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Plasma BNP and NT-proBNP Assays by Automated Immunoanalyzers: Analytical and Clinical Study

Address correspondence to Dr Clara Bionda, Laboratoire de Biochimie et de Biologie Moléculaire, Hôpital Cardio-Vasculaire et Pneumologique L Pradel, Lyon, 28 Avenue Doyen Lépine, 69 677 Lyon, France; tel 33 04 72 11 80 30; fax 33 04 72 35 72 46; e-mail clara.bionda{at}chu-lyon.fr.

The plasma concentrations of natriuretic peptides, BNP and NTproBNP, have been shown to be markers for the diagnosis of congestive heart failure (CHF). In this study, plasma BNP and NTproBNP concentrations were evaluated and stratified according to renal function, body mass index (BMI), and New York Heart Association (NYHA) classification. Comparison studies between the 2 natriuretic peptide markers were performed. Assays for BNP were performed with a Triage reagent pack (Biosite, Inc) on an Access 2 immunoanalyzer (Beckman-Coulter); NTproBNP assays were performed with a Roche reagent pack on an Elecsys 20.10 immunoanalyzer (Roche Diagnostics). Plasma samples were collected from consecutive patients hospitalized for cardiac disorders at our institution. Nonparametric tests were used for statistical analyses. The results show that alterations of renal function had less impact on BNP (p = 0.9) than on NTproBNP concentrations (p <0.0001). BNP and NTproBNP levels were lower in obese patients with CHF (515 ± 61 ng/L and 1652 ± 124 ng/L, respectively) than in lean patients (900 ± 85 ng/L and 6686 ± 749 ng/L). Although NTproBNP levels averaged about 10 times higher than BNP levels, there was significant correlation between these 2 markers (Deming regression r² = 0.40, IC: 0.95). In conclusion, plasma BNP and NTproBNP assays are both useful for the diagnosis of CHF and left ventricular dysfunction. However, renal function and obesity must be taken into account for clinical interpretation. These assays have good analytical performance and the choice between them depends on local preference.

Keywords: brain natriuretic peptides, NTproBNP, BNP, left ventricular ejection fraction (LVEF)

Abbreviations: NTproBNP, N-terminal (1–76) probrain natriuretic peptide; BNP, brain natriuretic peptide (77–108) fragment; LVEF, left ventricular ejection fraction; NYHA, New York Heart Association; CHF, congestive heart failure; LVD, left ventricular dysfunction

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