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NT-proBNP

Heart
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Report in 4Hrs

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No Fasting Required

Details

Crucial biomarker for heart failure and other cardiac conditions

₹3,500₹4,368

20% OFF

NT-Pro BNP Test Information Guide

  • Why is it done?
    • NT-Pro BNP (N-terminal pro B-type Natriuretic Peptide) measures a protein released by the heart when it is stressed or working harder than normal
    • Diagnose or rule out heart failure, especially acute decompensated heart failure presenting with shortness of breath
    • Assess severity and prognosis of existing heart failure
    • Monitor effectiveness of heart failure treatment and medication adjustment
    • Screen for left ventricular dysfunction in asymptomatic patients with risk factors
    • Predict long-term cardiac outcomes and risk stratification
    • Performed in emergency departments, outpatient cardiology clinics, and hospital settings when heart failure is suspected
  • Normal Range
    • Normal Range: Less than 100 pg/mL (picograms per milliliter) is generally considered normal
    • Borderline: 100-125 pg/mL may indicate mild cardiac stress or elevated risk; further evaluation recommended
    • Elevated: Greater than 125 pg/mL suggests possible heart failure or cardiac dysfunction
    • Significantly Elevated: Greater than 900 pg/mL typically indicates acute or severe heart failure requiring urgent intervention
    • Units: Measured in picograms per milliliter (pg/mL) or nanograms per liter (ng/L)
    • Normal Result: Indicates no significant heart failure or cardiac dysfunction at the time of testing; may exclude acute heart failure with high sensitivity
    • Abnormal Result: Suggests cardiac stress, ventricular dysfunction, or heart failure that requires further investigation and clinical correlation
  • Interpretation
    • NT-Pro BNP <100 pg/mL: Effectively rules out acute heart failure; suggests preserved cardiac function with excellent negative predictive value (>90%)
    • NT-Pro BNP 100-125 pg/mL: Requires clinical judgment and additional diagnostic workup; consider echocardiography to assess cardiac structure and function
    • NT-Pro BNP 125-900 pg/mL: Suggests possible heart failure; warrants further evaluation with echocardiography, physical examination, and assessment of clinical symptoms
    • NT-Pro BNP >900 pg/mL: Strongly suggests acute heart failure or severe decompensation; requires urgent medical intervention and hospitalization
    • Factors Affecting Results: Age (increases with age), renal dysfunction (reduced clearance), gender (higher in females), obesity (lower levels), acute illness, infections, sepsis, atrial fibrillation, hypertension, and acute coronary syndromes
    • Clinical Significance: Elevated levels correlate with left ventricular dysfunction, systolic or diastolic heart failure, increased mortality risk, hospital readmission rates, and disease progression
    • Serial Monitoring: Declining NT-Pro BNP levels during treatment suggest improving cardiac function and good prognosis; persistently elevated or rising levels indicate treatment failure or disease progression
    • Diagnostic Accuracy: High sensitivity (~90%) for detecting heart failure but moderate specificity (~76%); best used in conjunction with clinical findings and echocardiography rather than as standalone diagnostic tool
  • Associated Organs
    • Primary Organ: Heart (cardiac ventricles); specifically reflects left ventricular wall stress and dysfunction
    • Secondary Organs: Kidneys (affected by reduced cardiac output and poor perfusion; also involved in BNP clearance)
    • Associated Conditions: Systolic heart failure (ejection fraction <40%), diastolic heart failure (preserved ejection fraction), acute decompensated heart failure, cardiomyopathy, valvular disease, myocarditis, and post-myocardial infarction remodeling
    • Other Elevated Conditions: Atrial fibrillation, hypertensive crisis, sepsis, acute respiratory distress syndrome (ARDS), pulmonary embolism, renal failure, and acute coronary syndromes
    • Related Complications: Progressive left ventricular dysfunction, sudden cardiac death, cardiogenic shock, pulmonary edema, acute kidney injury from poor perfusion, arrhythmias, and sudden decompensation
    • Systemic Effects: Elevated NT-Pro BNP indicates neurohormonal activation affecting blood pressure regulation, fluid retention, and vascular resistance throughout the body
    • Prognostic Marker: Independently predicts mortality, rehospitalization rates, and adverse cardiac events in heart failure patients and post-acute coronary syndrome populations
  • Follow-up Tests
    • Echocardiography (Transthoracic Echo): Primary imaging test to assess left ventricular ejection fraction (LVEF), chamber size, wall motion abnormalities, and diastolic function; essential for confirming heart failure diagnosis
    • Electrocardiogram (ECG): Evaluates for arrhythmias, ischemia, hypertrophy, and conduction abnormalities that may contribute to heart failure
    • Chest X-ray: Assesses for pulmonary edema, cardiomegaly, and other intrathoracic pathology contributing to symptoms
    • Troponin (high-sensitivity): Cardiac biomarker to rule out acute coronary syndrome or myocardial infarction as cause of elevated NT-Pro BNP
    • Complete Metabolic Panel (CMP): Assesses renal function (creatinine, eGFR), electrolytes (potassium, sodium), and glucose; important for medication selection and disease management
    • Complete Blood Count (CBC): Evaluates hemoglobin/hematocrit for anemia, which may contribute to heart failure symptoms
    • BNP (B-type Natriuretic Peptide): Alternative form of natriuretic peptide; similar diagnostic utility to NT-Pro BNP with slightly different cut-off values
    • Coronary Angiography: May be warranted if acute coronary syndrome suspected or if patient has risk factors for ischemic heart disease
    • Cardiac MRI: Advanced imaging for specific cardiomyopathy subtypes, myocarditis evaluation, or when echocardiography is inconclusive
    • Repeat NT-Pro BNP: Recommended for serial monitoring during heart failure treatment; typically checked at 2-4 weeks after initiation of therapy and periodically during follow-up
    • Monitoring Frequency: For acute heart failure admission, baseline and 24-48 hours; for chronic management, every 3-6 months or when clinical status changes
  • Fasting Required?
    • Fasting Required: No
    • Special Instructions: Blood can be drawn at any time of day regardless of food intake; no dietary restrictions apply to this test
    • Medications: Continue taking all regularly prescribed medications including cardiac medications (beta-blockers, ACE inhibitors, diuretics) as they do not affect test interpretation
    • Patient Preparation: Remain seated or supine for 5-10 minutes before blood draw; avoid strenuous exercise immediately before collection as it may temporarily elevate NT-Pro BNP levels
    • Optimal Timing: Blood collection can be performed during emergency evaluations, outpatient visits, or routine office appointments without special scheduling considerations
    • Additional Notes: Pregnancy does not contraindicate testing; results may be interpreted differently in pregnant patients; inform phlebotomist of recent stress, illness, or strenuous activity

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