ISSN 2398-2942      

BNP assay


Mark Oyama

Keith Page

Synonym(s): B-type natriuretic peptide assay


  • The natriuretic peptides Natriuretic peptides are polypeptide hormone mediators. They are released in response to physiological and pathological stimulation, including exercise, hypoxia, ischemia, sepsis, increased cardiac wall stress and chamber dilatation.
  • BNP is more sensitive than ANP for diagnosis of chronic LV systolic and diastolic dysfunction and ventricular hypertrophy. BNP secretion increases relative to the severity of LV dysfunction.
  • There is also evidence (in humans) that RV dysfunction causes elevation of BNP (Nagaya, Bhatia V 2003).
  • Most commercial assays measure NT-proBNP as opposed to the mature BNP peptide:
    • NT-proBNP is a larger molecule than the biologically active mature peptide, and easier to measure using immunometric assay.
    • There is (20-50 times) higher plasma concentration of the N-terminal fragments and longer plasma half-life.


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  • Two methodologies are available:
    • Competitive immunoassays (radioimmunoassay (RIA) and electroimmunoassay (EIA)).
    • Noncompetitive sandwich immunoassays (IRMA and EIMA).


  • One commercial assay available in UK (Guildhay).



  • >210 pmol/L - 85%.


  • > 210 pmol/L - 90%.

Predictive value

  • At 310 pmol/L Positive Diagnostic Predictive value increases to 100% but sensitivity is reduced to ~65%.
  • In man negative predictive value is high (more than 90%), but the positive predictive value is weak (30%-40%).

Technique (intrinsic) limitations

  • Antibodies to BNP are species specific so NT-proBNP, C-or N-terminal human BNP assays cannot be used in dogs and cats.

Result Data

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Further Reading


Refereed papers

  • Recent references from VetMedResource and PubMed.
  • Baumwart R D, Meurs K M (2005) Assessment of plasma brain natriuretic peptide concentration in Boxers with arrhythmogenic right ventricular cardiomyopathy. Am J Vet Res 66 (12), 2086-2089 PubMed.
  • Chetboul V, Tessier-Vetzel D, Escriou C et al (2004) Diagnostic potential of natriuretic peptides in the occult phase of golden retriever muscular dystrophy cardiomyopathy. J Vet Intern Med 18 (6), 845-850 PubMed.
  • Sisson D D (2004) Neuroendocrine evaluation of cardiac disease. Vet Clin North Am Small Anim Pract 34 (5), 1105-1126. Review PubMed.
  • MacDonald K A, Kittleson M D, Munro C, Kass P (2003) Brain natriuretic peptide concentration in dogs with heart disease and congestive heart failure. J Vet Intern Med 17 (2),172-177 PubMed.
  • Eriksson A S, Jarvinen A K, Eklund K K, Vuolteenaho O J, Toivari M H & Nieminen M S (2001) Effect of age and body weight on neurohumoral variables in healthy Cavalier King Charles spaniels. Am J Vet Res 62 (11), 1818-1824 PubMed.
  • Haggstrom J et al (1997) Effects of naturally acquired decompensated mitral valve regurgitation on the RAA system and ANP concentration in dogs. Am J Vet Res 58, 77-82 PubMed.
  • Haggstrom J et al (1994) Plasma concentration of atrial natriuretic peptide in relation to severity of mitral regurgitation in Cavalier King Charles Spaniels. Am J Vet Res 55, 698-703 PubMed.

Other sources of information

  • Boswood A (2006) Update on NT pro-BNP research. Veterinary Cardiovascular Society Meeting, Birmingham.



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