NT-proBNP Testing for Heart Failure Diagnosis

NT-proBNP testing helps diagnose heart failure by measuring levels of a peptide that rises with heart stress or damage.

Why NT-proBNP and BNP?

important for diagnosis, as Australia’s population ages, congestive heart failure (CHF) is becoming an increasingly prevalent condition, particularly among elderly patients, with an estimated 1.5-2% of the population affected. The diagnosis of mild or early CHF has traditionally been difficult due to non-specific symptoms that often overlap with other conditions.

NT-proBNP testing offers a more accessible alternative to chest X-rays and echocardiograms.

NT–proBNP and BNP tests are treated as equivalent by Medicare and our laboratories. Testing FrequencyBNP or NT-proBNP will attract a Medicare benefit only once per 12-month period.

How it works

NT-proBNP is released by the heart in response to increased wall stress due to volume overload, a hallmark of heart failure. Very elevated levels of these markers strongly suggest the presence of heart failure, whereas low levels rule outCHF as a cause of the patient’s symptoms.

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Medicare rebate

From 1st Nov 2024, NT-proBNP testing will be Medicare rebatable when ordered byGPs. These biomarkers have been used primarily by cardiologists and emergency clinicians but now GPs can request the test to assess patients for heart failure and the test will attract a Medicare rebate.

When to request NT-proBNP for patients?

Request NT-proBNP when patients are presenting:

  • Dyspnea: acute or chronic shortness of breath, especially where heart failure is suspected but not confirmed.
  • Oedema: peripheral oedema, unexplained fatigue, or elevated JVP.
  • Comorbidity: a history of lung disease where you are assessing for coexisting heart failure.
  • Risk Factors: patients who are at risk of CHF due to age, hypertension, or diabetes but do not yet show clear signs of the condition.

Assess whether a patient presenting with one of the above factors is requiring echocardiography.

Benefits over traditional diagnostic methods

  • Accessible: easier to access compared to echocardiography, especially in non-urban settings.
  • Time-sensitive: faster results compared to waiting for imaging.
  • Specificity: high negative predictive value – a low NT-proBNP level virtually excludes CHF, allowing you to focus on alternative diagnoses.

Likelihood of heart failure

Resources

NT-proBNP testing for heart failure diagnosis
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