title: Alternate circulating pro-B-type natriuretic peptide and B-type natriuretic peptide forms in the general population.
abstract: OBJECTIVE
  This study was designed to determine whether alternate pro-B-type natriuretic peptide (proBNP) and BNP forms circulate in the general population.
  
  
  BACKGROUND
  Bioactive BNP(1-32) and NT-proBNP(1-76) are derived from a precursor molecule, proBNP(1-108). Recent data suggest that aminodipeptidase-processed forms of BNP(1-32) (BNP(3-32)) and of proBNP(1-108) itself (proBNP(3-108)) may circulate and have additional diagnostic potential.
  
  
  METHODS
  Residents (age > or =45 years) of Olmsted County, Minnesota, underwent medical review, echocardiography, and phlebotomy for 2 novel assays specific for proBNP(3-108) and BNP(3-32) and 2 commercial assays (Triage BNP and Roche NT-proBNP). Groups included normal subjects (n = 613), cardiovascular disease with normal ventricular function (n = 1,043), preclinical ventricular dysfunction (ALVD, n = 130), and chronic heart failure (HF, n = 52).
  
  
  RESULTS
  ProBNP(3-108) levels were above assay detection limits in 68% of normal subjects (50th; 25th to 75th percentiles: 7.85; 3.00 to 22.45 pmol/l) and correlated with age, gender, body size, and renal function and with results of commercial assays. ProBNP(3-108) levels were higher in ALVD (17.88; 6.07 to 42.76 pmol/l) or HF (42.75; 20.51 to 65.73 pmol/l), where they correlated more strongly with commercial assays. BNP(3-32) was above assay detection limits in 22% of normal subjects; levels were not correlated with age, body size, or renal function but were higher in HF. Neither novel assay was superior to commercial assays for the detection of ALVD or HF.
  
  
  CONCLUSIONS
  The presence of alternate circulating proBNP and BNP forms provides evidence for diverse proBNP and BNP processing in the general population. The physiologic consequences of these observations, both in terms of assay performance and endogenous BNP bioactivity, deserve further study.
authors: Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
authors: Carolyn S P
authors: CS
authors: Lam
authors: John C
authors: JC
authors: Burnett
authors: Lisa
authors: L
authors: Costello-Boerrigter
authors: Richard J
authors: RJ
authors: Rodeheffer
authors: Margaret M
authors: MM
authors: Redfield
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011336:Probability; D011379:Prognosis; D012372:ROC Curve; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000175:diagnosis
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain