Brain Natriuretic Peptide

Brain Natriuretic Peptide Brain natriuretic peptide (BNP), now known as B-type natriuretic peptide or Ventricular Natriuretic Peptide (still BNP), is a 32-amino acid polypeptide secreted by the ventricles of the heart in response to excessive stretching of heart muscle cells (cardiomyocytes). Biosynthesis Removal of the 25-residue N-terminal signal peptide generates the prohormone, proBNP, which is stored intracellularly as an O-linked glycoprotein BNP is synthesized as a 134-amino acid preprohormone (preproBNP), encoded by the human gene'NPPB. Clinical Significance BNP NT-proBNP The main clinical utility of either BNP or NT-proBNP is that a normal level rules out acute heart failure in the emergency setting. Both are also typically increased in patients with left ventricular dysfunction, with or without symptoms (BNP accurately reflects current ventricular status, as its half-life is 20 minutes, as opposed to 1-2 hours for NT-proBNP) Either BNP or NT-proBNP can also be used for screening and prognosis of heart failure. Measurement BNP and NT-proBNP are measured by immunoassay. BNP less than 100 pg per milliliter BNP less than 50 pg per milliliter Sensitivity = 90% Sensitivity = 97% Specificity = 76% Specificity = 62% Some laboratories report in units ng per Litre (ng/L), which is equivalent to pg/ml Therapeutic application Recombinant BNP, nesiritide, is used to treat decompensated heart failure. However, a recent clinical trial[28] failed to show a benefit of nesiritide in patients with acute decompensated heart failure, and the authors could not recommend its use Issued by "BISky Peptide