Abstract
The burden of disease in patients with congestive heart failure is high. The future of BNP looks promising as it may be a better diagnostic tool for the diagnosis of CHF in developing countries in new millennium. Natriuretic peptide hormones, a family of vasoactive peptides with many favourable physiological properties, have emerged as important contenders for development of diagnostic tools and therapeutic agents in cardiovascular disease. Measurement of B-type natriuretic peptide has become as an easy-to-perform bedside test. The clinical and diagnostic significance of the measurement of plasma Nt-proBNP in the diseases of the cardiovascular system with particular emphasis on the assessment of patients with heart failure and their effects on predicting survival rate. The plasma levels of Nt-proBrain Natriuretic peptide responds more vigorously after myocardial infarction than those of other natriuretic peptides. This article is an attempt to give a short overview on the utility of BNP-blood levels for the diagnosis and treatment of heart failure
Similar content being viewed by others
References
Dorothea KT, Apostolos IK, Kostas GR, Aspostolos Z. Brain natriuretic peptide. Hell J card 2003;44:266–70.
Sudoh T, Kangawa K, Miniamo N. A new natriuretic peptide in porcine brain. Nature 1988;332:78–81.
Kambayashi Y, Nakaoka K. Isolation and sequence determination of human BNP. Febs letters 1990;259:341–5.
Pfister R, Schneider CA. Natriuretic peptides BNP and NT-pro-BNP: established laboratory markers in clinical practice or just perspectives? Clin Chim Acta 2004 Nov; 349(1–2):25–38.
Thurpraf DJ, Glembotski CC. Differential effects of protein kinase C, Ras and Raf-1 kinase on induction of the cardiac B-type natriuretic peptide gene through a critical promotor-proximal M-CAT element. J Biol Chem 1997;272:7464–72.
Ogowa E. Fibronectin signaling stimulates BNP gene transcription by inhibiting neuron-restrictive silencere element dependent system repression. Cardiovascular Res. Commun. Cardiovascular Res 2001:53:451–9.
Hautala N. Pressure overload increase GATA 4 binding activity via endothelin I. Circulation 2001;103:730–5.
Tsutamoto T. Attenuation of compensation of endogenous cardiac natriuretic peptides system in chronic heart failure. Circulation 1997;96:509–16.
Wei CM. Natriuretic peptide system in human heart failure. Circulation 1993;88:1004–9.
Christopher B, Granger. Effects of candersaritan in patients with chronic heart failure and reduced left ventricular systolic function intolerant to angiotens in converting enzyme (ACE) inhibitors. The CHARMS—Alternative trial. Lancet 2003 Sep;326:772–6.
Yoshimura M. B-tNP as a marker of effects of enalapril in patients with heart failure. Am J Med 2002;112:716–30.
Yamamoto K. Superiority of BNP as a hormonal markers of ventricular systolic and diastolic dysfunction and ventricular hypertrophy. Hypertension 1996;28:988–94.
Troughton RW. Treatment of heart failure guided by plasma amino terminal brain natriuetic peptides (Nt-BNP) concentrations. Lancet 2000;355:1126–30.
Yasue H, Yoshimura M. Localization and mechanism of secretion of B-type natriuretic peptides in comparison with those of A type natriuretic peptide in normal subjects and patients with heart failure. Circulation 1994;90:195–203.
Omnland T, Aakvaag A. Plasma brain natriuretic peptides as an indicator of Left ventricular systolic function and long term survival after acute myocardial infarction. Comparison with plasma ANP and N terminal pro atrial natriuretic peptides. Circulation 1996;93:1963–9.
Kuchner N, Printzen G, et al. Low pro-brain natriuretic peptide benign clinical outcome in acute pulmonary embolsim. Circulation 2003 April 1;107(12):1576-8.
Thurpraf DJ & Glembotski CC. Differential effects of protein kinase C, Ras and Raf-1 kinase on induction of the cardiac B-type natriuretic peptide gene through a critical promotor-proximal M-CAT element. J Biol Chem 1997;272:7464–72.
Wu AH, Smith A, Wieczorrek S, Mather JF, Duncan B, White CM, McGill Katten D. Biological variations for NT-pro & BNP and implications for therapeutic monitoring of patients with congestive heart failure. Hel Am J Car 2003 Sep192:5;628–31.
Henricksen JH, Gotze JP, Fuglsang S, Christensen E, Bendtsen F, Mollers. Increased circulating proBNP and BNP in patients with cirrhosis related to cardiovascular dysfunction and severity of disease. Gut 2003 Oct:52:10:1511–7.
