New Conversion Formula Between B-Type Natriuretic Peptide and N-Terminal-Pro-B-Type Natriuretic Peptide　― Analysis From a Multicenter Study ―

Abstract

production and clearance. The production of BNP and NT-proBNP is regulated in the same manner, but their mechanisms for clearance are different. In particular, NT-proBNP is unable to bind to the biologically active and clearance receptors of BNP; furthermore, NT-proBNP is not a substrate of neprilysin, which is an enzyme that degrades BNP. Therefore, NT-proBNP is assumed to be more affected by non-receptor-mediated clearance through the kidney and non-neprilysin-mediated degradation compared with BNP. Furthermore, the clearance receptor and neprilysin are abundantly expressed in adipose tissues. 11,12 Considering these factors, renal function and body mass B -type natriuretic peptide (BNP) and N-terminal (NT)-proBNP are the products of the same gene (BNP) that encodes proBNP, a 108-amino acid peptide mainly expressed in the ventricles. Prior to secretion, this prohormone is processed into the biologically active BNP and biologically inactive NT peptides. 1,2 Because heart failure (HF) severity augments BNP expression, BNP and NT-proBNP are commonly used for diagnosing HF, predicting outcomes in clinical settings, 3-8 and for assessing the effects of therapeutic interventions in patients with HF. 9,10 These 2 peptides are the most clinically useful biomarkers of HF and generally correlate with each other, but differences are observed in regard to changes in their plasma levels.Plasma levels of circulating peptides are regulated by their

Clinical Benefit of Sacubitril/Valsartan for Hypertensive Patients in Daily Practice and Predictors of Its Antihypertensive Effect

“…Fifth, to evaluate the change in natriuretic peptide levels before and after treatment with Sac/Val, it might have been more appropriate to use N-terminal pro-BNP, which is less sensitive to neutral endopeptidase inhibition. 23 …”

External Validation of the Japanese Clinical Score for Mortality Prediction in Patients With Acute Heart Failure

“…Some studies have developed a formula to convert between BNP and NT-proBNP. 20, 21 However, the formulas are still unclear. Finally, the utility of this prediction model in other regions of Japan and under present clinical settings is unclear.…”

Chronic Effects of Adaptive Servo-Ventilation Therapy on Mortality and the Urgent Rehospitalization Rate in Patients Experiencing Recurrent Admissions for Heart Failure ― A Multicenter Prospective Observational Study (SAVIOR-L) ―

“…All these items were evaluated after stabilization of HF and registered before hospital discharge. B-Type natriuretic peptide (BNP) and N-terminal pro B-type natriuretic peptide (NT-proBNP) concentrations were assessed using the following conversion formula: 27 Log[NT-proBNP] = 1.21 + 1.03 × log[BNP] − 0.009 × BMI − 0.07 × eGFR where BMI is the body mass index and eGFR is the estimated glomerular filtration rate.…”