- N-terminal (NT)-pro hormone BNP (NT-proBNP) is a non-active prohormone that is released from the same molecule that produces BNP.
- B-type natriuretic peptide (BNP) is a hormone produced by your heart.
- Both BNP and NT-proBNP are released in response to changes in pressure inside the heart. These changes can be related to heart failure and other cardiac problems.
Levels goes up when heart failure develops or gets worse, and levels goes down when heart failure is stable. In most cases, BNP and NT-proBNP levels are higher in patients with heart failure than people who have normal heart function.
A NT-proBNP test can be used, along with other cardiac biomarker tests, to detect heart stress and damage and/or along with lung function tests to distinguish between causes of shortness of breath. Chest X-rays and an ultrasound test called echocardiography may also be performed. Your healthcare practitioner may also prescribe a stress test, which takes place on a treadmill.
When the left ventricle of the heart is having difficulty pumping sufficient amounts of blood to the body, the concentrations of NTproBNP produced can increase markedly. This may occur with many diseases that affect the heart and circulatory system. The increase in circulating NT-proBNP will reflect this diminished capacity to deliver oxygenated blood to the body.
A test for NT-proBNP is primarily used to help detect, support diagnosis, and in some instances evaluate the severity of heart failure. The two tests are not interchangeable and should not be used together. Your healthcare practitioner should order one or the other but not both.
Normal results indicate that signs and symptoms are likely due to something other than heart failure.
A normal level of NT-proBNP is:
- Less than 125 pg/mL for patients aged 0-74 years
- Less than 450 pg/mL for patients aged 75-99 years
If you have heart failure, the following NT-proBNP levels could mean your heart function is unstable:
- Higher than 450 pg/mL for patients under age 50
- Higher than 900 pg/mL for patients age 50 and older
Note: Your doctor or nurse can give you more specific information about your test results. Depending on your personal health history, your normal range may differ from other patients with different backgrounds.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767525/
NT-proBNP levels decrease in most people who are taking drug therapies for heart failure, such as angiotensin-converting enzyme (ACE) inhibitors, beta blockers, and diuretics.
Obese individuals may have lower concentrations of NT-proBNP.
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Higher-than-normal results suggest that you have some degree of heart failure, and the level of NT-proBNP in the blood may be related to its severity. Higher levels of NT-proBNP are often associated with an increased need for aggressive therapy. In some individuals with chronic heart failure, the markers may remain elevated and cannot be used to monitor response.
Levels of NT-proBNP tend to increase with age in the absence of disease.
Levels of NT-proBNP may be increased in persons with kidney disease due to reduced clearance.
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