Gottelib SS. Prognostic importance of aterial natriuretic peptide in patients with chronic heart failure. JACC 1989; 13:1534–9.
De Lemos JA, Morrow DA. The prognostic value of B-type natriuretic peptide in patients with acute coronary syndromes. N Engl J Med 2001;345:1014–21.
Fisher C, Berry C, Blue L, Morton JJ, McMurray J. N-tproB-NP, but not the new putative cardiac hormone relaxin, predicts prognosis in patients with chronic heart failure. Heart 2003 Aug;89(8):879–81.
James SK, Lindhal B, Siegalbhan A. Nt proBNP and other risk markers for the separate prediction of mortality and subsequent myocardial infarction in patients with unstable coronary artery disease. GUSTO-IV sub study. Circulation 2003 July22;108(3):275–81.
Moser P, Stanek B, Pacher R. BNP predicts sudden death in patients with chronic heart failure. Circulation 2002; 105:2392–7.
Weber M, Hamm C. Role of B-type natriuretic peptide (BNP) and NT-proBNP in clinical routine. Heart 2006Jun;92(6):843–9.
Nakamura M, Endo H. Value of plasma B-type natriuretic peptide measurement for heart disease screening in a Japanese population. Heart. 2002;87(2):131–5.
Isabgel H., Jose L., Arneau MA, et el. Ventricular natriuretic peptides (BNP) in heart transplantation; BNP correlation with endomyocardial bioipsy, laboratory and heamodynamic measures. Laboratory Invest 2003 p. 1–8.
Holtwick R. Pressure independent cardiac hypertrophy in mice with cardiomyocyte restricted inactivation of the atrial natriuretic peptide receptor Guanyl cyclase. J Clin. Invest 2003;111:1399–1407.
Buckley MG, Markandu ND. Plasma concentrations and comparisons of brain natriuretic peptide and atrial natriuretic peptide in normal subjects, cardiac transplant recipients and patients with dialysis-dependent or dialysis independent chronic renal failure. Clin Investigation 1992;83:437–44.
Kohno M, Horio T, Yokokowa K, Murakawa K. Brain natriuretic peptide as a novel cardiac hormone in essential hypertension. Am J Med 1992;201:29–34.
Yandle TG, Richards AM, Gilbert A. Assay of brain natriuretic peptide in human plasma: Evidence for high molecular weight BNP as a major plasma component in heart failure. J Clin. Endocrinol Metab. 1993;76:832–38.
Lang CC, Coutie WJ, Khong TK, Choy AM. Dietary sodium loading increases plasma brain natriuretic peptide levels in man. J Hypertens 1991;9:779–82.
Matsumo A. Effects of exercise on plasma level of BNP in CHF with and without left ventricular dysfunction. Am Heart J 1995;129:139–45.
Ikeda T, Matsuda K, Itoh H. Plasma levels of brain natriuretic peptides and atrial natriuretic peptide elevate in proportion to left ventricular end systolic wall stress in patients with aortic stenosis. Am Heart J 1997;133:307–14.
Thurpaf DJ, Glembotski CC. Differential effects of protein kinase C, RAS and RAF-1 kinase on induction of the cardiac B-type natriuretic peptide gene through a critical promotor-proximal M-CAT element. J Biol. Chem 1997;272:7464–72.
Hasegawa K, Fujiwara H, Doyama K, Miyamae M. Ventricular expression of brain natriuretic peptide in hypertrophic cardiomyopathy. Circulation 1993;88:372–80.
Morita E, Yasue H, Yoshimura M, Ogawa H. Increased plasma levels of brain natriuretic peptide in patients with acute myocardial infarction. Circulation 1993;88:82–91.
Buckley MG, Markandu ND. Brain and atrial natriuretic peptides: a dual peptide system of potential importance in sodium balance and blood pressure regulation in patients with essential hypertension. J Hypertens. 1994;12:809–13.
Melanson SE, Lewandrowski EL. Laboratory testing for B-type natriuretic peptides (BNP and NT-proBNP): clinical usefulness, utilization, and impact on hospital operations. Am J Clin Pathol 2005 Dec;124 Suppl:S122–8.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Raizada, A., Bhandari, S., Khan, M.A. et al. Brain type natriuretic peptide (BNP)—A marker of new millennium in diagnosis of congestive heart failure. Indian J Clin Biochem 22, 4–9 (2007). https://doi.org/10.1007/BF02912873
Issue Date:
DOI: https://doi.org/10.1007/BF02912873