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Are BNP And Pro-BNP Values Indicative Of Heart Failure?
Question: I have a history of cardiomyopathy, pvc-induced, now resolved. Last week I had a BNP test which was 12. Today I had pro-BNP test which was 67. I understand it's not exactly the same test and that the values would not be identical but is this a normal difference in the two tests or could I be experiencing an increase in heart failure indication? Very worried.
Brief Answer:
both the test results are normal , so be reassured nothing is wrong
Detailed Answer:
hello XXXX, As you have experienced the cardiomyopathy due to PVC s is reversible , and heart functioning including the pumping completely comes back to normal in most patients after the pvs are well controlled as like in your case
Now , NT- Pro BNP and BNP are hormones produced by stretching of the heart , it means when there is dysfunction there levels will be raised .
they are used for similar reason and differnt labs based on the assay available use either/ or the test , however most advance labs use NT pro bnp.
Now pro bnp is the precursor molecule to bnp , it woulds hence be more in blood as compared to bnp , so its cut off value is higher . in most labs its measured in pg/ml , the normal value of bnp less than 100 and pro bnp less than 300 is normal , so both your tests are withen normal limits and your having heart failure in near future based on these lab investigations and the type of cardiomyopathy you have is extremely rare , so be reassured
i would usggest yearly follow up 2d echo for initial years and than 3 yearly later on for any progression and if you want to rpt and single test is good enough and you dont need both .
*differnt labs may have different cut off points , but by all standard range would levels are normal , do see the report for normal range
2) Do continue the drugs prescribed by your doctor for pvc (if any) with regular follow up with your doctor . hoping this will alleviate your anxiety ,
Regards Dr. Priyank Mody
both the test results are normal , so be reassured nothing is wrong
Detailed Answer:
hello XXXX, As you have experienced the cardiomyopathy due to PVC s is reversible , and heart functioning including the pumping completely comes back to normal in most patients after the pvs are well controlled as like in your case
Now , NT- Pro BNP and BNP are hormones produced by stretching of the heart , it means when there is dysfunction there levels will be raised .
they are used for similar reason and differnt labs based on the assay available use either/ or the test , however most advance labs use NT pro bnp.
Now pro bnp is the precursor molecule to bnp , it woulds hence be more in blood as compared to bnp , so its cut off value is higher . in most labs its measured in pg/ml , the normal value of bnp less than 100 and pro bnp less than 300 is normal , so both your tests are withen normal limits and your having heart failure in near future based on these lab investigations and the type of cardiomyopathy you have is extremely rare , so be reassured
i would usggest yearly follow up 2d echo for initial years and than 3 yearly later on for any progression and if you want to rpt and single test is good enough and you dont need both .
*differnt labs may have different cut off points , but by all standard range would levels are normal , do see the report for normal range
2) Do continue the drugs prescribed by your doctor for pvc (if any) with regular follow up with your doctor . hoping this will alleviate your anxiety ,
Regards Dr. Priyank Mody
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you Dr Mody. So the probnp of 67 is no indication that anything has changed? Is it likely that my BNP would still be the same? On the report it says that normal value of pro bnp is less than 125 and BNP is less than 100. So 12 on BNP seems fine and normal but 67 seems much higher if cutoff is still only 125. Still very worried.
Brief Answer:
You are fine my friend and your heart is healthy :)
Detailed Answer:
hey XXXX, i do this test of daily basis for most of my patients , your values are very normal . even if i do my testing today or any normal friend of yours it may be higher than the present 67 . rather over-thinking and associated anxity with increase adrenalin in the circulation , which is bad for your heart . with all my professional acumen and years of study i assure you , be at peace nothing is wrong . its always single cut of point which is important , also other factors like obesity , or just the process of ablation may push it up transiently . if you look at XXXXXXX lab cut off fr pro bnp , its > 400 even to put you in grey zone and >900 for diagnosis .
regards Dr. Mody
You are fine my friend and your heart is healthy :)
Detailed Answer:
hey XXXX, i do this test of daily basis for most of my patients , your values are very normal . even if i do my testing today or any normal friend of yours it may be higher than the present 67 . rather over-thinking and associated anxity with increase adrenalin in the circulation , which is bad for your heart . with all my professional acumen and years of study i assure you , be at peace nothing is wrong . its always single cut of point which is important , also other factors like obesity , or just the process of ablation may push it up transiently . if you look at XXXXXXX lab cut off fr pro bnp , its > 400 even to put you in grey zone and >900 for diagnosis .
regards Dr. Mody
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you so much. I still cannot relax, though, as I found this information which says BNP and Pro-BNP are usually the same in healthy people and pro-bnp 4-6 times higher when there is left ventricular dysfunction.
" In healthy individuals, plasma concentrations of BNP and NT-proBNP are similar. However, in patients with left ventricular dysfunction, plasma NT-proBNP is approximately four to six times higher than BNP, even though both molecules are secreted in equimolar proportions."
