Paul M. McKie, BS, John C. Burnett, MD Mayo Clinic Proceedings

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B-Type Natriuretic Peptide as a Biomarker Beyond Heart Failure: Speculations and Opportunities Paul M. McKie, BS, John C. Burnett, MD Mayo Clinic Proceedings Volume 80, Issue 8, Pages 1029-1036 (August 2005) DOI: 10.4065/80.8.1029 Copyright © 2005 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 1 Circulating plasma B-type natriuretic peptide (BNP) (left) and BNP messenger RNA (mRNA) in left atrial (middle) and left ventricular (right) cardiac tissue from control (Crtl) dogs and from dogs with early left ventricular dysfunction (ELVD) and overt congestive heart failure (CHF). Middle and right, The amount of BNP mRNA is expressed in arbitrary units as a ratio of autoradiographic densities (BNP mRNA/glyseraldehyde-3-phosphate dehydrogenase [GAPDH] mRNA); n=5 dogs/group. *P<.01 vs control. †P<.02 vs ELVD. ‡P=.05 vs control. Mayo Clinic Proceedings 2005 80, 1029-1036DOI: (10.4065/80.8.1029) Copyright © 2005 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 2 B-type natriuretic peptide (BNP) is produced as pre–prohormone BNP (proBNP), processed to proBNP, and then cleaved by corin to mature, biologically active 32–amino acid (aa) BNP and non–biologically active N-terminal (NT)-proBNP. Mayo Clinic Proceedings 2005 80, 1029-1036DOI: (10.4065/80.8.1029) Copyright © 2005 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 3 Kaplan-Meier curves show the cumulative incidence of death at 10 months, according to the quartile of B-type natriuretic peptide level at enrollment. The range of B-type natriuretic peptide levels was as follows: 5.0 to 43.6 pg/mL (quartile 1), 43.7 to 81.2 pg/mL (quartile 2), 81.3 to 137.8 pg/mL (quartile 3), and 137.9 to 1456.6 pg/mL (quartile 4). P<.001 for the trend among quartiles. From de Lemos et al,32 with permission. Copyright ©2001 Massachusetts Medical Society. All rights reserved. Mayo Clinic Proceedings 2005 80, 1029-1036DOI: (10.4065/80.8.1029) Copyright © 2005 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 4 Plasma B-type natriuretic peptide (BNP) concentration as a function of age for each sex and assay system. The 5th, 25th, 50th, 75th, and 95th percentiles for BNP are shown, respectively, bottom to top in each nomogram according to age. From Redfield et al,33 with permission from the American College of Cardiology Foundation. Mayo Clinic Proceedings 2005 80, 1029-1036DOI: (10.4065/80.8.1029) Copyright © 2005 Mayo Foundation for Medical Education and Research Terms and Conditions