NTproBNP: An Important Biomarker in Cardiac Diseases

Abstract

Natriuretic neuropeptides (ANP, BNP, CNP) are produced primarily in the cardiac atria under normal conditions. The main stimulus for ANP and BNP peptide synthesis and secretion is cardiac wall stress. Cardiac ventricular myocytes constitute the major source of BNP-related peptides. Ventricular NT-proBNP production is upregulated in cardiac failure and locally in the area surrounding a myocardial infarct. NT-proBNP is cleared passively by organs with high rate of blood flow (muscle, liver, kidney). It has a longer half life than BNP and higher plasma concentration. BNP and NTproBNP tend to be higher in women and lower in obese individuals. They are also higher in elderly, in left ventricular tachycardia, right ventricular overload, myocardial ischemia, hypoxaemia, renal dysfunction, liver cirrhosis, sepsis and infection. NT-proBNP is useful both in the diagnosis and prognosis of heart failure and is considered to be a gold standard biomarker in heart failure similar to BNP. A cut-off point 300 pg/ml has 99% sensitivity, 60%specificity and NPV 98%for exclusion of acute heart failure. NT proBNP has also a strong prognostic value of death in acute and chronic heart failure and also predicts short and long term mortality in patient with suspected or confirmed unstable CVD. Natriuretic peptides are also prognostic markers for the RV (Right Ventricular) Dysfunction. Their release is due to myocardial stretch from right ventricular pressure overload.Finally, there are data supporting that NT-proBNP might be useful to put a time frame on atrial fibrillation of unknown onset.

Atorvastatin/trimetazidine combination therapy in patients with chronic cardiac failure

“…Recent studies have suggested that monitoring the BNP level could aid in the early diagnosis of chronic cardiac failure and serve as an indicator of the curative effects of treatment and prognosis. Patients with more serious disease had higher BNP levels [21].…”

“…21.0 software; all data were expressed as mean ± standard deviations (SD). The paired t-test was used to compare data obtained before and after treatment, and between-group comparisons were made using the two-sample t-test.…”

Sleep Apnea in Total Joint Arthroplasty Patients and the Role for Cardiac Biomarkers for Risk Stratification: an Exploration of Feasibility

“…Brain natriuretic peptide (BNP) belongs to a group of vasodilator and anti-proliferative neurohormonal natriuretic polypeptides that are produced primarily by the cardiac ventricles (and in lesser amounts by the brain and adrenal glands) in response to stretching of cardiac myocytes or increased cardiac wall stress [139]. ProBNP, a biologically inactive prohormone, is secreted by the ventricles in response to ventricular dysfunction and cleaved into the physiologically active BNP and the biologically inactive N-terminal fragment (NTproBNP) [139].…”

“…ProBNP, a biologically inactive prohormone, is secreted by the ventricles in response to ventricular dysfunction and cleaved into the physiologically active BNP and the biologically inactive N-terminal fragment (NTproBNP) [139]. BNP has a half-life of approximately 20 min, and is cleared actively and passively through the renal system.…”

“…BNP has a half-life of approximately 20 min, and is cleared actively and passively through the renal system. NT-proBNP has a plasma half-life of approximately 2 h, and is cleared primarily through the renal system (as well as through muscles and the liver) [139]. BNP and NT-proBNP increase with age, and are found in higher levels in women and in lower future science group Review Lyons, Bhatt, Kneeland-Szanto et al future science group…”