Template:BNP value - Revision history

Ostermayer: Marked this version for translation

2026-01-26T00:50:21Z

Marked this version for translation

← Older revision		Revision as of 00:50, 26 January 2026
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	===[[Special:MyLanguage/Brain natriuretic peptide (BNP)\|Brain natriuretic peptide (BNP)]]<ref>Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347(3):161-167. doi:10.1056/NEJMoa020233.</ref>===		===[[Special:MyLanguage/Brain natriuretic peptide (BNP)\|Brain natriuretic peptide (BNP)]]<ref>Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347(3):161-167. doi:10.1056/NEJMoa020233.</ref>=== <!--T:1-->

			<!--T:2-->
	*Measurement		*Measurement
	**'''<100 pg/mL''': Negative for acute CHF (Sn 90%, NPV 89%)		**'''<100 pg/mL''': Negative for acute CHF (Sn 90%, NPV 89%)
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	===[[Special:MyLanguage/NT-proBNP\|NT-proBNP]]<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>===		===[[Special:MyLanguage/NT-proBNP\|NT-proBNP]]<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>=== <!--T:3-->

			<!--T:4-->
	*<300 pg/mL → [[Special:MyLanguage/CHF\|CHF]] unlikely		*<300 pg/mL → [[Special:MyLanguage/CHF\|CHF]] unlikely
	*[[Special:MyLanguage/CHF\|CHF]] likely in:		*[[Special:MyLanguage/CHF\|CHF]] likely in:

Ostermayer at 00:49, 26 January 2026

2026-01-26T00:49:24Z

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Ostermayer: Prepared the page for translation

2026-01-26T00:48:59Z

Prepared the page for translation

← Older revision		Revision as of 00:48, 26 January 2026
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	===[[Brain natriuretic peptide (BNP)]]<ref>Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347(3):161-167. doi:10.1056/NEJMoa020233.</ref>===		<languages/>
			<translate>

			===[[Special:MyLanguage/Brain natriuretic peptide (BNP)\|Brain natriuretic peptide (BNP)]]<ref>Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347(3):161-167. doi:10.1056/NEJMoa020233.</ref>===

	*Measurement		*Measurement
	**'''<100 pg/mL''': Negative for acute CHF (Sn 90%, NPV 89%)		**'''<100 pg/mL''': Negative for acute CHF (Sn 90%, NPV 89%)
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	**Combination of BNP with clinician judgment 94% sensitive 70% specific (compared to 49% sn and 96% spec clinical judgement alone) <ref> McCullough et al. B-Type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from breathing not properly (BNP) multinational study. Circulation. 2002:DOI: 10.1161/01.CIR.0000025242.79963.4</ref>		**Combination of BNP with clinician judgment 94% sensitive 70% specific (compared to 49% sn and 96% spec clinical judgement alone) <ref> McCullough et al. B-Type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from breathing not properly (BNP) multinational study. Circulation. 2002:DOI: 10.1161/01.CIR.0000025242.79963.4</ref>

	===[[NT-proBNP]]<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>===
	*<300 pg/mL → [[CHF]] unlikely		===[[Special:MyLanguage/NT-proBNP\|NT-proBNP]]<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>===
	*[[CHF]] likely in:
			*<300 pg/mL → [[Special:MyLanguage/CHF\|CHF]] unlikely
			*[[Special:MyLanguage/CHF\|CHF]] likely in:
	**'''>450 pg/mL''' in age < 50 years old		**'''>450 pg/mL''' in age < 50 years old
	**'''>900 pg/mL''' in 50-75 years old		**'''>900 pg/mL''' in 50-75 years old
	**'''>1800 pg/mL''' in > 75 years old		**'''>1800 pg/mL''' in > 75 years old
			</translate>

Shihabali: /* Brain natriuretic peptide (BNP)Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347(3):161-167. doi:10.1056/NEJMoa020233. */

2019-11-24T21:51:19Z

Brain natriuretic peptide (BNP)Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347(3):161-167. doi:10.1056/NEJMoa020233.

← Older revision		Revision as of 21:51, 24 November 2019
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	**'''100-500 pg/mL''': Indeterminate (Consider differential diagnosis and pre-test probability)		**'''100-500 pg/mL''': Indeterminate (Consider differential diagnosis and pre-test probability)
	**'''>500 pg/mL''': Positive for acute CHF (Sp 87%, PPV 90%)		**'''>500 pg/mL''': Positive for acute CHF (Sp 87%, PPV 90%)
			**Combination of BNP with clinician judgment 94% sensitive 70% specific (compared to 49% sn and 96% spec clinical judgement alone) <ref> McCullough et al. B-Type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from breathing not properly (BNP) multinational study. Circulation. 2002:DOI: 10.1161/01.CIR.0000025242.79963.4</ref>

	===[[NT-proBNP]]<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>===		===[[NT-proBNP]]<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>===

Rossdonaldson1: /* NT-proBNPJanuzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP...

