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What Is Brain Natriuretic Peptide Test

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What Is The Bnp Test

ANP BNP Brain natriuretic peptide-

The BNP test is a diagnostic analysis that measures the amount of BNP hormone in the blood. Two central hormones BNP i.e. brain natriuretic peptide and ANP atrial natriuretic peptide are responsible for keeping the arteries and veins widened or dilated. This facilitates the smooth flow of blood via the circulatory tubules and averts the formation of blood clots. Furthermore, the optimal hormonal activity of BNP and ANP ensure kidney wellness and aid in the elimination of salts and fluids from the body.

In a normal individual, the levels of BNP in the bloodstream are within the normal range. However, in cases of congestive heart failure, the functioning of the heart is hampered and it fails to pump blood across the entire body since the walls of the heart chambers the ventricles, become very weak and fragile. As a result, the pressure within the heart vessels, as well as the systemic fluid volumes, increase and more BNP is produced to balance blood pressure and bodily fluid levels. This rise above the normal range of BNP is detected in the BNP test and helps identify an instance of heart failure.

Normal Bnp Range By Age And Sex

BNP levels increase naturally as you age, and people assigned female at birth typically have slightly higher levels. Underlying conditions can raise your BNP levels, too. Regardless of age or gender, a BNP level of 100 pg/mL or less is considered normal. The higher your level goes above that, the higher your chances are of developing heart failure. Other conditions, like kidney disease, can increase these chances even more.

Your doctor may use BNP tests alongside other diagnostic tests to confirm if you have heart failure, or if other conditions are responsible for the increase in your BNP levels.

The chart below shows the normal range, as well as the cutoff levels for a heart failure diagnosis at different ages. These figures use data from a specific type of BNP test called the N-terminal -pro hormone BNP .

Age Range
Acute heart failure

Why The Test Is Performed

You may need this test if you have signs of heart failure. Symptoms include shortness of breath and swelling of your legs or abdomen. The test helps make sure the problems are due to your heart and not your lungs, kidneys, or liver.

It is unclear if repeated BNP tests are helpful in guiding treatment in those already diagnosed with heart failure.

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How To Prepare For The Test

No special preparation is needed for a BNP test. As it is possible for stress and anxiety to temporarily raise your BNP levels, just do your best to stay calm during the blood draw.

If you faint at the sight of blood or feel weak from fasting, your doctor may recommend that someone come with you in case youre not able to drive or get yourself home.

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Role of B

Furthermore, an UpToDate reviews on Pathophysiology, clinical manifestations, and diagnosis of patent ductus arteriosus in premature infants states that Biomarkers, especially B-type natriuretic peptide or the inactive N-terminal pro-BNP, which has a longer half-life, have been proposed as useful in the diagnosis and management of PDA. However, the sensitivity and specificity of these tests vary in different populations and sites and further study is needed to identify their role in the diagnosis of PDA.

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What Is A Dangerous Bnp Level

A result higher than 100 pg/mL is abnormal and indicates that you may have heart failure. The higher the result, the more likely you have heart failure and the more you need urgent medical attention. However, do not overlook the impact of low BNP since low BNP levels can also imply heart failure. According to a report, a small number of people hospitalized for conditions similar to heart failure had BNP levels lower than usual.

Specifically, deficient BNP levels, measured at below 50 pg/ml, were found in a small percentage of hospitalized patients with heart failure. A smaller percentage of patients had too low BNP levels that tests failed to determine any value. Although the cause of these incidents was not fully understood, scientists believed that high body mass index and obesity might be the possible determinant of low BNP.

What Are Natriuretic Peptide Tests

Natriuretic peptides are substances made by the heart. Two main types of these substances are brain natriuretic peptide and N-terminal pro b-type natriuretic peptide . Normally, only small levels of BNP and NT-proBNP are found in the bloodstream. High levels can mean your heart isn’t pumping as much blood as your body needs. When this happens, it’s known as heart failure, sometimes called congestive heart failure.

Natriuretic peptide tests measure the levels of BNP or NT-proBNP in your blood. Your health care provider may order a BNP test or an NT-proBNP test, but not both. They are both useful in diagnosing heart failure, but rely on different types of measurements. The choice will depend on the equipment available in your provider’s recommended laboratory.

Other names: brain natriuretic peptide, NT-proB-type natriuretic peptide test, B-type natriuretic peptide

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Are Test Results Accurate

Many variables affect the accuracy and interpretation of the BNP and NT-proBNP tests, which is why it is so important to discuss your results with your physician.

