The clearance of BNP modeled using the NT-proBNP-BNP relationship.
BACKGROUND
The ventricular myocardium simultaneously secretes two natriuretic peptides useful in the evaluation of heart failure: BNP, hormonally active, and NT-proBNP, the N-terminal end, non-hormonally active, but ultimately their concentrations differ and their clearance patterns are poorly defined.


METHODS
We measured NT-proBNP and BNP in patients with and without heart failure and compared their concentrations using regression analysis.


RESULTS
The relationship between NT-proBNP with BNP is nonlinear. Between 45 and 70 pmol of BNP/L (class II heart failure) the slope is much higher than in other ranges and the NT-proBNP/BNP ratio reaches its maximum in patients with class II NYHA heart failure.


CONCLUSIONS
The difference in concentration for NT-proBNP and BNP can be related to the diffusion across the renal basement membrane. Their ratio is nonlinear because BNP is cleared faster than in patients with class II heart failure than other classes or normal, suggesting a change in a non-renal mode of clearance.
Kroll
Martin H
MH
North Texas Veterans Affairs Medical Center, Pathology and Laboratory Medicine, 4500 S. Lancaster Road 113, Dallas, TX 75216, USA. martin.kroll@med.va.gov
Srisawasdi
Pornpen
P
D016022:Case-Control Studies; D006333:Heart Failure / Q000378:metabolism; D006801:Humans; D007668:Kidney / Q000378:metabolism; D008955:Models, Cardiovascular; D009206:Myocardium / Q000378:metabolism; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D017711:Nonlinear Dynamics; D010446:Peptide Fragments / Q000378:metabolism*; D049490:Systems Biology
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain