N-terminal pro B type Natriuretic Peptide (NT-proBNP)

This precursor molecule is cleaved to form the active BNP and the inactive N-terminal fragment of pro-BNP (NT-proBNP). ProBNP is secreted by myocardial cells in response to increased volume and pressure. The comparisons of BNP and NT-proBNP have shown that both molecules effectively diagnose left ventricular dysfunction in the acute care/emergency setting.


B-type natriuretic peptide (brain natriuretic peptide: BNP) is a small ringed peptide secreted by the heart to regulate blood pressure and fluid balance. The peptide is stored and secreted predominantly from membrane granules in the heart ventricles in a pro-form (preproBNP). The prohormone is cleavaged into preBNP, then processed to a biologically active form BNP with 32 amino acids and another biologically inactive form of N-terminal proBNP (NT-proBNP) with 76 amino acids. NT-proBNP has a relatively long plasma half-life, which would lead to higher stability of its levels in patients. NT-proBNP emerges as a biomarker of heart failure (HF) in clinical studies.

NT-proBNP is an independent predictor of coronary artery diseases (CAD) such as acute coronary syndrome (ACS) and stable angina pectoris (SAP). A significant correlation was observed between BNP and NT-proBNP at all stages of kidney function, but the correlation was significantly affected by kidney function. Observational studies showed a close inverse relationship between plasma N terminal probnp and creatinine clearance. NT-proBNP also increases left ventricular hypertrophy and left ventricular systolic and diastolic dysfunction. It is also indicated that age and gender difference in the ability of NT-proBNP is considered to identify myocardial dysfunction in metabolic disturbances.

N Terminal Pro Bnp