2019-07-20T12:12:00Z

/* NT-proBNPJanuzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP...

← Older revision		Revision as of 12:12, 20 July 2019
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	**'''>500 pg/mL''': Positive for acute CHF (Sp 87%, PPV 90%)		**'''>500 pg/mL''': Positive for acute CHF (Sp 87%, PPV 90%)

	===NT-proBNP<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>===		===[[NT-proBNP]]<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>===
	*<300 pg/mL → [[CHF]] unlikely		*<300 pg/mL → [[CHF]] unlikely
	*[[CHF]] likely in:		*[[CHF]] likely in:

Rossdonaldson1: /* NT-proBNPJanuzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP...

2019-07-20T12:09:53Z

← Older revision		Revision as of 12:09, 20 July 2019
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	===NT-proBNP<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>===		===NT-proBNP<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>===
	*N-terminal proBNP (biologically inert metabolite of proBNP)
	*<300 pg/mL → [[CHF]] unlikely		*<300 pg/mL → [[CHF]] unlikely
	*[[CHF]] likely in:		*[[CHF]] likely in:

Rossdonaldson1 at 12:08, 20 July 2019

2019-07-20T12:08:45Z

← Older revision		Revision as of 12:08, 20 July 2019
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	**'''>900 pg/mL''' in 50-75 years old		**'''>900 pg/mL''' in 50-75 years old
	**'''>1800 pg/mL''' in > 75 years old		**'''>1800 pg/mL''' in > 75 years old

	~~===BNP In Obese Patients===~~
	*Visceral fat expansion leads to increased clearance of active natriuretic peptides<ref>Clerico A, Giannoni A, Vittorini S, Emdin M. The paradox of low BNP levels in obesity. Heart Fail Rev. 2011;17(1):81-96. doi:10.1007/s10741-011-9249-z.</ref>
	*Obese patients also frequently treated for hypertension or coronary artery disease which may also contribute to lower BNP levels

	~~====Interpretation====~~
	*In one study of 204 patients with acute CHF, an inverse relationship between BMI and BNP was noted. The standard cutoff of 100pg/mL resulted in a 20% false-negative rate<ref>Krauser DG, Lloyd-Jones DM, Chae CU, et al. Effect of body mass index on natriuretic peptide levels in patients with acute congestive heart failure: A ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) substudy. Am Heart J. 2005;149(4):744-750. doi:10.1016/j.ahj.2004.07.010.</ref>
	*Analysis of a subgroup of patients with documented BMI from the Breathing Not Properly study showed that a lower cutoff was more appropriate to maintain 90% sensitivity in obese and morbidly obese patients (54pg/mL)<ref>Daniels LB, Clopton P, Bhalla V, et al. How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure. Results from the Breathing Not Properly Multinational Study. Am Heart J. 2006;151(5):999-1005. doi:10.1016/j.ahj.2005.10.011.</ref>

Rossdonaldson1 at 12:07, 20 July 2019

2019-07-20T12:07:57Z

← Older revision		Revision as of 12:07, 20 July 2019
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	**'''100-500 pg/mL''': Indeterminate (Consider differential diagnosis and pre-test probability)		**'''100-500 pg/mL''': Indeterminate (Consider differential diagnosis and pre-test probability)
	**'''>500 pg/mL''': Positive for acute CHF (Sp 87%, PPV 90%)		**'''>500 pg/mL''': Positive for acute CHF (Sp 87%, PPV 90%)
	*American College of Cardiology, American Heart Association, Heart Failure Society of America guidelines as of May 2017<ref>Yancy CW et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure.</ref>
	**BNP should be measured in patients presenting with dyspnea to help diagnose or exclude heart failure
	**BNP or nt-pro-BNP should be measured to determine prognosis or disease severity in chronic heart failure
	**Baseline BNP, cardiac troponin, or both should be measured upon hospital admission to determine prognosis in patients with acutely decompensated heart failure

	===NT-proBNP<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>===		===NT-proBNP<ref>Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006 Feb. 27(3):330-7.</ref><ref>Kragelund C, Gronning B, Kober L, Hildebrandt P, Steffensen R. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease. N Engl J Med. 2005 Feb 17. 352(7):666-75.</ref><ref>Moe GW, Howlett J, Januzzi JL, Zowall H,. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation. 2007 Jun 19. 115(24):3103-10.</ref>===

