Hunter Area Pathology Service

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Brain Natriuretic Peptide (BNP)

(January 2005)

(Download  Brain Natriuretic Peptide.pdf)

Hunter Area Pathology Service is happy to introduce Brain Natriuretic Peptide (BNP) analysis to our already broad range of test menu.

Background

BNP is a peptide synthesized in and released by the cardiac ventricles. It is normally present in circulation in very low concentration and is released in high concentration when there is increased end diastolic left ventricular pressure. It is essentially a measure of an overloaded ventricle.

Causes of Increased BNP Levels

• Congestive cardiac failure including ischaemia related.
• AMI (first 2-5 days)
• Pulmonary embolus
• Liver cirrhosis
• Obstructive pulmonary disease
• Renal failure
• Increased age

When to Order BNP Levels

• To assist with the diagnosis of CCF, particularly where there are confounding factors.
• To monitor response to therapy and/or compliance to cardiac failure therapy
• To prognosticate upon discharge.

When Not to Order BNP

• When the diagnosis is clear-cut.
• When clinical markers for therapeutic outcomes are clear cut.
• BNP should NOT be used as a screening test in the general community for CCF.
• Within 24 hours of the last BNP measurement.

Reference Range

• Normal: < 20 pg/mL
• Likely CCF: > 100 pg/mL.
• Between 20-100 pg/mL, clinical input will be critical in assisting with the interpretation of the result.

Sample Type

• EDTA blood sample
• Minimal volume of blood: 2-5 mL

Cost

• $50.00 per test.
• BNP is not a reimbursable item under the HIC ruling and the cost will be billed directly to the patient in private consultation or to the department in charge.

About the Author

This HAPS Communique was written by Dr Huy Tran , Clinical Chemistry Staff Specialist

If you have any questions regarding this topic Clinical Chemistry can be contacted on Telephone: (02) 49214000, Facsimile: (02) 49214400.