Not medically reviewed
Cardiac
B-type natriuretic peptide (BNP)
Not medically reviewed · Content last updated · 1 min read ·
This is the date the draft was written, not a medical review date.
A hormone released by ventricular myocytes in response to wall stretch and pressure or volume overload. It is used to help exclude or support the diagnosis of heart failure in patients with dyspnoea.
Reference interval
| Conventional (pg/mL) | SI (ng/L) | |
|---|---|---|
| Adults | < 100 (upper limit) pg/mL | < 100 (upper limit) ng/L |
Specimen: Whole blood or plasma (EDTA) · Conventional × 1 = SI
Causes of high values
Heart failure (reduced or preserved ejection fraction), acute coronary syndrome, atrial fibrillation, valvular disease, pulmonary hypertension and embolism, renal failure, older age, sepsis, cirrhosis.
Causes of low values
Obesity lowers BNP, so heart failure may be present with relatively low values. Treatment with sacubitril-valsartan raises BNP but not NT-proBNP.
Pre-analytical and method notes
A value below 100 pg/mL makes acute heart failure unlikely in the acute setting; rule-in thresholds are age-stratified and cut-offs vary by guideline and assay. Age, female sex and renal impairment raise values, whereas obesity lowers them. Reference intervals vary by laboratory, method and population; use the interval printed on the report.
References
- 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Society of Cardiology (2021) — Tier 2 (guidelines / primary literature)
- Rifai N, Horvath AR, Wittwer CT. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Elsevier, 6th edition (2018) — Tier 3 (textbook)
- Loscalzo J, et al.. Harrison's Principles of Internal Medicine. McGraw-Hill, 21st edition (2022) — Tier 3 (textbook)
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