General
Synonym/Acronym:
BNP and proBNP.
Common Use:
To assist in diagnosing congestive heart failure.
Specimen:
Plasma (1 mL) collected in a plastic, lavender-top (EDTA) tube.
Normal Findings:
(Method: Chemiluminescent immunoassay for BNP; electrochemiluminescent immunoassay for proBNP).
| BNP | Conventional Units | SI Units (Conventional Units × 1) |
|---|
| Male & Female | Less than 100 pg/mL | Less than 100 ng/L |
| proBNP (N-terminal) | | |
| 0–74 yr | Less than 125 pg/mL | Less than 125 ng/mL |
| Greater than 75 yr | Less than 449 pg/mL | Less than 449 ng/mL |
| BNP levels are increased in elderly adults. |
Two primary systems are used to classify heart failure (HF) presentation by stage or class. The American College of Cardiology and American Heart Association (ACC/AHA) collaborated to develop a staging system focused on the development and progression of HF based on symptoms. The ACC/AHA is unique in that it includes pre–heart failure as the initial stage. The New York Heart Association (NYHA) Functional Classification System focuses on classification of HF based on activity tolerance.
| ACC/AHA | NYHA |
|---|
| Stage A—at risk for developing heart failure; at-risk groups are people with diabetics, coronary artery disease, hypertension; no structural heart disease; no symptoms of HF | Class I—participates in ordinary physical activity; no undue fatigue, dyspnea, or angina |
| Stage B—some structural changes; no symptoms of HF; at-risk groups are those with history of myocardial infarction, valve regurgitation, ventricular hypertrophy | Class II—slight limitation of activity; asymptomatic at rest; ordinary physical activity causes dyspnea, fatigue, palpations, and angina |
| Stage C—structural changes are noted; HF symptoms are noted | Class III—marked limitation of physical activity; asymptomatic at rest; less than ordinary activity causes fatigue, dyspnea, palpations, and angina |
| Stage D—refractory HF present; requires mechanical or pharmaceutical support; may require a heart transplant; may require end-of-life counseling | Class IV—cannot perform any activity without discomfort; symptoms present at rest; discomfort increases with any activity; may require heart transplant, mechanical or pharmaceutical support; may require end-of-life counseling |
B-Type Natriuretic Peptide and Pro-B-Type Natriuretic Peptide has been found in Davis's Lab & Diagnostic Tests
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