Bnp

[Jall]

How useful is this test for people with hcm? I had a primary care type doctor run the test which came back with a high number (900+) which equates to a NY catagory IV. I am fortuantely nowhere near a catagory IV. I doubt that I will be able to get to up to see my HCM doc anytime in the near future. Has anyone discussed this test with an HCM doc and does it have any usefullness for hcm patients.

Gracias
J Alley

[BlueDevil]

The best answer I can give to this is that the BNP is one indicator of the level of heart failure you're experiencing. I know it was one of the factors by which I was recommended for a transplant, but at the time my level was in the 900 range. Now it is down in the 300 range. I'm guessing that knowing the BNP results might indicate a need to adjust treatment in some way, but perhaps someone else can clarify or expand.

[Pam Alexson]

3 Articles re: BNP

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WHG-4P37HK2-D&_user=10&_origUdi=B6T0X-46X0RBC-1S&_fmt=high&_coverDate=06%2F30%2F2007&_rdoc=1&_orig=article&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=87f20a877f29a84cb4f720c9a7729e2a

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T18-45TSF01-G&_user=10&_origUdi=B6WHG-4P37HK2-D&_fmt=high&_coverDate=05%2F15%2F2002&_rdoc=1&_orig=article&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=7e633893f92e63245b4af9c1dd70dba2

http://circ.ahajournals.org/cgi/content/full/circulationaha;109/8/984

[Cynaburst]

If you search the archives here, you will find that some people, like you and me, have very high BNP #s even though we are not in class 3 or 4 heart failure. And some have low numbers and they are in serious heart failure.

I have asked several specialists this question, and the answer is that they don't really know what BNP means with regard to HCM.

You are not alone though. My BNP has been as high as 1300 and as low as 300, and I have had severe symptoms at 300 and felt pretty good at over 1000.

[EmilysMom]

BNP = Brain natriuretic peptide

for those of us who didn't know....

[Jall]

Great Answers. thx to all responders.

Jall

[nikmcd]

I'm new here and fairly new to the HOCM world. AICD implanted several years ago without many symptoms since. Several weeks ago.at work, I experienced my original symptoms of weakness and feeling faint (near syncope). I do this when I'm near dehydration and under physical stress at work. FYI, I'm a respiratory therapist in a hospital.

They first did the regular things that have always worked... lay down and IV fluids. They also ran bloodwork and the BNP came back at 3000 so treatment came to a crashing halt and they began treating me for CHF. Here is the problem - they totally treated me for the BNP number although I had no symptoms of CHF. They would not listen to me and for 2 days they messed with my medications and fed me lasix. My cardiologist and PCP were out of town and the on calls acted like I was just being an uncooperative patient. which I was.

I finally told them I was leaving, they could release me or I would leave AMA and I would sue for malpractice which earned me a visit from my boss. That night my cardiologist was back and returned everything to order and I went home the next day. It has been 2 weeks and I'm just now feeling back to normal.

Be very careful with the BNP levels. It may be a matter of whether the HCM is obstructive or non obstructive.

Any ideas or suggestions?

Nikki McDowell

[Cynaburst]

Nikki -

Your story exemplifies why it is so impt. to be treated by a doctor with expertise with HCM. As you said, in HCM the BNP # does not necessary correlate with the symptoms that the patient is having. I personally have had very high BNP #s (although I have to admit, yours are much higher) and I have not had symptoms of congestive heart failure along with the high numbers. I have never been treated with a diuretic and do not usually have trouble with fluid retention. In fact, before my myectomy, I had much more significant problems with dehydration. Those issues are much improved after myectomy, but are certainly still impt.


I am not sure that being obstructed or non-obstructed makes the difference with regard to the treatment of BNP levels.

Everytime I have asked my specialist at Mayo Clinic about BNP levels, he has told me that the experts just don't know what BNP really means for HCM. That is totally true and bears out in this string.

Nikki - I am not sure that we have seen you around here before. As far as my advice for you, I would recommend calling the HCMA office and making an appointment to discuss your situation. The HCMA also recommends that HCM patients see an HCM specialist at least once every few years to make sure that you are getting the best treatment for your situation. As you have experienced, HCM is a disease that is very different from all other heart conditions and it is very impt. to make sure that you are getting the best treatment available for yourself.

[nikmcd]

Thanks Cynaburst for your reply. I am new here and will introduce myself under the "Hello" topic. I have just received written info from the assoc. and look forward to learning a whole lot more than I do now.

[Pam Alexson]

http://circ.ahajournals.org/cgi/content/full/circulationaha;109/8/984

This link is to article I posted earlier in this thread, it was one of 3 links...here in the conclusion section of the article.....

Conclusions— Plasma BNP is independently related to the presence and magnitude of heart failure symptoms in patients with HCM. As a clinical marker for heart failure, BNP is limited by considerable overlap in values between categories of heart failure severity as well as confounding variables of left ventricular wall thickness and age.

...written by one our HCM experts B. Maron et al.