Cardiac natriuretic hormones: methodological aspects

It is known the important role of cardiac natriuretic hormones (CNH) assay (especially BNP) in screening for heart disease, detection of left ventricular dysfunction, differential diagnosis of dyspnea and prognostic stratification of patients with congestive heart failure. CNH can be measured with c...

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Published inImmuno-analyse & biologie spécialisée Vol. 22; no. 4; pp. 236 - 246
Main Authors Vittorini, S., Prontera, C., Zucchelli, G.C., Clerico, A.
Format Journal Article
LanguageEnglish
Published Elsevier SAS 01.08.2007
Subjects
Cardiovascular disease
Heart failure
Immuno-analyse
Immunoassay
Insuffisance cardiaque
Maladies cardiovasculaires
Heart failure
Immunoassay
Cardiovascular disease
Maladies cardiovasculaires
Insuffisance cardiaque
Immuno-analyse
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Abstract It is known the important role of cardiac natriuretic hormones (CNH) assay (especially BNP) in screening for heart disease, detection of left ventricular dysfunction, differential diagnosis of dyspnea and prognostic stratification of patients with congestive heart failure. CNH can be measured with competitive or non-competitive immunoassays. Non-competitive immunoassays share better degree of sensitivity, precision and specificity than the respective competitive immunoassays. Recently, a new generation of fully automated immunoassays, for BNP and NT-proBNP, became commercially available. They are non-competitive sandwich-type immunoassays which uses non-radioactive materials as labels for antigen/antibody reaction and two monoclonal antibodies (or a combination of monoclonal and polyclonal) for peptide binding. Although these assays produce results in a short time and with excellent analytical imprecision, the BNP/NT-proBNP values continue to significantly depend on the type of assay used, as a result of the specificity of the employed antibodies and of different analytical standardization deriving from the different calibration materials. L'importance des dosages des hormones natriurétiques cardiaques (CHN), en particulier BNP, est bien connue pour le screening des maladies cardiaques, détection du disfonctionnement ventriculaire gauche, diagnostic différentiel de la dyspnée et stratification pronostique des patients atteints d'insuffisance cardiaque congestive. On peut mesurer CNH avec des dosages immunologiques de type compétitifs ou non compétitifs. Les dosages immunologiques non compétitifs sont plus sensibles, précis et spécifiques que les dosages compétitifs correspondants. Récemment, une nouvelle génération d'immunoanalyses complètement automatisée, de BNP et NT-proBNP, est devenue commercialement disponible. Ce sont des immunoanalyses type sandwich non compétitifs qui utilisent matériel non radioactive, en tant que marqueurs de la réaction antigène/anticorps, ainsi que deux anticorps monoclonaux (ou bien la combinaison d'un monoclonal et d'un polyclonal) pour la liaison peptidique. Bien que ces dosages donnent des résultats dans un bref délai et avec une imprécision analytique excellente, on constate que les valeurs BNP/NT-proBNP sont toujours dépendantes du type de dosage utilisé, selon la spécificité des anticorps utilisés et la différente standardisation analytique due aux différents matériels de calibrage.
AbstractList It is known the important role of cardiac natriuretic hormones (CNH) assay (especially BNP) in screening for heart disease, detection of left ventricular dysfunction, differential diagnosis of dyspnea and prognostic stratification of patients with congestive heart failure. CNH can be measured with competitive or non-competitive immunoassays. Non-competitive immunoassays share better degree of sensitivity, precision and specificity than the respective competitive immunoassays. Recently, a new generation of fully automated immunoassays, for BNP and NT-proBNP, became commercially available. They are non-competitive sandwich-type immunoassays which uses non-radioactive materials as labels for antigen/antibody reaction and two monoclonal antibodies (or a combination of monoclonal and polyclonal) for peptide binding. Although these assays produce results in a short time and with excellent analytical imprecision, the BNP/NT-proBNP values continue to significantly depend on the type of assay used, as a result of the specificity of the employed antibodies and of different analytical standardization deriving from the different calibration materials. L'importance des dosages des hormones natriurétiques cardiaques (CHN), en particulier BNP, est bien connue pour le screening des maladies cardiaques, détection du disfonctionnement ventriculaire gauche, diagnostic différentiel de la dyspnée et stratification pronostique des patients atteints d'insuffisance cardiaque congestive. On peut mesurer CNH avec des dosages immunologiques de type compétitifs ou non compétitifs. Les dosages immunologiques non compétitifs sont plus sensibles, précis et spécifiques que les dosages compétitifs correspondants. Récemment, une nouvelle génération d'immunoanalyses complètement automatisée, de BNP et NT-proBNP, est devenue commercialement disponible. Ce sont des immunoanalyses type sandwich non compétitifs qui utilisent matériel non radioactive, en tant que marqueurs de la réaction antigène/anticorps, ainsi que deux anticorps monoclonaux (ou bien la combinaison d'un monoclonal et d'un polyclonal) pour la liaison peptidique. Bien que ces dosages donnent des résultats dans un bref délai et avec une imprécision analytique excellente, on constate que les valeurs BNP/NT-proBNP sont toujours dépendantes du type de dosage utilisé, selon la spécificité des anticorps utilisés et la différente standardisation analytique due aux différents matériels de calibrage.
Author Zucchelli, G.C.
Clerico, A.
Prontera, C.
Vittorini, S.
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Keywords Heart failure
Immunoassay
Cardiovascular disease
Maladies cardiovasculaires
Insuffisance cardiaque
Immuno-analyse
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Snippet It is known the important role of cardiac natriuretic hormones (CNH) assay (especially BNP) in screening for heart disease, detection of left ventricular...
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elsevier
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Publisher
StartPage 236
SubjectTerms Cardiovascular disease
Heart failure
Immuno-analyse
Immunoassay
Insuffisance cardiaque
Maladies cardiovasculaires
Title Cardiac natriuretic hormones: methodological aspects
URI https://dx.doi.org/10.1016/j.immbio.2007.06.003
Volume 22
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