For example, some factors that may affect test accuracy include:

  • Type of test: There can be some variation in results from rapid tests and tests analyzed by a laboratory. Reference ranges may also differ by laboratory.
  • Individual factors: The expected BNP and NT-proBNP level in healthy people varies by age. A doctor will also take into account your sex, genetics, and body mass index when interpreting your results.
  • Other health conditions: More than one type of health problem can cause BNP or NT-proBNP levels to be elevated, which means that this test alone may not be able to diagnose congestive heart failure or another condition.

If you have any questions about the accuracy of your test results, talk with your health care provider to learn more about the type of test you had and its significance for your health.

Why Is A Bnp Blood Test Needed

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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. Itâll help your doctor decide what treatments you need and if you need to be hospitalized. It may also give them a look into what the future may hold. It is a sensitive test to allow the doctor to evaluate improvement or worsening of heart failure and to help monitor whether or not the medication is working well.

Depending on your medical center, you may get tested for one or both proteins.

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Prediction Of The Occurrence Of Atrial Fibrillation After Thoracic Surgery

In a systematic review and meta-analysis, Simmers et al examined if elevated pre-operative BNP measurements are an independent predictor of AF in patients having thoracic surgery. Embase, Ovid Health Star, Ovid Medline, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ProQuest Dissertations and Theses A& I databases were searched for all studies of non-cardiac thoracic surgery patients in whom a pre-operative NP was measured up to 1 month before surgery, and that measured the incidence of post-operative AF. Studies were included regardless of their language, sample size, publication status, or study design. Study quality was evaluated using the Newcastle Ottawa Scale. The combined incidence of post-operative AF was 14.5 % , and the NP thresholds used to predict AF varied among studies. An elevated pre-operative NP measurement was associated with an OR of 3.13 for post-operative AF, with the sensitivity analysis reporting an OR of 9.51 . The authors concluded that patients with an elevated pre-operative NP measurement were at an increased risk of post-operative AF. They stated that there may be value in incorporating NP measurement into existing AF risk prediction models.

What Are Normal And High Bnp Levels

BNP tests, also called a B-type natriuretic peptide test, measure BNP by picograms per milliliter or nanograms per liter. The range includes:

  • Normal: Less than 100 pg/mL
  • High: More than 400 pg/mL
  • Between 100 to 400 pg/mL requires a doctors evaluation

Another test that measures BNP, called the NT-proBNP, has these ranges that vary by age:

BNP Levels by Ages Chart

Over the age of 75More than 1,800

Tests results can also vary by sex, body mass index, health history, and other factors. Levels tend to get higher as you age. BNP is also usually higher in women than men. People who are obese tend to have lower levels. Ask your doctor what your specific results mean for you.

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Workplacetesting Explains Brain Natriuretic Peptide Test

Brain natriuretic peptides are hormones naturally present in the blood of healthy individuals. Produced by the heart and blood vessels, more of this protein is produced when the heart is failing. When symptoms of heart failure such as shortness of breath or swelling of the legs and abdomen are present, the BNP test may be used to rule out other causes such as lung or liver dysfunction. Brain natriuretic peptide testing may also be used to monitor a patient’s response to treatment for heart failure.

How Is A Bnp Test Performed

Figure 1 from Natriuretic peptides and cGMP signaling control of energy ...

You should have your doctor perform a BNP test on you if you have symptoms of congestive heart failure, including:

  • Difficulty breathing
  • Nausea or loss of appetite

During a BNP test, your doctor will use a small needle to draw blood from your arm. After collecting a small amount of your blood, your doctor will use a test tube or vial to hold the blood sample. The test tube is then placed in a machine that measures BNP concentration. The entire process usually takes less than 15 minutes.

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How Is My Level Of Bnp/nt

You may hear your healthcare team refer to BNP or NT-proBNP levels, depending on the equipment used by the laboratory. BNP and NT-proBNP are measured as a simple blood test to help diagnose and monitor heart failure. BNP and NT-proBNP test results provide different values. At Cleveland Clinic, doctors rely mostly on NT-proBNP testing to monitor patients with heart failure. You do not need to fast or do anything to prepare for the test.

Brain Natriuretic Peptide/bnp Test: Procedure Risks And Results

The heart is a crucial internal organ within the human body, pumping blood enriched with oxygen and nutrients to other cells, tissues at the rate of 60 100 beats per minute , in addition to transporting metabolic wastes for elimination from the system and maintaining normal blood pressure in the blood vessels of the arteries and veins. Hence, when any health anomalies arise in the cardiac tissues, they must be promptly diagnosed and treated, to ensure timely recovery and overall wellbeing. A key diagnostic assay that detects instances of heart failure is the brain natriuretic peptide test also referred to as the B-type natriuretic peptide test or the BNP test.

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How Is This Test Performed

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 , in the blood sample.

The results from the test are usually ready in 15 to 20 minutes. Results may take up to a week if the blood is sent to a separate lab facility for analysis.

