Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (756 page)

   Left ventricular dysfunction

   Renal impairment

   Coronary artery disease

   Valvular disease

   Arrhythmias

   Brain injury

   Anemia (BNP)

   Sepsis and shock (NT-proBNP)

   Limitations

   Routine blood BNP or NT-proBNP testing is not justified for determining specific therapy for patients with chronic or acute heart failure.

   Nesiritide (human recombinant BNP) increases BNP. Studies indicate a minimal effect on NT-proBNP.

   Age and exercise also increase BNP.

   Obesity decreases BNP.

   Intraindividual variation (approximately 50% and 60%, respectively, for BNP and NT-proBNP from week to week) indicates altered cardiac status.