" In healthy individuals, plasma concentrations of BNP and NT-proBNP are similar. However, in patients with left ventricular dysfunction, plasma NT-proBNP is approximately four to six times higher than BNP, even though both molecules are secreted in equimolar proportions."
Brief Answer:
The way out for satisfying your anxiety
Detailed Answer:
Dear mam, I do respect your concern but the ratio holds true only for abnormal values when they are elevated in presence of a disease. The whole purpose of you paying for a qualified person is so there is no misinterpretation of free information on Internet And importantly a single test should never be considered in isolation. It's not a gold standard test. If your echocardiography is normal, there are no symptoms I don't think you should worry. However still for your satisfaction, The best on medical grounds I can suggest is to repeat the test after three months to see the trend, if it's moving on the higher side we may have a discussion on the same, make sure it's same lab and even two different labs will have different readings based in the standardisation (considering the two test done were in same lab) Hoping this will help
The way out for satisfying your anxiety
Detailed Answer:
Dear mam, I do respect your concern but the ratio holds true only for abnormal values when they are elevated in presence of a disease. The whole purpose of you paying for a qualified person is so there is no misinterpretation of free information on Internet And importantly a single test should never be considered in isolation. It's not a gold standard test. If your echocardiography is normal, there are no symptoms I don't think you should worry. However still for your satisfaction, The best on medical grounds I can suggest is to repeat the test after three months to see the trend, if it's moving on the higher side we may have a discussion on the same, make sure it's same lab and even two different labs will have different readings based in the standardisation (considering the two test done were in same lab) Hoping this will help
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you so much, Dr Mody. I have considerable anxiety because there is disagreement among my doctors as to whether my pvc-induced cardiomyopathy is cured or if I need to be maintained on medications. One doctor says I am permanently cured and another says I will never be cured and will always be in danger. I am especially fearful of fluid retention as this doctor told me I could easily go into heart failure and to be vigilent. So BNP numbers are frightening.
3 months ago, I was taken off of lisinopril 5 mg. 1 month ago, carvedilol was tapered down from 9.375 twice a day to 6.25 twice a day and will be further tapered and discontinued. My last echo was 3 weeks ago with normal heart size and EF 60. I'm aftaid that heart function has gone down already and am frightened all the time because of mixed messages from my doctors. I want to live my life without fear but there is so little experience with PVC-induced cardiomyopathy that I don't feel so much confidence in my doctors who cannot agree on if I am permanently cured or not.
Thank you for your help
.
3 months ago, I was taken off of lisinopril 5 mg. 1 month ago, carvedilol was tapered down from 9.375 twice a day to 6.25 twice a day and will be further tapered and discontinued. My last echo was 3 weeks ago with normal heart size and EF 60. I'm aftaid that heart function has gone down already and am frightened all the time because of mixed messages from my doctors. I want to live my life without fear but there is so little experience with PVC-induced cardiomyopathy that I don't feel so much confidence in my doctors who cannot agree on if I am permanently cured or not.
Thank you for your help
.
Brief Answer:
Be vigilant, not apprehensive
Detailed Answer:
Hello, now normal ejection fraction is 60%, it is NOT reduced, also the dimensions are normal. So here without doubt the cardiomyopathy has reversed already. So don't worry about that .
So what should we be vigilant about?
The thing we have to take care is prevention or reoccurring. So how I we do that?
One is medication, and two best to help in maintaining healthy Heart is lisinopril group and carvedilol group.. But are we justified in taking them when our heart is normal. Most probably No.
So as your concern, what is the safest way.
See you will again get heart failure if pvc's come back.
So what are the chances of it coming back?
Now in good centers ablation is 70-90% successful. So pvc s coming back might be 10%
So how do we take care of that
1)Be Vigilant, if same symptoms report to doc.
2)as I suggested in previous reply, routine follow up if echo and other supportive test, once a year
3) if meds. Small dose of carvedilol as per your doctor
Hopefully I could help. You may take further appointment with HCM, for routine follow up with me.
Regards Dr Priyank Mody
Be vigilant, not apprehensive
Detailed Answer:
Hello, now normal ejection fraction is 60%, it is NOT reduced, also the dimensions are normal. So here without doubt the cardiomyopathy has reversed already. So don't worry about that .
So what should we be vigilant about?
The thing we have to take care is prevention or reoccurring. So how I we do that?
One is medication, and two best to help in maintaining healthy Heart is lisinopril group and carvedilol group.. But are we justified in taking them when our heart is normal. Most probably No.
So as your concern, what is the safest way.
See you will again get heart failure if pvc's come back.
So what are the chances of it coming back?
Now in good centers ablation is 70-90% successful. So pvc s coming back might be 10%
So how do we take care of that
1)Be Vigilant, if same symptoms report to doc.
2)as I suggested in previous reply, routine follow up if echo and other supportive test, once a year
3) if meds. Small dose of carvedilol as per your doctor
Hopefully I could help. You may take further appointment with HCM, for routine follow up with me.
Regards Dr Priyank Mody
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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