Potential pitfalls when interpreting plasma BNP levels in heart failure practice

B-type (or brain) natriuretic peptide (BNP) is synthesized in cardiac myocytes and released constitutively into the circulation. Pressure/volume overload, neurohumoral factors, cytokines, ischemia enhance BNP gene expression, then precursor proBNP produced. It has been thought that cleaved active molecule inactive marker NT-proBNP intracellularly by processing enzyme furin, they are However, recent studies have shown considerable amount of uncleaved circulates blood. The commercially available assay kits consist two antibodies sandwich molecule. Therefore, if present, kit cross-reacts to measures it as BNP. should be noted current value plus BNP.BNP established a biomarker for heart failure patients presenting dyspnea. But many pitfalls present interpreting value. For example, presence renal dysfunction, age, female sex, atrial fibrillation, inflammation, hyperthyroidism, use sacubitril/valsartan, macro-proBNPemia overestimate value, whereas obesity, immediately after acute coronary syndrome onset, pericardial effusion underestimate In management patients, plays an important role. clinicians note pitfall interpretation we describe mechanism involved.