1. Date of download: 6/25/2016 Copyright © The American College of Cardiology. All rights reserved. From: Discriminating Between Cardiac and Pulmonary Dysfunction in the General Population With Dyspnea by Plasma Pro-B-Type Natriuretic Peptide J Am Coll Cardiol. 2007;50(17):1694-1701. doi:10.1016/j.jacc.2007.07.073 Differences in Measurement of proBNP Between the Processing-Independent Assay and the Roche Assay (A) Summary of the processing-independent assay (PIA) for measurement of pro-B-type natriuretic peptide (proBNP) 1-108 and 1-76. During analysis, both peptides are cleaved with an endoprotease (trypsin) releasing an N-terminal fragment (proBNP 1-21, red boxes). The larger, blue boxes represent the glycosylated midregion in proBNP. Note that both proBNP 1-108 and 1-76 will be quantified with equal affinity and irrespective of the glycosylation degree. (B) The N-terminal (NT)-proBNP assay by Roche (Karlsruhe, Germany). Two antibodies raised against distinct regions in proBNP 1-76 are used in a sandwich assay. One antibody is raised against the glycosylated region in endogenous proBNP. The assay is calibrated with synthetic, nonglycosylated proBNP 1- 76, and the assay affinity to proBNP 1-108 is unknown. Figure Legend:

2. Date of download: 6/25/2016 Copyright © The American College of Cardiology. All rights reserved. From: Discriminating Between Cardiac and Pulmonary Dysfunction in the General Population With Dyspnea by Plasma Pro-B-Type Natriuretic Peptide J Am Coll Cardiol. 2007;50(17):1694-1701. doi:10.1016/j.jacc.2007.07.073 Flow Diagram of the Study Population Figure Legend:

3. Date of download: 6/25/2016 Copyright © The American College of Cardiology. All rights reserved. From: Discriminating Between Cardiac and Pulmonary Dysfunction in the General Population With Dyspnea by Plasma Pro-B-Type Natriuretic Peptide J Am Coll Cardiol. 2007;50(17):1694-1701. doi:10.1016/j.jacc.2007.07.073 Mean Plasma proBNP Concentrations According to Severity of Dyspnea Dyspnea was classified according to a slightly modified Medical Research Council (MRC) dyspnea scale. No dyspnea refers to MRC category 0, mild dyspnea to MRC category 1 to 2, and severe dyspnea to MRC category 3 to 5. proBNP = pro-B-type natriuretic peptide. Figure Legend:

4. Date of download: 6/25/2016 Copyright © The American College of Cardiology. All rights reserved. From: Discriminating Between Cardiac and Pulmonary Dysfunction in the General Population With Dyspnea by Plasma Pro-B-Type Natriuretic Peptide J Am Coll Cardiol. 2007;50(17):1694-1701. doi:10.1016/j.jacc.2007.07.073 Mean Plasma proBNP According to Pulmonary and Cardiac Dysfunction in Dyspneic Subjects (n = 959) Bars indicate standard errors. proBNP = pro-B-type natriuretic peptide. Figure Legend:

5. Date of download: 6/25/2016 Copyright © The American College of Cardiology. All rights reserved. From: Discriminating Between Cardiac and Pulmonary Dysfunction in the General Population With Dyspnea by Plasma Pro-B-Type Natriuretic Peptide J Am Coll Cardiol. 2007;50(17):1694-1701. doi:10.1016/j.jacc.2007.07.073 Curves for Expected Level of Plasma proBNP According to Gender and Age for Dyspneic Subjects A measured pro-B-type natriuretic peptide (proBNP) above the blue area indicates a value >2.5 times the expected level and thus a high risk of left ventricular systolic and/or diastolic dysfunction. A measured proBNP below the blue area indicates a value less than one-half of the expected level and thus left ventricular systolic and diastolic dysfunction can be ruled out. A measured proBNP in the blue area indicates that the risk of left ventricular systolic and/or diastolic dysfunction is small and further diagnostic evaluation is required. Figure Legend: