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BNP Fact Sheet

BNP (NTproBNP) testing has been introduced to help diagnose suspected heart failure. BNP is released when the heart is stretched and causes fluid loss in the urine. Elevated BNP levels indicate heart failure. NTproBNP should be measured in patients with suspected heart failure, unless they have a history of heart attack, known heart failure, abnormal heart rate or rhythm, or significant ECG abnormality. Several medical conditions can increase BNP levels. The test involves a blood sample in a gold top tube which is analyzed at Southmead Hospital. Results are used along with symptoms and history to determine if heart failure is likely and guide referral to cardiology services.

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74 views2 pages

BNP Fact Sheet

BNP (NTproBNP) testing has been introduced to help diagnose suspected heart failure. BNP is released when the heart is stretched and causes fluid loss in the urine. Elevated BNP levels indicate heart failure. NTproBNP should be measured in patients with suspected heart failure, unless they have a history of heart attack, known heart failure, abnormal heart rate or rhythm, or significant ECG abnormality. Several medical conditions can increase BNP levels. The test involves a blood sample in a gold top tube which is analyzed at Southmead Hospital. Results are used along with symptoms and history to determine if heart failure is likely and guide referral to cardiology services.

Uploaded by

Tadilakshmikiran
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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BLOOD SCIENCES

DEPARTMENT OF CLINICAL BIOCHEMISTRY


Title of Document: BNP Fact Sheet
Q Pulse Reference No: BS/CB/DCB/GEN/10 Version NO: 1
Authoriser: Peter Beresford

BNP fact sheet


The BNP (NTproBNP) assay has now been introduced at North Bristol NHS Trust to support
the BNSSG Suspected Heart Failure Pathway. The following will help you understand the test
and when and how to request appropriately.

What is NTproBNP
Brain Natriuretic Peptide (BNP) is a hormone released by the heart when the ventricles are
stretched e.g. by fluid overload. The hormone then causes fluid and sodium loss in the urine
and mild vasodilation. In heart failure BNP levels are raised, and increase in level according to
New York Heart Association classification. If BNP is normal it generally rules out heart failure.
(Negative Predictive Value 97%)

When should I request a BNP test?


The NICE guideline CG108 recommends that NTproBNP is measured in patients with
suspected heart failure. BNP testing will not be indicated however when there is:
A previous history of MI
A confirmed diagnosis of heart failure
Bradycardia or tachycardia (<60 or >100bpm)
Atrial fibrillation
Significant abnormality on ECG

Note: A history of previous MI and symptoms suggestive of heart failure should prompt urgent
referral for Echo without delay.

Is there anything else that can affect BNP levels?


Left ventricular hypertrophy, right ventricular overload, ischaemia, tachycardia, hypoxaemia,
PE, sepsis, COPD, diabetes, liver cirrhosis, age >70 and eGFR <60 ml/min can all increase
BNP.
Obesity, diuretics, ACE inhibitors, beta blockers, angiotensin receptor antagonists and
aldosterone antagonists can lead to falsely low levels although it is felt unlikely to impact on
screening but should be factored into clinical judgement when interpreting test results.

How do I do the test?


NT proBNP is analysed by Clinical Biochemistry at Southmead Hospital. The sample should
be collected into a gold top SST tube and sent to the laboratory on the day of collection.
Requests should be made electronically via the ICE system where available or by paper
request.

What to do with the results


The BNSSG Suspected Heart Failure pathway recommends the cut-offs and care pathway
below. Referral in the majority of cases will be to the Community Heart Failure service.

Page 1 of 2
BLOOD SCIENCES
DEPARTMENT OF CLINICAL BIOCHEMISTRY
Title of Document: BNP Fact Sheet
Q Pulse Reference No: BS/CB/DCB/GEN/10 Version NO: 1
Authoriser: Peter Beresford

Heart failure is unlikely if the NTproBNP level is:

Men under 70yr <100pg/ml


Women under 70yr <150pg/ml
All 70yr or over <300pg/ml

Suspected Heart Failure


 History
 Examination
 ECG

Previous MI No previous MI

Refer to Echo and specialist Order NTproBNP


opinion URGENTLY Order other baseline tests

NTproBNP result

NTproBNP NORMAL NTproBNP RAISED


NTproBNP >2000pg/ml
Men under 70yr <100pg/ml Men under 70yr
Women under 70yr <150pg/ml Women under 70yr Refer to Echo and
All 70yr or over <300pg/ml All 70yr or over specialist opinion
URGENTLY
Consider other diagnosis Refer for Echo and specialist opinion

Page 2 of 2

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