B-type natriuretic peptide: Physiologic role and assay characteristics

The discovery of cardiac natriuretic peptides two decades ago has lead to considerable research to investigate their biochemical and physiological properties. Clearly the heart is not just a pump but is also an endocrine organ that together with the kidneys control volume overload. The natriuretic peptides are a group of structurally similar but genetically distinct peptides that exhibit diverse actions in cardiovascular, renal, and endocrine homeostasis. Atrial natriuretic peptide (ANP) and brain (or B-type) natriuretic peptide (BNP) are of myocardial cell origin. BNP is released mainly from the left ventricle in response to volume overload and has become the first biochemical marker for the identification of individuals with congestive heart failure (CHF). The development of assays, including rapid point-of-care tests, has made BNP measurement a clinical reality.