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Natriuretic Peptide Tests (BNP, NT-proBNP)

What are natriuretic peptide tests (BNP, NT-proBNP)?

Natriuretic peptides are substances made by the heart. Two main types of these substances are brain natriuretic peptide (BNP) and N-terminal pro b-type natriuretic peptide (NT-proBNP). Normally, only small levels of BNP and NT-proBNP are found in the bloodstream. High levels can mean your heart isn't pumping as much blood as your body needs. When this happens, it's known as heart failure, sometimes called congestive heart failure.

Natriuretic peptide tests measure the levels of BNP or NT-proBNP in your blood. Your health care provider may order a BNP test or an NT-proBNP test, but not both. They are both useful in diagnosing heart failure, but rely on different types of measurements. The choice will depend on the equipment available in your provider's recommended laboratory.

Other names: brain natriuretic peptide, NT-proB-type natriuretic peptide test, B-type natriuretic peptide

What are they used for?

A BNP test or an NT-proBNP test is most often used to diagnose or rule out heart failure. If you've already been diagnosed with heart failure, the test may be used to:

  • Find out the severity of the condition
  • Plan treatment
  • Find out if treatment is working

The test may also be used to find out whether or not your symptoms are due to heart failure.

Why do I need a natriuretic peptide test?

You may need a BNP test or an NT-proBNP test if you have symptoms of heart failure. These include:

If you are being treated for heart failure, your health care provider may order one of these tests to see how well your treatment is working.

What happens during a natriuretic peptide test?

For a BNP test or an NT-proBNP test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don't need any special preparations for a BNP test or an NT-proBNP test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

If your BNP or NT-proBNP levels were higher than normal, it probably means you have heart failure. Usually, the higher the level, the more serious your condition is.

If your BNP or NT-proBNP results were normal, it probably means your symptoms are not being caused by heart failure. Your provider may order more tests to help make a diagnosis.

If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about a natriuretic peptide test?

Your health care provider may order one or more of the following tests in addition to or after you've had a BNP or NT-proBNP test:

  • Electrocardiogram, which looks at heart's electrical activity
  • Stress test, which shows how well your heart handles physical activity
  • Chest x-ray to see if your heart is larger than normal or if you have fluid in your lungs

You may also get one or more of the following blood tests:

  • ANP test. ANP stands for atrial natriuretic peptide. ANP is similar to BNP but it is made in a different part of the heart.
  • Metabolic panel to check for kidney disease, which has similar symptoms to heart failure
  • Complete blood count to check for anemia or other blood disorders

References

  1. American Heart Association [Internet]. Dallas (TX): American Heart Association Inc.; c2019. Diagnosing Heart Failure [cited 2019 Jul 24]; [about 3 screens]. Available from: https://www.heart.org/en/health-topics/heart-failure/diagnosing-heart-failure
  2. Bay M, Kirk V, Parner J, Hassager C, Neilsen H, Krogsgaard, K, Trawinski J, Boesgaard S, Aldershvile, J. NT-proBNP: a new diagnostic screening tool to differentiate between patients with normal and reduced left ventricular systolic function. Heart. [Internet]. 2003 Feb [cited 2019 Jul 24]; 89(2):150–154. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767525
  3. Doust J, Lehman R, Glasziou P. The Role of BNP Testing in Heart Failure. Am Fam Physician [Internet]. 2006 Dec 1 [cited 2019 Jul 24]; 74(11):1893–1900. Available from: https://www.aafp.org/afp/2006/1201/p1893.html
  4. Cleveland Clinic [Internet]. Cleveland (OH): Cleveland Clinic; c2019. NT-proB-type Natriuretic Peptide (BNP) [cited 2019 Jul 24]; [about 3 screens]. Available from: https://my.clevelandclinic.org/health/diagnostics/16814-nt-prob-type-natriuretic-peptide-bnp
  5. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2019. BNP and NT-proBNP [updated 2019 Jul 12; cited 2019 Jul 24]; [about 2 screens]. Available from: https://labtestsonline.org/tests/bnp-and-nt-probnp
  6. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2019. Congestive Heart Failure; [updated 2017 Oct 10; cited 2019 Jul 31]; [about 2 screens]. Available from: https://labtestsonline.org/conditions/congestive-heart-failure
  7. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2019. Blood tests for heart disease; 2019 Jan 9 [cited 2019 Jul 24]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease/art-20049357
  8. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests [cited 2019 Jul 24]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
  9. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2019. Brain natriuretic peptide test: Overview [updated 2019 Jul 24; cited 2019 Jul 24]; [about 2 screens]. Available from: https://ufhealth.org/brain-natriuretic-peptide-test
  10. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2019. Exercise stress test: Overview [updated 2019 Jul 31; cited 2019 Jul 31]; [about 2 screens]. Available from: https://ufhealth.org/exercise-stress-test
  11. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2019. Health Encyclopedia: BNP (Blood) [cited 2019 Jul 24]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=bnp_blood
  12. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Health Information: Brain Natriuretic Peptide (BNP) Test: Results [updated 2018 Jul 22; cited 2019 Jul 24]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/brain-natriuretic-peptide-bnp/ux1072.html#ux1079
  13. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Health Information: Brain Natriuretic Peptide (BNP) Test: Test Overview [updated 2018 Jul 22; cited 2019 Jul 24]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/brain-natriuretic-peptide-bnp/ux1072.html
  14. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Health Information: Brain Natriuretic Peptide (BNP) Test: Why It is Done [updated 2018 Jul 22; cited 2019 Jul 24]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/brain-natriuretic-peptide-bnp/ux1072.html#ux1074

The medical information provided is for informational purposes only, and is not to be used as a substitute for professional medical advice, diagnosis or treatment. Please contact your health care provider with questions you may have regarding medical conditions or the interpretation of test results.

In the event of a medical emergency, call 911 immediately.