Cardiomyocytes produce and secrete cardiac natriuretic peptides. Plasma levels rise in a variety of conditions but high levels are predominantly associated with heart failure, and increase in relation to severity. A sensitivity of 90-100% is claimed, whereas specificity is approximately 70-80%. Numerous commercial assays for B-type natriuretic peptide (BNP) or proBNP are now available, each with their own diagnostic range. They are useful as a screening tool for patients presenting with dyspnoea, for prognostication, and for titration of therapy. Levels rise in the elderly, in renal failure, and in pulmonary diseases causing right ventricular overload (e.g. pulmonary embolus).
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