NT-proBNP is a valuable biomarker for diagnosing and prognosticating heart failure, with a 300 pg/ml cut-off providing 99% sensitivity and 98% negative predictive value for excluding acute heart failure.
What is the diagnostic and prognostic utility of NT-proBNP in cardiac diseases?
NT-proBNP is a highly sensitive biomarker for excluding acute heart failure and provides strong prognostic value across various cardiovascular diseases.
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.
Panagopoulou et al. (Fri,) conducted a review in Cardiac Diseases. NT-proBNP was evaluated on Exclusion of acute heart failure. NT-proBNP is a valuable biomarker for diagnosing and prognosticating heart failure, with a 300 pg/ml cut-off providing 99% sensitivity and 98% negative predictive value for excluding acute heart failure.