NPPB and ischemia: Increased plasma concentrations of NT-pro-BNP or troponin T (assays commonly available in routine clinical laboratories) provide quantitative estimates of the severity of cardiovascular disease in an individual: NT-pro-BNP level may be associated with left ventricular hypertrophy and dysfunction, fluid overload, and ischemia, although it also may indicate more severe decreases in GFR,31 and troponin T most likely reflects a combination of myocardial necrosis, hypertrophy, and dysfunction.32