Test Catalog

Test Id : BNP

B-Type Natriuretic Peptide, Plasma

Useful For
Suggests clinical disorders or settings where the test may be helpful

Aiding in the diagnosis of congestive heart failure (CHF)

 

The role of B-type natriuretic peptide in monitoring CHF therapy is under investigation

Method Name
A short description of the method used to perform the test

Immunoenzymatic Assay

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

B-Type Natriuretic Peptide (BNP)

Aliases
Lists additional common names for a test, as an aid in searching

BNP (Brain Natriuretic Peptide)

Brain Natriuretic Peptide

Natriuretic Peptide

Specimen Type
Describes the specimen type validated for testing

Plasma EDTA

Necessary Information

Include patient's age and sex.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube: Lavender top (EDTA)

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge, aliquot plasma into plastic vial, and freeze immediately or within 7 hours from time of collection.

Forms

If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.4 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Plasma EDTA Frozen (preferred) 365 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Aiding in the diagnosis of congestive heart failure (CHF)

 

The role of B-type natriuretic peptide in monitoring CHF therapy is under investigation

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

B-type natriuretic peptide (BNP: formerly brain natriuretic peptide) is a 32-amino acid-ringed peptide secreted by the heart to regulate blood pressure and fluid balance.(1) BNP is stored in, and secreted predominantly from, membrane granules in the heart ventricles and is continuously released from the heart in response to both ventricle volume expansion and pressure overload.(2)

 

The natriuretic peptide system and the renin-angiotensin system counteract each other in arterial pressure regulation. When arterial pressure decreases, the kidneys release renin, which activates angiotensinogen resulting in increased peripheral resistance of the arterioles, thus increasing arterial pressure.

 

The natriuretic peptides counteract the effects of renin secretion, causing a reduction of blood pressure and extracellular fluid volume.(3) Both BNP and atrial natriuretic peptide (ANP) are activated by atrial and ventricular distension due to increased intracardiac pressure. These peptides have both natriuretic and diuretic properties: they raise sodium and water excretion by increasing the glomerular filtration rate and inhibiting sodium reabsorption by the kidney.

 

The New York Heart Association (NYHA) developed a functional classification system for congestive heart failure (CHF) consisting of 4 stages based on the severity of the symptoms. Various studies have demonstrated that circulating BNP concentrations increase with the severity of CHF based on the NYHA classification.(4-6)

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Males

< or =45 years: < or =35 pg/mL

46 years: < or =36 pg/mL

47 years: < or =37 pg/mL

48 years: < or =38 pg/mL

49 years: < or =39 pg/mL

50 years: < or =40 pg/mL

51 years: < or =41 pg/mL

52 years: < or =42 pg/mL

53 years: < or =43 pg/mL

54 years: < or =45 pg/mL

55 years: < or =46 pg/mL

56 years: < or =47 pg/mL

57 years: < or =48 pg/mL

58 years: < or =49 pg/mL

59 years: < or =51 pg/mL

60 years: < or =52 pg/mL

61 years: < or =53 pg/mL

62 years: < or =55 pg/mL

63 years: < or =56 pg/mL

64 years: < or =57 pg/mL

65 years: < or =59 pg/mL

66 years: < or =60 pg/mL

67 years: < or =62 pg/mL

68 years: < or =64 pg/mL

69 years: < or =65 pg/mL

70 years: < or =67 pg/mL

71 years: < or =69 pg/mL

72 years: < or =70 pg/mL

73 years: < or =72 pg/mL

74 years: < or =74 pg/mL

75 years: < or =76 pg/mL

76 years: < or =78 pg/mL

77 years: < or =80 pg/mL

78 years: < or =82 pg/mL

79 years: < or =84 pg/mL

80 years: < or =86 pg/mL

81 years: < or =88 pg/mL

82 years: < or =91 pg/mL

> or =83 years: < or =93 pg/mL

 

