What is BNP?
BNP is a hormone that is secreted by the cardiac ventricles in response to increased wall stress and volume overload. BNP has multiple effects on the cardiovascular system, such as promoting vasodilation, natriuresis, diuresis, and inhibition of the renin-angiotensin-aldosterone system.
It means that BNP can affect your heart and blood vessels in different ways. For example, it can make your blood vessels wider so that blood can flow more easily. It can also make your kidneys get rid of more salt and water in your urine. This can lower the pressure and volume of blood in your body. It can also stop a hormone system that makes your blood vessels narrower and increases the amount of salt and water in your body. BNP can also reduce swelling and scarring in your heart and blood vessels
The Versatility of BNP as a Biomarker
BNP also has anti-inflammatory and antifibrotic properties. BNP reflects the current hemodynamic status and neurohormonal activation of the heart. In other way to say, BNP shows how well your heart is pumping blood and how much hormones are affecting your heart. Therefore, BNP can be used as a biomarker for diagnosing, prognosticating, and managing patients with heart failure and other cardiac conditions.
The interpreatation of BNP levels in the patients can be utilized for the diagnosis in the Acute patients of ER. In the current situation, it is a difficult task to distinguish heart failure from pulmonary diseases such as lung cancer. There are no laboratory test which can be specifically used for it. Nevertheless, BNP result can help to diagnose the urgency of heart failure so far. When NP test 100pg/mL is used to diagnose heart failure, it correctly identifies 90% of the cases and 76% of the non-cases. Out of those who test positive, 79% actually have heart failure and out of those who test negative, 89% actually do not have heart failure. The level of BNP increases with ventricular dysfunction and gets even higher with more severe heart failure
Average specification ( BNP > 100 pg/mL)
Catogory | (%) |
Sensitivity | 90 |
Specificity | 70 |
Positive Predictive value | 79 |
Negative Predictivie value | 89 |
Based on these results, the use of BNP can be used as follows. BNP is suggested to be used to distinguish between heart failure and acute coronary syndrome (ACS) patients.
Role of BNP in Heart Failure Treatment and Management
The increase in BNP levels can indicate the disease progression, incidence rate and mortality rate of heart failure patients. In addition, studies show that ACS patients with increased BNP levels have a higher rate of cardiac complications and myocardial infarction at the time of death. In the initial studies, the usefulness of BNP measurement was announced for the most widely used treatment and management of heart failure patients. For the treatment of sever heart failure with the patient having a hard time to breath, Nesitiride is used. Nesiritide is the recombinant form of human B-type natriuretic peptide, which relaxes and dilates blood vessels, lowering blood pressure. Nesiritide overcomes resistance to endogenous BNP present in patients with heart failure and regulates cardiovascular fluid balance. The level of BNP is measured after 2 hours of injection of the medication.
Takeaway message
In summary, BNP is a valuable biomarker that provides important information about the status of the cardiovascular system and can assist in the diagnosis, prognosis, and management of heart failure and other cardiac conditions. The increase in BNP levels can indicate disease progression, incidence rate, and mortality rate of heart failure patients. Additionally, BNP levels have been shown to correlate with the risk of cardiac complications and myocardial infarction in acute coronary syndrome patients.
Reference
BNP, The department of Diagnostic and Laboratory Medicine, Seoul National University Hospital
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