Understanding the clinical biochemistry of N-terminal pro-B-type natriuretic peptide: the prerequisite for its optimal clinical use.

With the introduction of the first rapid, fully automated assay for N-terminal pro-B-type natriuretic peptide (Nt-proBNP) determination, clinical laboratories are now able to transfer a number of preliminary information derived from pilot research experiences to the context of clinical cardiology. Some confounding factors may, however, affect the interpretation of the Nt-proBNP test and its clinical value. The objective of this review is to highlight and discuss these potentially confounding variables.