Clinical Lab Handbook

Preferred Container/Tube: Light green-top (lithuim heparin) gel tube

Alternate tube: K2EDTA Plasma

Specimen Volume: 1.5 ml Heparinized plasma

Collection Instructions: Samples should be thoroughly separated from all cellular material. Failure to do so may lead to an erroneous result.

Stability:

The VITROS NT-proBNP II test utilizes a one-step immunometric bridging design. A well is pushed from the pack and patient sample is dispensed into the antibody coated well. The assay reagent and the conjugate reagent are then dispensed into the well with the patient sample. NT-proBNP present in the sample binds with horseradish peroxidase (HRP)-labeled antibody conjugate which is captured by biotinylated anti-NT-proBNP capture antibody which is bound to Streptavidin coated microwells. The well is incubated for 8 minutes, before unbound materials are removed by washing.

The bound HRP conjugate is measured by a luminescent reaction. A reagent containing luminogenic substrate (a luminol derivative and a peracid salt) and an electron transfer agent, is added to the wells. The HRP in the bound conjugate catalyzes the oxidation of the luminol derivative, producing light. The electron transfer agent (a substituted acetanilide) increases the level of light produced and prolongs its emission. The light signals are read by the System. The amount of HRP conjugate bound is directly proportional to the concentration of NT-proBNP present.

Purpose: For the quantitative measurement of N-terminal pro Brain Natriuretic Peptide (NT-proBNP) in human serum and plasma (K2 EDTA or Lithium Heparin) using the VITROS ECi/ECiQ Immunodiagnostic Systems and the VITROS 5600/XT 7600 Integrated Systems to aid in the diagnosis of heart failure. The test can also be used in the assessment of heart failure severity in patients diagnosed with heart failure.

Non-heart failure clinical conditions which could modify NP levels: Although LV dysfunction wall stress is a prime factor responsible for the release of natriuretic peptides, several other conditions may trigger elevation in BNP or NT-proBNP such as valvular abnormalities, arrythmias, pericardial diseases, acute coronary syndrome, heart muscle disease, pulmonary embolism, pulmonary hypertension, sepsis, stroke, cardiotoxic drugs, and renal dysfunction. Obesity, flash pulmonary edema, cardiac tamponade, and pericardial constriction are conditions associated with reduced NP. Therefore, the NT-proBNP (and BNP) values have to be interpreted in the clinical context.

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