Females

< or =45 years: < or =64 pg/mL

46 years: < or =66 pg/mL

47 years: < or =67 pg/mL

48 years: < or =69 pg/mL

49 years: < or =71 pg/mL

50 years: < or =73 pg/mL

51 years: < or =74 pg/mL

52 years: < or =76 pg/mL

53 years: < or =78 pg/mL

54 years: < or =80 pg/mL

55 years: < or =82 pg/mL

56 years: < or =84 pg/mL

57 years: < or =87 pg/mL

58 years: < or =89 pg/mL

59 years: < or =91 pg/mL

60 years: < or =93 pg/mL

61 years: < or =96 pg/mL

62 years: < or =98 pg/mL

63 years: < or =101 pg/mL

64 years: < or =103 pg/mL

65 years: < or =106 pg/mL

66 years: < or =109 pg/mL

67 years: < or =112 pg/mL

68 years: < or =114 pg/mL

69 years: < or =117 pg/mL

70 years: < or =120 pg/mL

71 years: < or =123 pg/mL

72 years: < or =127 pg/mL

73 years: < or =130 pg/mL

74 years: < or =133 pg/mL

75 years: < or =137 pg/mL

76 years: < or =140 pg/mL

77 years: < or =144 pg/mL

78 years: < or =147 pg/mL

79 years: < or =151 pg/mL

80 years: < or =155 pg/mL

81 years: < or =159 pg/mL

82 years: < or =163 pg/mL

> or =83 years: < or =167 pg/mL

Interpretation
Provides information to assist in interpretation of the test results

>Normal to <200 pg/mL: likely compensated congestive heart failure (CHF)

> or =200 to < or =400 pg/mL: likely moderate CHF

>400 pg/mL: likely moderate-to-severe CHF

 

B-type natriuretic peptide (BNP) levels are loosely correlated with New York Heart Association (NYHA) functional class (see Table).

  

Interpretive Levels for CHF

Functional Class

5th to 95th Percentile

Median

I

15 to 499 pg/mL

95 pg/mL

II

10 to 1080 pg/mL

222 pg/mL

III

38 to >1300 pg/mL

459 pg/mL

IV

147 to >1300 pg/mL

1,006 pg/mL

All CHF

22 to >1300 pg/mL

360 pg/mL

 

Elevation in BNP can occur due to right heart failure with cor pulmonale (200-500 pg/mL), pulmonary hypertension (300-500 pg/mL), and acute pulmonary embolism (150-500 pg/mL). Elevations also occur in patients with acute coronary syndromes.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Lack of elevations have been reported if congestive heart failure is very acute (first hour) or with ventricular inflow obstruction (hypertrophic obstructive cardiomyopathy, mitral stenosis, atrial myxoma).

 

Some patients who have been exposed to animal antigens, either in the environment or as part of treatment or imaging procedures, may have circulating anti-animal antibodies present. These antibodies may interfere with the assay reagents to produce unreliable results.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Krishnaswamy P, Lubien E, Clopton P, et al: Utility of B-natriuretic peptide as a rapid, point-of-care test for screening patients undergoing echocardiography to determine left ventricular dysfunction. Am J Med. 2001;111(4):274-279

2. McNairy M, Gardetto N, Clopton P, et al: Stability of B-type natriuretic peptide levels during exercise in patients with congestive heart failure: implications for outpatient monitoring with B-type natriuretic peptide. Am Heart J. 2002 March;143(3):406-411

3. Redfield MM, Rodeheffer RJ, Mahoney DW, et al: What is a normal BNP? - a community-based study employing two assays for measurement of BNP. J Card Fail. 2001 September;7(3):30

4. Apple FS, Goetze JP, Jaffe AS: Cardiac function. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:1201-1255

5. Dietzen DJ: Amino acids, peptides, and proteins. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:373-403

Method Description
Describes how the test is performed and provides a method-specific reference

The instrument used is a Beckman Coulter Dxl 800. The brain natriuretic peptide (BNP) test is a 2-site immunoenzymatic sandwich assay. A sample is added to a reaction vessel with mouse monoclonal anti-human BNP antibody-alkaline phosphatase conjugate and paramagnetic particles coated with mouse Omniclonal anti-human BNP antibody. BNP in human plasma binds to the immobilized anti-BNP on the solid phase, while the mouse anti-BNP conjugate reacts specifically with bound BNP. After incubation in a reaction vessel, materials bound to the solid phase are held in a magnetic field while unbound materials are washed away. A chemiluminescent substrate, Lumi-Phos* 530, is added to the reaction systems for in vitro quantitative measurement of BNP. Vessel and light generated by the reaction is measured with a luminometer. The light production is directly proportional to the concentration of BNP in the sample. The amount of analyte in the sample is determined from a stored, multi-point calibration curve. (Package insert: Quidel Triage BNP 26608en. Quidel Corp; Rev. A 05/2018)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

83880

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports