
This study hypothesized that diurnal variations in NP concentration might affect their diagnostic accuracy for acute heart failure. Among patients adjudicated to have acute heart failure, BNP, NT-proBNP, and MR-proANP concentrations were comparable among daytime versus evening/nighttime presenters. These differences were not observed for MR-proANP. Diurnal variation of BNP and NT-proBNP with lower evening/nighttime concentration was confirmed in 44 stable individuals (P<0.01). BNP and NT-proBNP, but not MR-proANP, exhibit a daily rhythm that results in even higher diagnostic accuracy among evening/nighttime presenters versus daytime presenters.
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