Preparing For The Bnp Lab Test

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You dont need to fast or do anything to prepare for the test. You can get it at any time of day.

Make sure your doctor knows about all medications, vitamins, herbs, and supplements you take. That includes ones that dont need a prescription. These can affect how your doctor interprets your BNP readings.

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Diagnosis Prognostic Evaluation And Screening For Hypertrophic Cardiomyopathy

An UpToDate review on Hypertrophic cardiomyopathy: Clinical manifestations, diagnosis, and evaluation states that The range of values associated with plasma brain natriuretic peptide and N-terminal pro-BNP concentration is quite broad and does not correlate well with HF symptoms in patients with HCM. As a result, we do not order this test as part of the diagnostic or prognostic evaluation of patients with suspected HCM.

However, guidelines on hypertrophic cardiomyopathy from the European Society of Cardiology recommend measurement of BNP. “High levels of brain natriuretic peptide , N-terminal pro-brain natriuretic peptide and high sensitivity cardiac troponin T are associated with cardiovascular events, heart failure and death. Despite comparable values of ventricular wall thickness, plasma BNP values are three to five times as high in patients with cardiac amyloidosis as those in other causes of HCM.”

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The authors stated that this study had 2 main drawbacks. First, this trial was a cross-sectional study thus, these researchers could not draw conclusions regarding causality or the direction of the associations. However, from a biologic perspective, and on the basis of animal studies, it is more likely that cardiac dysfunction affects brain changes than vice versa. Second, this study consisted largely of white participants, and this may have limited extrapolation of these findings to patients of other ethnicities.

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Why Do I Need A Natriuretic Peptide Test

You may need a BNP test or an NT-proBNP test if you have symptoms of heart failure. These include:

If you are being treated for heart failure, your health care provider may order one of these tests to see how well your treatment is working.

Causes Of Elevated Bnp And Information About Bnp Test â Emergency Medicine EducationBNP Level in the Emergency ...

BNP, or brain natriuretic peptide, is a heart produced hormone found in blood. It is secreted due to abnormal stretching of the heart muscle. Its levels are known to be the indicator of the state of the cardiovascular system, and are of big assistance when diagnosing the severity of a heart failure and conditions such as diastolic dysfunction. Normally, a low amount of this hormone is always present in our blood however, an elevated BNP is far from normal.

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What Happens During A Natriuretic Peptide Test

For a BNP test or an NT-proBNP test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

What Are The Benefits Of A Bnp Or Nt

Using just a small amount of blood, this test gives your provider important information about your heart health. A BNP or NT-proBNP test helps your provider diagnose heart failure and rule out other health conditions that cause similar symptoms. The results of a BNP test or NT-proBNP test also allow your provider to plan treatments and monitor how well theyre working.

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When Do Doctors Use The Bnp Test

Doctors often order the BNP test for people they believe may experiencing heart failure. Heart failure is where a persons heart does not pump blood efficiently enough to support their bodys needs or when the heart does not relax normally, leading to elevated heart pressure.

However, any factors that can increase pressure in the heart or stretch its atria chambers, such as blood clots in the lungs which doctors refer to as pulmonary embolism can cause elevated BNP levels.

Some signs that an individual may be experiencing heart failure include:

Doctors usually use a BNP test to help detect heart failure. Additionally, they can use the test to help with prognoses, as elevated BNP levels can increase the risk of adverse outcomes, even in those without heart failure. Healthcare professionals may also order a blood screening to investigate what might be contributing to heart failure and to help devise a treatment plan.

Additionally, doctors may use the BNP test to assess how well a persons heart failure treatments are working.

The BNP test follows a standard blood test procedure, which a doctor, nurse, or phlebotomist performs. A phlebotomist is a person trained in drawing blood.

The medical professional will:

Most people can resume their normal activities immediately after the screening.

How Does The Test Work

Natriuretic peptides

BNP, first discovered in 1988, belongs to the natriuretic peptide family that also contains atrial natriuretic peptide , Ctype natriuretic peptide , and urodilatin.

Naturally the heart secretes natriuretic peptides to maintain a normostatic blood pressure and blood plasma volume and to prevent excess salt and water retention. The major source of BNP synthesis and secretion is the ventricular myocardium specifically in response to the left ventricular stretching or wall tension.

Other actions of natriuretic peptides, including BNP include:

  • Down-regulating the sympathetic nervous system and the renin-angiotensin-aldosterone system
  • Facilitating natriuresis and diuresis through the afferent and efferent hemodynamic mechanisms of the kidney and distal tubules
  • Increasing smooth muscle relaxation

In CHF, these natriuretic peptides are damaged and unable to function properly. This causes a rise in your BNP which is used as an indicator for new onset heart failure or worsening heart failure.

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