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ALL / Cardiology
B-type natriuretic peptide
B-type natriuretic peptide
B-type natriuretic peptide (BNP) is a hormone produced mainly by the left ventricular myocardium in response to strain.Whilst heart failure is the most obvious cause of raised BNP levels any cause of left ventricular dysfunction such as myocardial ischaemia or valvular disease may raise levels. Raised levels may also be seen due to reduced excretion in patients with chronic kidney disease. Factors which reduce BNP levels include treatment with ACE inhibitors, angiotensin-2 receptor blockers and diuretics.
Effects of BNP
- vasodilator
- diuretic and natriuretic
- suppresses both sympathetic tone and the renin-angiotensin-aldosterone system
Clinical uses of BNP
Diagnosing patients with acute dyspnoea
- a low concentration of BNP(< 100pg/ml) makes a diagnosis of heart failure unlikely, but raised levels should prompt further investigation to confirm the diagnosis
- NICE currently recommends BNP as a helpful test to rule out a diagnosis of heart failure
Prognosis in patients with chronic heart failure
- initial evidence suggests BNP is an extremely useful marker of prognosis
Guiding treatment in patients with chronic heart failure
- effective treatment lowers BNP levels
Screening for cardiac dysfunction
- not currently recommended for population screening
+PassMedicine Notes
B-type natriuretic peptide (BNP) is a hormone produced mainly by the left ventricular myocardium in response to strain.
Whilst heart failure is the most obvious cause of raised BNP levels any cause of left ventricular dysfunction such as myocardial ischaemia or valvular disease may raise levels. Raised levels may also be seen due to reduced excretion in patients with chronic kidney disease. Factors which reduce BNP levels include treatment with ACE inhibitors, angiotensin-2 receptor blockers and diuretics.
Effects of BNP- vasodilator
- diuretic and natriuretic
- suppresses both sympathetic tone and the renin-angiotensin-aldosterone system
Clinical uses of BNP
Diagnosing patients with acute dyspnoea- a low concentration of BNP(< 100pg/ml) makes a diagnosis of heart failure unlikely, but raised levels should prompt further investigation to confirm the diagnosis
- NICE currently recommends BNP as a helpful test to rule out a diagnosis of heart failure
- initial evidence suggests BNP is an extremely useful marker of prognosis
- effective treatment lowers BNP levels
- not currently recommended for population screening