Background Secretion of cardioprotective B-type natriuretic peptide 1–32 (BNP1-32) is increased proportionately with cardiac dysfunction, but its measurement in plasma is difficult. Therefore, less specific BNP and amino-terminal proBNP (NT-proBNP) assays that detect the precursor molecule proBNP alongside BNP or NT-proBNP metabolites were developed to reflect BNP1-32 secretion and are now mandated in the diagnosis of heart failure (HF). We compared the diagnostic performance of 2 widely used clinical assays: the Roche proBNPII assay, and Abbott BNP assay, against our recently developed in-house assays that measure either intact BNP1-32 or NT-proBNP. Methods EDTA plasma samples obtained from patients presenting with breathlessness (n = 195, 60 [31%] with clinically adjudicated HF) were assayed using the Roche NT-proBNP and our specific in-house BNP1-32 and NTBNP assays. A subset (n = 75) were also assessed with the Abbott BNP assay. Results Roche NT-proBNP was highly correlated with BNP1-32 and NTBNP (Spearman rho = 0.92 and 0.90, respectively, both Ps < 0.001), and all 3 assays similarly discriminated acute HF from other causes of breathlessness (ROC analysis areas under the curve 0.85–0.89). The Abbott BNP assay performed similarly to the other assays. Roche NT-proBNP and BNP1-32 assays had similar sensitivity (83% and 80%), specificity (83% and 84%), positive (70% and 71%) and negative (91% and 90%) predictive values, and accuracy (both 83%) at their optimal cutoffs of 1536 and 12 ng/L, respectively. Conclusions Since all assays exhibited similar performance in the diagnosis of HF, currently mandated assays provide a reliable proxy for circulating concentrations of active BNP1-32 in HF diagnosis.

中文翻译：

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特定于 BNP1-32 和 NT-proBNP 的检测在心力衰竭诊断中表现出与两种广泛使用的检测相似的性能

背景 心脏保护性 B 型利钠肽 1-32 (BNP1-32) 的分泌随心功能不全成比例增加，但其在血浆中的测量很困难。因此，开发了检测前体分子 proBNP 以及 BNP 或 NT-proBNP 代谢物的特异性较低的 BNP 和氨基末端 proBNP (NT-proBNP) 测定法，以反映 BNP1-32 的分泌，现在已被强制用于诊断心力衰竭 (HF) . 我们比较了 2 种广泛使用的临床试验的诊断性能：罗氏 proBNPII 试验和雅培 BNP 试验，与我们最近开发的测量完整 BNP1-32 或 NT-proBNP 的内部试验。方法 EDTA 血浆样本取自出现呼吸困难的患者（n = 195，使用罗氏 NT-proBNP 和我们特定的内部 BNP1-32 和 NTBNP 测定法对 60 名 [31%] 临床判定为 HF 的患者进行了测定。还用 Abbott BNP 测定法评估了一个子集 (n = 75)。结果 罗氏 NT-proBNP 与 BNP1-32 和 NTBNP 高度相关（Spearman rho 分别为 0.92 和 0.90，均 Ps < 0.001），并且所有 3 项检测均类似地将急性 HF 与其他导致呼吸困难的原因区分开来（ROC 分析区域在曲线 0.85–0.89)。Abbott BNP 测定的执行与其他测定类似。罗氏 NT-proBNP 和 BNP1-32 检测具有相似的敏感性（83% 和 80%）、特异性（83% 和 84%）、阳性（70% 和 71%）和阴性（91% 和 90%）预测值，并且准确度（均为 83%）分别在 1536 和 12 ng/L 的最佳截止值下。