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In extremes of heart failure the BNP levels, although elevated, may not be proportionate to the degree of heart failure. Of course BNP fall in response to antihyperytensive therapy, it goes up with blood pressure elevation. However, it is still a very good rule out test even in patients on therapy. We showed this last year at Focus It is always good to watch the lab community working hard to delay new, evidence based, tests. P. O. Collinson -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Mainwaring-Burton Richard (RGZ) Sent: 24 May 2007 09:43 To: [log in to unmask] Subject: Re: Does BNP fall off with chronicity? BNP is known to fall with antihypertensive therapy - a fact which is too often missing from the advocates of BNP as a magic rule-out of heart failure. This may not be unrelated to your query. with best wishes Richard Richard Mainwaring-Burton Consultant Biochemist Queen Mary's Hospital Sidcup, Kent 020-8308-3084 -----Original Message----- From: Grimes, Helen, UCHG [mailto:[log in to unmask]] Sent: 24 May 2007 09:35 To: [log in to unmask] Subject: Does BNP fall off with chronicity? I received the following query, and I cannot recall either reading or hearing about this phenomena. Can anyone comment as to whether it is correct or not. "Is there a phenomenon whereby people who have chronic heart failure reach a stage where they fail to produce elevated levels of BNP or is it that they fail to produce the expected high levels that their symptoms would suggest they should have. Is there a phenomenon in which they get "BNP fatigue" i.e. the body after producing high levels for a long time then is unable to produce these high levels indefinitely and the level drops off." Thanks in anticipation, Helen ------------------------------------------------------------------------ ------------------ Dr Helen Grimes, Dept Clinical Biochemistry, University College Hospital, Galway, Ireland ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ Disclaimer: This e-mail and any files transmitted with it are confidential. If you are not the intended recipient, any reading, printing, storage, disclosure, copying or any other action taken in respect of this e-mail is prohibited and may be unlawful. If you are not the intended recipient, please notify the sender immediately by using the reply function and then permanently delete what you have received. Incoming and outgoing e-mail messages are routinely monitored for compliance with the Department of Health's policy on the use of electronic communications. For more information on the Department of Health's e-mail policy click here http://www.doh.gov.uk/emaildisclaimer.htm ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/