proBNP, N-terminal

The proBNP, N-terminal test contains 1 test with 1 biomarker.

Brief Description: The N-terminal proBNP (NT-proBNP) test is a crucial diagnostic tool used to measure the levels of N-terminal pro-brain natriuretic peptide in the blood. NT-proBNP is released by the heart in response to increased pressure and stretching of the heart muscle. This test plays a significant role in assessing cardiac health and diagnosing various heart-related conditions.

Also Known As: Brain Natriuretic Peptide Test, proBNP test,

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an N-Terminal proBNP test ordered?

When a person exhibits signs and symptoms that could indicate heart failure, a doctor may request a BNP test.

When someone is in a crisis or has symptoms that could be due to heart failure, testing may be done in the emergency room to identify if they have heart failure or another medical problem.

When a person is being treated for heart failure, several BNP tests may be performed throughout time to track the effects of the treatment.

What does an NT-proBNP blood test check for?

N-terminal propeptide and B-type natriuretic peptide are chemicals created and released when the heart is strained and working hard to pump blood. BNP and NT-proBNP tests are used to detect and evaluate heart failure by measuring their levels in the blood.

Because it was first discovered in brain tissue, BNP was given the name brain natriuretic peptide. The left ventricle of the heart is the primary producer of BNP. It has to do with blood volume and pressure, as well as the amount of work the heart has to do in pumping blood around the body. The heart produces small amounts of a precursor protein called pro-BNP on a regular basis. The enzyme corin then cleaves pro-BNP, releasing the active hormone BNP and an inactive fragment, NT-proBNP, into the bloodstream.

When the heart’s left ventricle is stretched, the levels of BNP and NT-proBNP generated rise dramatically. This signifies that the heart is working harder and having more difficulty keeping up with the needs of the body. This might happen as a result of heart failure or other disorders that affect the heart and circulatory system. The term “heart failure” can be deceptive. It doesn’t mean the heart has stopped beating; it simply indicates it isn’t pumping blood as efficiently as it should be. This reduced capacity will be reflected in an increase in circulating BNP or NT-proBNP.

Lab tests often ordered with an NT-proBNP test:

When an NT-proBNP test is ordered, it's often part of a broader evaluation of cardiac function and heart health. Here are some tests commonly ordered alongside it:

1. Brain Natriuretic Peptide (BNP) Test:

   • Purpose: Similar to NT-proBNP, BNP is another marker used to assess heart failure.
   • Why Is It Ordered: To provide additional information about heart function and to help differentiate heart failure from other conditions with similar symptoms.

2. Complete Blood Count (CBC):

   • Purpose: To evaluate overall blood health.
   • Why Is It Ordered: To check for signs of anemia or infection, which can exacerbate or mimic symptoms of heart failure.

3. Comprehensive Metabolic Panel (CMP):

   • Purpose: To assess kidney function, electrolyte balance, and glucose levels.
   • Why Is It Ordered: To evaluate factors that can affect heart function and to monitor for side effects of certain heart failure medications.

4. Liver Function Test:

   • Purpose: To assess liver health.
   • Why Is It Ordered: To evaluate liver function, as worsening heart function can lead to liver congestion and dysfunction.

5. Lipid Profile:

   • Purpose: To measure levels of cholesterol and triglycerides.
   • Why Is It Ordered: To assess cardiovascular risk factors, as dyslipidemia is a major contributor to heart disease.

6. Troponin:

   • Purpose: To detect markers of heart muscle injury.
   • Why Is It Ordered: To rule out or confirm acute myocardial infarction or other forms of heart muscle damage.

These tests, when ordered alongside an NT-proBNP test, provide a comprehensive evaluation of cardiac function and heart health. They are crucial for diagnosing heart failure, assessing its severity, identifying potential underlying causes or contributing factors, and guiding appropriate treatment. The specific combination of tests will depend on the individual’s symptoms, clinical presentation, and medical history.

Conditions where an NT-proBNP test is recommended:

The NT-proBNP test is essential for diagnosing and monitoring:

• Heart Failure: Elevated levels of NT-proBNP indicate heart muscle stress, which is often seen in heart failure cases. The test helps in confirming heart failure and assessing its severity.

