Brain natriuretic peptide

From Citizendium
Revision as of 08:29, 26 May 2009 by imported>Robert Badgett
Jump to navigation Jump to search
This article is developing and not approved.
Main Article
Discussion
Related Articles  [?]
Bibliography  [?]
External Links  [?]
Citable Version  [?]
 
This editable Main Article is under development and subject to a disclaimer.

In medicine, brain natriuretic peptide (BNP) is a "peptide that is secreted by the brain and the heart atria, stored mainly in cardiac ventricular myocardium. It can cause natriuresis; diuresis; vasodilation; and inhibits secretion of renin and aldosterone. It improves heart function. It contains 32 amino acids."[1]

BNP is one member or a family of closely related peptides called "natriuretic peptides" because of their ability to stimulate sodium excretion (natriuresis). Natriuretic peptides are functional antagonists to the renin-angiotensin-aldosterone system. BNP was given its name because it was first discovered in the porcine brain. [2] However, confusingly, there appears to be relatively little BNP expressed in the brain compared to atrial natriuretic peptide [3]

An elevated concentration of BNP in the circulation can detect heart failure:[4]

Test accuracy

Usig the BNP to detect heart failure[4]
  Sensitivity Specificity
BNP > 100 pg per milliliter 90% 76%
BNP > 50 pg per milliliter 97% 62%

Effect on clinical decision making

Providing physicians quick access to BNP results may[5] or may not[6] improve the emergency evaluation of dyspnea.

References

  1. Anonymous (2024), Brain natriuretic peptide (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Baxter GF (2004) The natriuretic peptides. Basic Res Cardiol 99:71-5. PMID 14963664
  3. Langub MC et al. (1995) Distribution of natriuretic peptide precursor mRNAs in the rat brain. J Comp Neurol 356:183-99. PMID 7629314
  4. 4.0 4.1 Maisel AS, Krishnaswamy P, Nowak RM, et al (July 2002). "Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure". N Engl J Med 347: 161–7. DOI:10.1056/NEJMoa020233. PMID 12124404. Research Blogging.
  5. Mueller C, Scholer A, Laule-Kilian K, et al. (February 2004). "Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea". N. Engl. J. Med. 350 (7): 647–54. DOI:10.1056/NEJMoa031681. PMID 14960741. Research Blogging.
  6. Schneider HG, Lam L, Lokuge A, et al. (March 2009). "B-type natriuretic peptide testing, clinical outcomes, and health services use in emergency department patients with dyspnea: a randomized trial". Ann. Intern. Med. 150 (6): 365–71. PMID 19293069[e]