ProBNP in Dehradun

What is a ProBNP?

When the heart's ventricles are stretched by excess pressure or volume, the heart muscle itself releases a hormone that helps the body shed salt and water. NT-proBNP is the inactive fragment left over when that hormone is made, and because it is stable and easily measured it serves as a direct signal of how hard the heart is having to work. Its greatest strength is what a low result tells you. A normal NT-proBNP makes heart failure very unlikely, which is enormously useful when someone presents with breathlessness, since that symptom has many causes and the test can effectively rule the heart out without an echocardiogram. A raised level, by contrast, is less specific: it indicates cardiac strain but does not identify the cause, and it also rises with age, in kidney disease, in atrial fibrillation, in anaemia, in severe infection and in pulmonary embolism. Obesity, confusingly, lowers it, so a person with a high body mass index can have heart failure with a less impressive number. It informs the decision to arrange an echocardiogram; it never replaces one.

Why take this test?

NT-proBNP is advised for unexplained breathlessness, particularly breathlessness on exertion or when lying flat, waking at night short of breath, swelling of the ankles and legs, unexplained fatigue, or a reduced ability to do things that were previously easy. It is used when the question is whether these symptoms are coming from the heart or from the lungs, anaemia, or deconditioning, and the answer changes what happens next. It is also used to monitor established heart failure, where a rising level can indicate deterioration before symptoms worsen, and to help judge prognosis. It is not a general screening test for healthy people and does not belong in a routine full-body panel. If you have breathlessness with chest pain or pressure, breathlessness at rest, or breathlessness of sudden onset, seek medical care immediately rather than arranging a blood test.

• Unexplained breathlessness, especially on exertion or lying flat
• Waking at night short of breath
• Swelling of the ankles and legs
• Distinguishing a cardiac from a respiratory cause of breathlessness
• Monitoring known heart failure
• Not a screening test for people without symptoms

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