Unexplained week-to-week variation in BNP and NT-proBNP is low in chronic heart failure patients during steady state

Eur J Heart Fail. 2007 Jan;9(1):68-74. doi: 10.1016/j.ejheart.2006.05.001. Epub 2006 Jul 7.


Background: The usefulness of brain-natriuretic-peptide (BNP) and N-terminal-pro-brain-natriuretic-peptide (NT-proBNP) for monitoring of chronic heart failure (CHF) patients has been questioned because of high levels of unexplained variation.

Aims: Week-to-week total variance (CV(T)), unexplained variation (CV(I)), reference change values (RCV), index of individualities (IOI) and number of samples (N) with week-to-week intervals needed to estimate the underlying homeostatic set point (+/-15%) for BNP and NT-proBNP were calculated in pre-specified stable CHF patients.

Methods and results: We measured plasma concentrations of BNP and NT-proBNP, clinical and laboratory variables in 20 CHF patients with a 7-days interval. Only patients considered to be in steady state were included. The CV(I) was 15% (BNP) and 8% (NT-proBNP). CV(T) was 16% (BNP) and 8% (NT-proBNP) and RCV was 43% (BNP) and 23% (NT-proBNP). IOI was 0.14 for BNP and 0.03 for NT-proBNP and N was 1 for BNP and 1 for NT-proBNP.

Conclusions: Our data demonstrate that unexplained variation of BNP and NT-proBNP is low in CHF patients during steady state, which is a prerequisite for the use of these peptides for monitoring of the disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms
  • Biomarkers / blood
  • Female
  • Heart Failure / blood*
  • Heart Failure / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods
  • Natriuretic Peptide, Brain / blood*
  • Patient Selection
  • Peptide Fragments / blood*
  • Reference Values
  • Reproducibility of Results
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Function, Left / physiology


  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain