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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
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