessment for predicting adverse HF outcomes such as cardiopulmonary exercise testing. 10 Indeed, it is now widely accepted that NPs are among the gold standards for prognosis in HF, affording easily obtainable, reproducible, and interpretable information of all sorts for clinicians.
Is natriuretic peptide testing useful?
We have been asked to take the position that serial natriuretic peptide (NP) testing is useful for heart failure (HF) management. To do so, we primarily draw on our experience as physicians with active clinical practices replete with patients suffering from the diagnosis but also from our in-depth knowledge of NP testing and its strengths and weaknesses.
Is natriuretic peptides a good measure of heart failure?
Although natriuretic peptides (NPs) are powerful markers of cardiovascular risk in heart failure patients, there is little evidence that heart failure therapy should vary according to measured NP levels. Titration of neurohormonal antagonists to effective or maximally tolerated doses is recommended for all patients regardless of background risk, including the vast majority without markedly elevated NP levels. Although it is intuitively appealing to view NP levels as an objective measure of the adequacy of heart failure therapy, “optimal” NP targets are frequently unachievable in practice. When levels are persistently high, the “guidance” provided by serial NP measurements amounts to little more than a simple prompt to routinely intensify treatment, even when clinical judgment might direct caution. The low rate of serious adverse events with this approach in carefully selected clinical trial populations of younger patients with reduced ejection fraction does not guarantee safety during broader application in real-world practice, in which heart failure patients are often older with complex medical comorbidities and preserved ejection fraction. Drs Januzzi and Troughton correctly highlight the substantial opportunity for improvement in the quality of heart failure care through more consistent application and adjustment of guideline-recommended therapies; however, performance gaps are perhaps better addressed by educating clinicians to make evidence-based decisions rather than by encouraging them to substitute judgment with laboratory testing that has little bearing on the selection of appropriate treatment.
Are Serial BNP Measurements Useful in Heart Failure Management?
James L. Januzzi From the Cardiology Division, Massachusetts General Hospital, Boston (J.L.J.), and Christchurch Heart Institute, University of Otago, Christchurch, New Zealand (R.T.).
Response to Januzzi and Troughton
Although natriuretic peptides (NPs) are powerful markers of cardiovascular risk in heart failure patients, there is little evidence that heart failure therapy should vary according to measured NP levels.