bpac - BNP POEM January 2007

BNP testing in primary care

Introduction - Assays of B-type natriuretic peptides
Underlying pathophysiology
BNP is useful as a ‘rule-out’ test of heart failure when a patient presents with acute dyspnoea and the diagnosis is not clear
The use of BNP testing in the diagnosis and management of heart failure in primary care is promising although not yet established
Review of methods for the diagnosis of heart failure in primary care
References
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Introduction - Assays of B-type natriuretic peptides

Our key recommendations are:

BNP is useful as a ‘rule-out’ test of heart failure when a patient presents with acute dyspnoea and the diagnosis is not clear
The use of BNP testing in the diagnosis and management of heart failure in primary care is promising although not yet established

B-type natriuretic peptide (BNP) assays have become important aids in the diagnosis and perhaps more importantly, the exclusion of heart failure. Normal levels virtually exclude the diagnosis of heart failure and very high levels effectively confirm the diagnosis; intermediate levels require confirmation by echocardiography.

These peptides are released into the circulation by distended ventricular walls as the active peptide, BNP, and the inactive peptide, NT-proBNP. Assays may be performed on either but there are no conversion factors for comparison between these measures. Furthermore, there is variability in the type of assay used and availability of testing across the country.

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