• Myocardial Infarction (Heart Attack): After a heart attack, the heart muscle may experience stress, leading to increased NT-proBNP levels.

How does my health care provider use an NT-proBNP test?

Pro B-type natriuretic peptide testing is most commonly used to identify, diagnose, and assess the severity of heart failure. It can be used in conjunction with other cardiac biomarker tests to detect heart stress and damage, or it can be used in conjunction with lung function tests to differentiate between causes of shortness of breath. X-rays of the chest and an ultrasound test called echocardiogram may be used.

Heart failure can be misdiagnosed as other illnesses, and it can coexist with them. proBNP levels can aid doctors in distinguishing between heart failure and other issues like pulmonary illness. Because the therapies are typically diverse and must be started as soon as possible, a precise diagnosis is critical.

Although proBNP is commonly used to detect heart failure, an elevated level in those who have had an acute coronary syndrome implies a higher risk of repeat episodes. As a result, a health care provider can use BNP to assess the risk of a future cardiac attack in someone who has ACS.

What do my proBNP N-Terminal test results mean?

Higher-than-normal results indicate that a person has heart failure, and the level of proBNP in the blood is linked to the severity of the condition. proBNP levels beyond a certain threshold are generally linked to a poor prognosis.

The person's symptoms are most likely caused by anything other than heart failure if the results are normal.

Most Common Questions About the N-terminal proBNP test:

Purpose and Applications

Why is the N-terminal proBNP test ordered?

The N-terminal proBNP test is primarily ordered to assist in the diagnosis of heart failure and to assess the severity of this condition. Elevated levels can indicate the presence and severity of heart failure.

Can the N-terminal proBNP test be used for conditions other than heart failure?

Yes, while the primary use is for diagnosing and gauging the severity of heart failure, it can also be utilized to evaluate the risk of developing heart failure in patients with coronary artery disease, diabetes, or hypertension.

Clinical Significance

What does an elevated level of N-terminal proBNP indicate?

Elevated levels of N-terminal proBNP often suggest that the heart is under stress and may not be working efficiently. Higher levels generally indicate more severe heart dysfunction and are associated with an increased risk of heart-related events and mortality.

How does the N-terminal proBNP test differ from the BNP test?

Both tests measure proteins released when the heart is stressed or damaged, aiding in diagnosing heart failure. BNP has a shorter half-life than N-terminal proBNP, which might influence the timing of the test. However, both are clinically valuable, and the choice between them usually depends on the specific laboratory's preference or available equipment.

Interpretation

If my N-terminal proBNP levels are normal, does it mean I don't have heart failure?

While normal levels of N-terminal proBNP significantly reduce the likelihood of heart failure, it doesn't conclusively rule it out. The results should always be interpreted in the context of clinical symptoms, physical examination, and other diagnostic tests.

How often should the N-terminal proBNP test be repeated?

The frequency of testing varies based on individual cases. For patients diagnosed with heart failure, monitoring may be periodic to assess the efficacy of treatments or the progression of the condition. For those at risk but without a diagnosis, the test might be less frequent and based on a doctor's judgment.

Clinical Limitations

Can other conditions cause elevated N-terminal proBNP levels?

Yes, conditions other than heart failure, such as pulmonary hypertension, kidney disease, acute coronary syndromes, and certain lung diseases, can elevate N-terminal proBNP levels. Hence, it's essential to interpret the results in the broader clinical context.

Are there factors that can falsely lower N-terminal proBNP levels?

Obesity can sometimes result in lower levels of N-terminal proBNP. Additionally, some treatments for heart failure can reduce N-terminal proBNP concentrations. Thus, it's essential to consider the patient's overall clinical picture when interpreting the results.

Additional Considerations

Why might the N-terminal proBNP levels be measured during and after treatment for heart failure?

Measuring N-terminal proBNP levels during and post-treatment helps assess the effectiveness of therapeutic interventions. Decreasing levels can suggest that the treatment is working, while increasing or persistently high levels might indicate that the condition is worsening or not responding to the current therapy.

How do N-terminal proBNP levels relate to age?

N-terminal proBNP levels tend to increase with age, which is why age-specific reference ranges are sometimes used to interpret the results. Higher levels in older adults might not necessarily indicate heart failure as strongly as similar levels in younger individuals.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.