Background: Natriuretic peptides (NPs) have broad indications during heart failure (HF) and the detection of left ventricular dysfunction in high-risk patients. They can also be used for the diagnosis/management of other cardiac diseases. However, very little is known regarding their use in routine practice.

Methods: We examined all biological tests performed from February 2010 to August 2015 in two districts from the French Brittany, covering 13,653 km2 and including 22,265 physicians. We report the settings and conditions of N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) measurements (the only locally NP available).

Results: From a total of 3,606,432 tests requested in 557,650 adult (older than 20 years) patients, only 56,653 (1.6%) included at least one NT-proBNP measurement. NT-proBNP measurements gradually increased, from 9,188 in 2011 to 12,938 in 2014 (p<0.001). Most NT-proBNP tests were measured in urban laboratories (72.7%) and in private (62.9%) non-hospital/clinics laboratories, they were mostly ordered by general practitioners (66% compared with 11% by cardiologists). The number of NT-proBNP measurements increased with age up to 80-90 years, and 70.3% of tests were measured in ≥75y patients. Creatinine and electrolytes were not associated with NT-proBNP in 15.8% and 19.7% of tests, respectively.

Conclusion: Among a very large cohort, we observed that NPs remain largely undermeasured. NT-proBNP is mostly measured in elderly patients, and its interpretation may be hazardous in up to 16% of all individuals because no measurement of creatinine was associated to NT-proBNP.

背景：利尿钠肽（NPs）在心力衰竭（HF）和高危患者左心室功能不全的检测中具有广泛的适应症。它们还可以用于其他心脏病的诊断/治疗。但是，对于它们在常规实践中的使用知之甚少。

方法：我们检查了从2010年2月至2015年8月在法国布列塔尼两个地区进行的所有生物学测试，面积为13,653平方公里，其中包括22,265位医生。我们报告的设置和条件的N端前B型利钠肽（NT-proBNP）测量（可用的唯一本地NP）。

结果：在针对557,650名成人（20岁以上）患者的3,606,432项测试中，只有56,653（1.6％）包括至少一项NT-proBNP测量。NT-proBNP测量值逐渐增加，从2011年的9,188增至2014年的12,938（p <0.001）。大多数NT-proBNP测试是在城市实验室（72.7％）和私人医院（62.9％）的非医院/诊所实验室中进行的，这些检查大多由全科医生进行（66％，而心脏病专家则为11％）。NT-proBNP测量的数量随着年龄的增长而增加，最高可达80-90岁，并且在7500日元的患者中测量了70.3％的测试。肌酐和电解质与NT-proBNP无关，分别为15.8％和19.7％。

结论：在一个非常大的队列中，我们观察到NP仍然在很大程度上被低估。NT-proBNP通常在老年患者中进行测量，其解释可能对多达16％的个体有害，因为没有肌酐测量值与NT-proBNP相关。