NT-proBNP

N-terminal pro B-type natriuretic peptide (NT-proBNP) is a useful diagnostic marker for the diagnosis of HF. NT-proBNP is a 76–amino acid peptide produced primarily in the heart. B-type natriuretic peptide (BNP) is synthesized in cardiomyocytes as the precursor form (proBNP 1-108) that is cleaved by a specific enzyme to form the physiologically active BNP (77-108) and inactive N-terminal proBNP (1-76, NT-proBNP)[4].

B-type natriuretic peptide (BNP) and N-terminal pro BNP (NT-proBNP) are natriuretic peptides and serve as serum biomarkers for the diagnosis of heart failure [5].  Despite being equally used for the diagnosis of heart failure, there are major differences including the plasma half-time, which is about 20 min for BNP and 25–70 min for NT-proBNP [6]. In healthy subjects the plasma levels of NT-proBNP are higher than BNP-levels, and in patients with increased ventricular walls tress NT-proBNP rises more than BNP [5,7].

1.     Hosoda K, Nakao K, Mukoyama M, et al. Expression of brain natriuretic peptide gene in human heart. Production in the ventricle.Hypertension 1991;17:1152–5.

2.     Yamamoto K, Burnett JC, Jr, Jougasaki M, et al. Superiority of brain natriuretic peptide as a hormonal marker of ventricular systolic and diastolic dysfunction and ventricular hypertrophy. Hypertension 1996;28:988–94.

3.     Grantham JA, Burnett JC, Jr. BNP: increasing importance in the pathophysiology and diagnosis of congestive heart failure (editorial;comment). Circulation 1997;96:388–90.

4.     Natalia N. Tamm , Alexander G. Semenov a, Karina R. Seferian，et al. Measurement of B-type natriuretic peptide by two assays utilizing antibodies with different epitope specificity.Clinical Biochemistry 44 (2011) 257–259

5.     A.S. Maisel, P. Krishnaswamy, R.M. Nowak, et al., Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure, N. Engl. J. Med. 347(2002) 161–167.

6.     J. Mair, Biochemistry of B-type natriuretic peptide—where are we now? Clin. Chem.Lab. Med. 46 (2008) 1507–1514.

7.     J.L. Januzzi, R. van Kimmenade, J. Lainchbury, et al., NT-proBNP testing for diagnosis and short-term prognosis inacute destabilized heart failure:an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study, Eur.Heart J. 27 (2006) 330–337.