A. Clerico et al., Immunoassay methods for the measurement of natriuretic cardiac Hormones - ANP, BNP, and related peptides - in humans, J CLIN LIG, 22(2), 1999, pp. 194-204
Cardiac natriuretic peptides (ANP, BNP, and related peptides) have differen
t patterns of production, secretion, and clearance rates. Consequently, the
assays for these peptides may or may not provide complementary clinical in
formation. Assays for cardiac natriuretic peptides have been utilized in cl
inical conditions associated with expanded fluid volume. In particular, the
se tests can be useful in discriminating between normal subjects and patien
ts with heart failure, and can also be considered a prognostic indicator of
long-term survival in patients with heart failure or after acute myocardia
l infarction. Non-competitive immunometric assays (such as two-site immunor
adiometric assays [IRMA]), though more expensive, are preferable to radioim
munoassays (RIA) for routine assay of cardiac peptide hormones because they
generally are more sensitive, accurate, and precise. However, there is no
consensus on the best assay procedures for cardiac natriuretic peptides; to
allow more routine use of tests for these hormones in all clinical laborat
ories it is necessary to develop a new generation of non-competitive immuno
metric methods which do not require radioactive labels and can be directly
used in fully automated analytical systems.