NT-proBNP Level query

[gentryman]

Trying to line up a few questions for a Cardio call in December and cannot seem to find this bit out.

My last Se N-term pro BNP conc result was 444 ng/L, is this the same as pg/mL?

It came back as abnormal with normal given as 0-400, I`m 66, so could I have Heart failure as no one has said I have.

I have Afib and my last call with the Cardio he asked did I want another Cardioversion ( which worked for a few weeks or so), I said I don`t think I do to which he wrote to my Doctor saying he would discharge me back to my Doctor depending on our next call.

Just wondering what to ask on the call I suppose ( much easier face to face, but that is not going to happen).

I know with me saying I don`t want another Cardioversion it ends it really, but could I request other/ repeat tests?.

[CDreamer]

Hi - I’m no scientist but believe n=nano and p=pico but both are measurements per litre and more or less equate 1:1. I can’t see the point of asking for another blood test so soon but your might ask the cardiologist what he makes of it?

Doesn’t really matter how many times you repeat the tests if you don’t accept further treatment, nothing much is going to change - which is why specialists refer back to GP care. Personally I would ask for a face to face with GP and hope they know something about AF so they can signpost and refer on, before your call with the cardiologist.

Heart failure is such a misleading term, it means that simply that your heart is not pumping as efficiently as it should and if that’s due solely to the AF, it’s not going to improve any time soon without treatment of some sort.

To get a more complete picture most people would have an echocardiogram and although this can be a subjective (interpretation by operator can result in a subjective rather than completely objective opinion) the combined results would give your cardiologist a more information to suggest treatments or ask for more detailed tests such as scans, stress tests etc.

Apart from CV, you don’t mention any other treatments? Have none been suggested? Is your cardiologist an arrythmia specialist ie: Electrophysiologist? If not you might ask to be referred to one for specialist opinion.

If I were you I would be looking for some treatment plan if I were heading toward Heart Failure and not accept that CV is the one and only treatment available.

Hope some of that helps.

[gentryman in reply to CDreamer]

Thanks for the information and thoughts in your post, really helpful.

I’ve had 2 calls with the Cardiologist, first was after my referral and he suggested CV which worked for a short while, the Second was a follow up 6 months later to see how the CV was going.

At the moment our Surgery is not doing face to face appointments unless it’s something they have to see it seems. I see Nurses face to face though!

When I have asked the Doctors on a call about my tablets they are waiting or leaving it to see what the Cardiologist says.

Nothing shows my cardiologist is an arrythmia specialist, but I am just going off searches on his name at the Hospital really.

I had an echocardiogram leading up to the CV but apart from offering another CV and put on Zemtard to control my rate that’s it.

I can see it being a very short call with the Cardiologist 😉, but I think I’ll try the Doctors again and get more input from them on what to do going forward and before my Cardio call.

Again, thanks for your help.

[JOY2THEWORLD49 in reply to gentryman]

Hi again

You should have a 24-hr monitor, ECG and seen by a cardiac specialist. In NZ I had 3 24-moniters due to changing from Metroprolol - to Bisoprolol - uncontrolled still - to CCB Diltiazem am 120mg and 2.5 mg Bisoprolol at night.

Now controlled.

NZ are more interested in rate than rythmn. But both a CCB and BB are controlling my rate and rythmn.

Now day 123/72. 77-88.

Night. 47 (always been)

I was told by the DHB Public National Specialist that NO ABLATION or CARDIOVERSION due to enlarged chamber in heart. And he found a soft systolic Heart Murmur.

Tests like an ECHO of your Heart isalso paramount before Ablation or cardioversion.

Chers JOY. (NZ)

[LondonEngland]

I would look into whether he is an electrophysiologist and at least look into the possibility of an ablation. AF can lead to or exacerbate Heart Failure so finding a way of stopping AFib as permanently as possible could be a good option to assist in reducing the HF or keeping it in check. A cardioversion is usually a first step but I had a few and I know many others who did too and from my personal observation they don’t always seem to last. I had a couple of ablations which did end up fixing my AFib and I don’t seem to have signs of HF anymore. My ProBNP fluctuates a bit depending on how much working out I have done immediately prior to having blood tests but it seems to be usually less than 70 now (although one time it was around 200).

I am not a doctor so I can’t give medical advice but I would very much be trying to get in front of an electrophysiologist just to check whether an ablation might be possible for you. It may or may not be depending on your specific circumstances.

Sending best wishes.

Shawn

[AussieHeart]

I know this is left field but are you in the USA as I don’t think the UK will do it without a referral. If in USA pay to have a Chromogranin A (CgA) blood test and a 5HIAA 24-hour urine test. I’m in Australia but I wish I was given this advice as N-terminal pro–B-type natriuretic peptide (NT-proBNP) is the best biomarker for evidence of carcinoid heart disease acc.org/latest-in-cardiolog... … don’t freak out about what’s said in the link as it’s imminently treatable. Just get checked to rule it out. If you have suffered flushing, especially after alcohol, aged cheese, diahrea, weight loss, for exampleIf your right valves are affected. If you have a murmur or patent foramen ovale (PFO) please ask for these blood and urine tests. Hope I haven’t spooked you

[JOY2THEWORLD49 in reply to AussieHeart]

Hi. over the ditch fellow member..

I was told it gives your heart condition in years.

I was at a rate for a 75-80 year old.

But after Johnson & Johnson ugly mesh and damage removed I dropped down nearer my age.

In NZ it is not a high number like yours.

I thought it is to do with the condition of your heart - stiffness of nuscles etc. Readings come in group ages

cheri Joy. 73. (NZ)

[JOY2THEWORLD49]

Hi

Mine spec cardio wanted to discharge me from outpatients as well this year also.

I hesitant as it is important to be ahead of any negs against the drugs.

For instance there is a Caution again PRADAXA in that it causes 33% risk of heart attack.

PRADAXA is one of the new anti-coagulates.

Still hoping for a return of normal heart rate and rythmn and I would need to come off my CCB Diltiazem 120mg quickly.

I would insist that you see your specialist yearly. I did.

'cheers JOY. 73. (NZ)