ProBNP reference ranges in heart failure

Reference ranges natriuretic peptides

• Serum natriuretic peptides
  
  
  • High levels
    • BNP > 400 pg/ml (116 pmol/litre) or NTproBNP > 2000 pg/ml (236 pmol/litre)
      
      
  • Raised levels
    • BNP 100-400 pg/ml (29-116 pmol/litre) or NTproBNP 400-2000 pg/ml (47-236 pmol/litre)
      
      
  • Normal levels
    • BNP < 100 pg/ml (29 pmol/litre) or NTproBNP < 400 pg/ml (47 pmol/litre)

Notes:

• serum natriuretic peptides:
  • obesity or treatment with diuretics, angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, angiotensin II receptor antagonists (ARBs) and aldosterone antagonists can reduce levels of serum natriuretic peptides
    
    
  • high levels of serum natriuretic peptides can have causes other than heart failure (for example, left ventricular hypertrophy, ischaemia, tachycardia, right ventricular overload, hypoxaemia [including pulmonary embolism], renal dysfunction [GFR < 60 ml/minute], sepsis, chronic obstructive pulmonary disease [COPD], diabetes, age > 70 years and cirrhosis of the liver)
    
    
  • a serum BNP level less than 100 pg/ml (29 pmol/litre) or an NTproBNP level less than 400 pg/ml (47 pmol/litre) in an untreated patient makes a diagnosis of heart failure unlikely
    
    
  • the level of serum natriuretic peptide does not differentiate between heart failure due to left ventricular systolic dysfunction and heart failure with preserved left ventricular ejection fraction

Reference:

• 1) NICE (August 2010). chronic heart failure