Curriculum in CardiologySerial testing of B-type natriuretic peptide and NTpro-BNP for monitoring therapy of heart failure: The role of biologic variation in the interpretation of results
Section snippets
Determination of biologic variability and reference change values for BNP and NT-proBNP
The biologic variation (BV) of a marker is important for the proper interpretation of serial test results.3 The derived values are the analytical (CVA), intra-individual (CVI), and inter-individual (CVG) variations. Studies are typically conducted on healthy individuals, although some investigators have reported values in stable patients with heart failure. Table I summarizes the BV studies for BNP and NT-proBNP.4, 5, 6 The CVA for automated BNP and NT-proBNP assays is considerably lower than
Inpatient monitoring of BNP/NT-proBNP for decompensated HF
There have been a few studies that have compared BNP and NT-proBNP concentrations before and after therapeutic management. Short-term inhospital management of patients with HF focuses on the reduction of natriuretic peptides as the result of compensating patients who are admitted with volume and fluid overloads. In the majority of the cases cited below, the investigators stated that the results of the BNP tests were blinded to those assessing the outcomes. There would be significant study
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Biological variation: from principles to practice
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