Sign in →

Test ID: PBNP NT-Pro B-Type Natriuretic Peptide, Serum

Reporting Name

NT-Pro BNP, S

Useful For

Aids in the diagnosis of congestive heart failure

Specimen Type

Serum


Necessary Information


Patient's age and sex are required.



Specimen Required


Patient Preparation: For 12 hours before specimen collection do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions:

1. Serum gel tubes should be centrifuged within 2 hours of collection.

2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.


Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Frozen (preferred) 365 days
  Refrigerated  7 days

Reference Values

Males

≤45 years: 10-51 pg/mL

46 years: 10-53 pg/mL

47 years: 10-55 pg/mL

48 years: 10-56 pg/mL

49 years: 10-58 pg/mL

50 years: 10-59 pg/mL

51 years: 10-61 pg/mL

52 years: 10-62 pg/mL

53 years: 10-64 pg/mL

54 years: 10-67 pg/mL

55 years: 10-68 pg/mL

56 years: 10-70 pg/mL

57 years: 10-71 pg/mL

58 years: 10-73 pg/mL

59 years: 10-76 pg/mL

60 years: 10-77 pg/mL

61 years: 10-79 pg/mL

62 years: 10-82 pg/mL

63 years: 10-83 pg/mL

64 years: 10-85 pg/mL

65 years: 10-88 pg/mL

66 years: 10-89 pg/mL

67 years: 10-92 pg/mL

68 years: 10-95 pg/mL

69 years: 10-97 pg/mL

70 years: 10-100 pg/mL

71 years: 10-103 pg/mL

72 years: 10-104 pg/mL

73 years: 10-107 pg/mL

74 years: 10-110 pg/mL

75 years: 10-113 pg/mL

76 years: 10-116 pg/mL

77 years: 10-119 pg/mL

78 years: 10-122 pg/mL

79 years: 10-125 pg/mL

80 years: 10-128 pg/mL

81 years: 10-131 pg/mL

82 years: 10-135 pg/mL

≥83 years: 10-138 pg/mL

 

Females

≤46 years: 10-140 pg/mL

47 years: 10-141 pg/mL

48 years: 10-144 pg/mL

49 years: 10-146 pg/mL

50 years: 10-149 pg/mL

51 years: 10-150 pg/mL

52 years: 10-152 pg/mL

53 years: 10-155 pg/mL

54 years: 10-157 pg/mL

55 years: 10-160 pg/mL

56 years: 10-162 pg/mL

57 years: 10-166 pg/mL

58 years: 10-168 pg/mL

59 years: 10-171 pg/mL

60 years: 10-173 pg/mL

61 years: 10-177 pg/mL

62 years: 10-179 pg/mL

63 years: 10-183 pg/mL

64 years: 10-185 pg/mL

65 years: 10-189 pg/mL

66 years: 10-193 pg/mL

67 years: 10-196 pg/mL

68 years: 10-199 pg/mL

69 years: 10-202 pg/mL

70 years: 10-206 pg/mL

71 years: 10-210 pg/mL

72 years: 10-214 pg/mL

73 years: 10-218 pg/mL

74 years: 10-222 pg/mL

75 years: 10-227 pg/mL

76 years: 10-230 pg/mL

77 years: 10-235 pg/mL

78 years: 10-239 pg/mL

79 years: 10-244 pg/mL

80 years: 10-248 pg/mL

81 years: 10-253 pg/mL

82 years: 10-258 pg/mL

≥83 years: 10-263 pg/mL

Day(s) and Time(s) Performed

Monday through Sunday; Continuously

Test Classification

This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

83880

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PBNP NT-Pro BNP, S 83107-3

 

Result ID Test Result Name Result LOINC Value
PBNP NT-Pro BNP, S 83107-3

Clinical Information

B-type natriuretic peptide (brain natriuretic peptide: BNP) is a small, ringed peptide secreted by the heart to regulate blood pressure and fluid balance.(1) This peptide is stored in and secreted predominantly from membrane granules in the heart ventricles in a pro form (proBNP). Once released from the heart in response to ventricle volume expansion or pressure overload, the N-terminal (NT) piece of 76 amino acids (NT-proBNP) is rapidly cleaved by the enzymes corin and furin to release the active 32-amino acid peptide (BNP).(2)

 

Both BNP and NT-proBNP are markers of atrial and ventricular distension due to increased intracardiac pressure. The New York Heart Association (NYHA) developed a 4-stage functional classification system for congestive heart failure (CHF) based on the severity of the symptoms. Studies have demonstrated that the measured concentrations of circulating BNP and NT-proBNP increase with the severity of CHF based on the NYHA classification.

Interpretation

Under 50 years of age:

N-terminal pro brain natriuretic peptide (NT-proBNP) values below 300 pg/mL have a 99% negative predictive value for excluding acute congestive heart failure (CHF). A cutoff of 1,200 pg/mL for patients with an estimated glomerular filtration rate (eGFR) below 60 yields a diagnostic sensitivity and specificity of 89% and 72% for acute CHF. NT-proBNP values greater than 450 pg/mL are consistent with CHF in adults under 50 years of age.

 

50-75 years of age:

NT-proBNP values below 300 pg/mL have a 99% negative predictive value for excluding acute CHF. A cutoff of 1,200 pg/mL, for patients with an eGFR below 60 yields a diagnostic sensitivity and specificity of 89% and 72% for acute CHF. A diagnostic NT-proBNP cutoff of 900 pg/mL has been suggested in adults 50 to 75 years of age in the absence of renal failure.

 

Over 75 years of age:

NT-proBNP values below 300 pg/mL have a 99% negative predictive value for excluding acute CHF. A cutoff of 1,200 pg/mL for patients with an eGFR below 60 yields a diagnostic sensitivity and specificity of 89% and 72% for acute CHF. A diagnostic NT-proBNP cutoff of 1,800 pg/mL has been suggested in adults over 75 years of age in the absence of renal failure.

 

NT-Pro BNP levels are loosely correlated with New York Heart Association (NYHA) functional class (see Table).

 

Interpretive Levels for CHF

Functional Class

5th to 95th Percentile

Median

I

31-1,110 pg/mL

377 pg/mL

II

55-4,975 pg/mL

1,223 pg/mL

III

77-26,916 pg/mL

3,130 pg/mL

IV

*

*

*In a Mayo Clinic study of 75 patients with CHF, only 4 were characterized as Class IV. Accordingly, range and median are not provided.

 

Clinical Reference

1. Januzzi JL, van Kimmenade R, Lainchbury J: NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1,256 patients; The International Collaborative of NT-proBNP Study. Eur Heart J 2006;27:330-337

2. van Kimmenade R, Pinto YM, Bayes-Genis A: Usefulness of intermediate amino-terminal pro-brain natriuretic peptide concentrations for diagnosis and prognosis of acute heart failure. Am J Cardiol 2006;98:386-390

3. DeFilippi C, van Kimmenade R, Pinto YM: Amino-terminal pro-B-type natriuretic peptide testing in renal disease. Am J Cardiol 2008;101[suppl]:82A- 88A

Analytic Time

Same day/1 day

Method Name

Electrochemiluminescence Immunoassay

Forms

If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen.

Testing Algorithm

See Laboratory Approach to the Diagnosis of Amyloidosis in Special Instructions.

Mayo Clinic Laboratories | Cardiology Catalog Additional Information:

mml-heart-failure