Rossdonaldson1 at 12:07, 20 July 2019

2019-07-20T12:07:13Z

← Older revision		Revision as of 12:07, 20 July 2019
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	===[[Brain natriuretic peptide (BNP)]]<ref>Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347(3):161-167. doi:10.1056/NEJMoa020233.</ref>===		===[[Brain natriuretic peptide (BNP)]]<ref>Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347(3):161-167. doi:10.1056/NEJMoa020233.</ref>===
	*Biologically active metabolite of proBNP (released from ventricles in response to increased volume/pressure)
	*Utility is controversial and may not affect patient centered outcomes<ref>Carpenter CR et al. BRAIN NATRIURETIC PEPTIDE IN THE EVALUATION OF EMERGENCY DEPARTMENT DYSPNEA: IS THERE A ROLE? J Emerg Med. 2012 Feb; 42(2): 197–205.</ref>
	*May be trended to gauge treatment response in acute decompensated CHF
	*May have false negative with isolated diastolic dysfunction
	*Measurement		*Measurement
	**'''<100 pg/mL''': Negative for acute CHF (Sn 90%, NPV 89%)		**'''<100 pg/mL''': Negative for acute CHF (Sn 90%, NPV 89%)

Rossdonaldson1 at 12:04, 20 July 2019

2019-07-20T12:04:23Z

← Older revision		Revision as of 12:04, 20 July 2019
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	**'''>900 pg/mL''' in 50-75 years old		**'''>900 pg/mL''' in 50-75 years old
	**'''>1800 pg/mL''' in > 75 years old		**'''>1800 pg/mL''' in > 75 years old

	~~====Differential Diagnosis (Elevated BNP)====~~
	*[[CHF]]/[[ACS]]/[[Cardiogenic shock]]
	*[[PE]]
	*[[Pulmonary Hypertension]]
	*[[Renal Failure]]
	*[[LVH]]
	*[[Subarachnoid hemorrhage]]

	===BNP In Obese Patients===		===BNP In Obese Patients===
	*Visceral fat expansion leads to increased clearance of active natriuretic peptides<ref>Clerico A, Giannoni A, Vittorini S, Emdin M. The paradox of low BNP levels in obesity. Heart Fail Rev. 2011;17(1):81-96. doi:10.1007/s10741-011-9249-z.</ref>		*Visceral fat expansion leads to increased clearance of active natriuretic peptides<ref>Clerico A, Giannoni A, Vittorini S, Emdin M. The paradox of low BNP levels in obesity. Heart Fail Rev. 2011;17(1):81-96. doi:10.1007/s10741-011-9249-z.</ref>
	*Obese patients also frequently treated for hypertension or coronary artery disease which may also contribute to lower BNP levels		*Obese patients also frequently treated for hypertension or coronary artery disease which may also contribute to lower BNP levels

	====Interpretation====		====Interpretation====
	*In one study of 204 patients with acute CHF, an inverse relationship between BMI and BNP was noted. The standard cutoff of 100pg/mL resulted in a 20% false-negative rate<ref>Krauser DG, Lloyd-Jones DM, Chae CU, et al. Effect of body mass index on natriuretic peptide levels in patients with acute congestive heart failure: A ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) substudy. Am Heart J. 2005;149(4):744-750. doi:10.1016/j.ahj.2004.07.010.</ref>		*In one study of 204 patients with acute CHF, an inverse relationship between BMI and BNP was noted. The standard cutoff of 100pg/mL resulted in a 20% false-negative rate<ref>Krauser DG, Lloyd-Jones DM, Chae CU, et al. Effect of body mass index on natriuretic peptide levels in patients with acute congestive heart failure: A ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) substudy. Am Heart J. 2005;149(4):744-750. doi:10.1016/j.ahj.2004.07.010.</ref>
	*Analysis of a subgroup of patients with documented BMI from the Breathing Not Properly study showed that a lower cutoff was more appropriate to maintain 90% sensitivity in obese and morbidly obese patients (54pg/mL)<ref>Daniels LB, Clopton P, Bhalla V, et al. How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure. Results from the Breathing Not Properly Multinational Study. Am Heart J. 2006;151(5):999-1005. doi:10.1016/j.ahj.2005.10.011.</ref>		*Analysis of a subgroup of patients with documented BMI from the Breathing Not Properly study showed that a lower cutoff was more appropriate to maintain 90% sensitivity in obese and morbidly obese patients (54pg/mL)<ref>Daniels LB, Clopton P, Bhalla V, et al. How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure. Results from the Breathing Not Properly Multinational Study. Am Heart J. 2006;151(5):999-1005. doi:10.1016/j.ahj.2005.10.011.</ref>