To help detect, diagnose, and in some cases evaluate the severity of heart disease, including congestive heart failure (CHF)
BNP and NT-proBNP
When you have symptoms such as shortness of breath, fatigue, excessive fluid in your abdomen, and swollen ankles and legs after a heart attack or during treatment for heart disease
A blood sample drawn from a vein
None
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How is the test used?
A test for BNP or NT-proBNP is primarily used to help detect, support diagnosis, and in some instances evaluate the severity of heart failure. The two tests are not interchangeable and should not be used together. Your healthcare practitioner should order one or the other but not both.
A BNP test or NT-proBNP test can be used, along with other cardiac biomarker tests, to detect heart stress and damage and/or along with lung function tests to distinguish between causes of shortness of breath. Chest X-rays and an ultrasound test called echocardiography may also be performed. Your healthcare practitioner may also prescribe a stress test, which takes place on a treadmill.
Heart failure can be confused with other conditions, and it may co-exist with them. BNP and NT-proBNP levels can help healthcare practitioners differentiate between heart failure and other problems, such as lung disease. An accurate diagnosis is important because the treatments are often different and must be started as soon as possible.
Although BNP and NT-proBNP are usually used to recognize heart failure, an increased level in people who have had a heart attack may indicate an increased risk of further heart disease. Thus, a healthcare practitioner may use either BNP or NT-proBNP to evaluate risk of further heart disease in someone who has had a heart attack.
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When is it ordered?
A BNP or NT-proBNP test may be ordered in a healthcare practitioner's office when you have signs and symptoms that could be due to heart failure. These may include:
- Difficulty breathing, shortness of breath
- Fatigue
- Swelling in the feet, ankles, legs, abdomen
Testing may be done in the emergency room or in a hospital bed when you are in crisis and/or have symptoms that could be due to heart failure and healthcare practitioners need to quickly distinguish whether you are suffering from heart failure or some other medical problem.
Several BNP or NT-proBNP tests may be done over a period of time when you are being treated for heart failure to monitor the effects of therapy.
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What does the test result mean?
Higher-than-normal results suggest that you have some degree of heart failure, and the level of BNP or NT-proBNP in the blood may be related to its severity. Higher levels of BNP or NT-proBNP are often associated with an increased need for aggressive therapy. In some individuals with chronic heart failure, the markers may remain elevated and cannot be used to monitor response.
Normal results indicate that signs and symptoms are likely due to something other than heart failure.
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Is there anything else I should know?
BNP and NT-proBNP levels decrease in most people who are taking drug therapies for heart failure, such as angiotensin-converting enzyme (ACE) inhibitors, beta blockers, and diuretics.
Levels of both BNP and NT-proBNP tend to increase with age in the absence of disease.
Levels of NT-proBNP and BNP may be increased in persons with kidney disease due to reduced clearance. Obese individuals may have lower concentrations of BNP or NT-proBNP.
While both BNP and NT-proBNP will rise with left ventricle dysfunction and either can be measured for diagnosis or monitoring therapy, they are not interchangeable and the results cannot be directly compared.
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How common is heart failure?
According to the American Heart Association, more than 6 million people in the United States are living with heart failure and the number is growing. It is estimated that one in five American adults age 40 and older will develop heart failure in their lifetime. You may be at increased risk of developing heart failure if you have conditions such as heart disease, high blood pressure, or diabetes, or if you have had a heart attack. Other risk factors include tobacco use, alcohol use, and obesity.
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How is heart failure treated?
For information on treatment, read the article on Congestive Heart Failure or visit the American Heart Association webpage on Heart Failure.



