BNP is released by cardiac myocytes of the ventricles in response to myocardial wall stress. This is brought on by increased transmural wall tension and elevations of end diastolic pressure, ventricular volume expansion and pressure overload. The secretion of this important peptide serves to regulate sodium and water balance by the kidneys and causes vasodilatation of arteries, which benefits the failing heart.
Elevated BNP levels are detected in the blood of patients with heart failure but levels are normal in patients with shortness of breath caused by pulmonary disease. The rapid measurement of levels of BNP in the blood has proved useful in the diagnosis of heart failure. More important, in emergency rooms the BNP test rapidly clarifies whether severe shortness of breath is caused by heart failure or by pulmonary disease. Heart

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• I. CLINICAL STUDIES A. Maisel et al.
  Methods: A study was done of 1586 patients who visited the emergency with acute shortness of breath, dyspnea, and whose BNP level was measured with a bedside assay. The diagnosis of heart failure was confirmed by two indepen¬dent cardiologists.
• II. PERSPECTIVE
  Rapid measurement of BNP is useful in establishing or excluding the diagnosis of heart failure in patients with acute severe shortness of breath. BNP levels can confirm the diagnosis of heart failure when the cause of acute severe shortness of breath remains uncertain after assessment of the history, physical findings, and chest x-ray. The severity of heart failure appears to be reflected by the height of BNP levels. The discovery that A-type (atrial), natriuretic peptide is secreted by the atrium (atrial natriuretic factor), was a major breakthrough that paved the way for the revelation of BNPs.
• BIBLIOGRAPHY
  Adams, J., Apple, F. et al. New blood tests for detecting heart disease.