Value of ProBNP test6

[cudagirl]

Went to the doc about a month ago with severe edema in my abdomin and legs.  He had me take a pro BNP test.  I got the results and they were elevated (395) but not enough to call it CHF, it had to be 500 or higher.  My question is should I be concerned about the elevation at all.  I have been really short of breath and holding a lot of fluid even on 80mg of lasix a day.  Any suggestion would be appreciated.

[Dr Santos]

Hi,

B-type, or brain, natriuretic peptide (BNP) was first isolated from brain tissue, but is synthesized primarily in the ventricles of the heart.  It is a marker of cardiac dysfunction that correlates with the severity of symptomatic and asymptomatic left ventricular hypertrophy and congestive heart failure. It can be used to triage  patients who may experience symptoms. The degree of BNP or NT-proBNP elevation can be used to predict future cardiac events and survival. When levels are within the normal reference range, the patient's symptoms are probably not due to heart failure. Conversely, when levels are elevated, there is an increased probability of heart failure and further cardiac assessment is warranted.

With your history of cardiomyopathy and lupus, it would help to have a further evaluation of your condition. A complete medical history and physical evaluation is important. In addition to this, your new doctor could contact your old doctor to obtain your previous records and discuss what has been previously done.

Take care and regards.

[cudagirl]

Thank you so much for your comment.  I do take heart meds, and I have dilated cardiomyopthy and my EF is 40. We have switched medical insurance, so I can't see my former DR and the new one doesn't really know my history.  I was concerned because of the fluid retention, and it seems to be getting worse.  I will keep pushing him to dig a little deeper.  Because I have Lupus they tend to peg that disease with everything.
Anyway thank you again for your info.

Pam

[Sirenet]

Hi, I'm Steve. While I don't know too much, I noticed that no one has responded and I thought I might offer input. The heart releases these hormones ( BNP and Pro-BNP) when it is stressed. Normal level is under 100. 0ver 300 - mild heart failure, over 600- moderate, over 900 - severe.
  I was admitted to ER in Dec of 2007 because my BNP level was 1092. Dr was extremely concerned ( I went to ER with severe abdominal pain from a bad Gall Bladder). It was from this # that he ordered a full workup on heart ( needed cardiac clearance for Gall Bladder surgery). All my results were bad. Won't  bore you with details, but I was DX'd with CHF, etc....
  Since fluid levels are a problem for you, you should have a full workup on heart. From what I know, this high fluid level can cause your heart stress and even lead to Dilated Cardiomyopathy (the left ventricle enlarges to accomodate the higher fluid level, if the heart cannot keep up). This can lead to arrythmia problems, etc.
  If you are not taking heart meds, beta blockers and ace inhibitors can help reduce stress on heart. Have you had any tests on heart done? You should have a cardiologist do a full range of tests.
  Your Pro-BNP numbers would put you in the mild to moderate range. I hope I've helped somewhat. Good luck with getting your condition under control. -Steve