B-Type Natriuretic Peptide Predicts Clinical Presentations and Ventricular Overloading in Patients with Heart Failure.
10.3349/ymj.2003.44.4.623
- Author:
Bo Young JOUNG
1
;
Byung Eun PARK
;
Dong Soo KIM
;
Bum Kee HONG
;
Dong Yeon KIM
;
Yun Hyeong CHO
;
Sang Hak LEE
;
Young Won YOON
;
Hyun Seung KIM
;
Jeong Ho KIM
;
Hyuck Moon KWON
Author Information
1. Cardiology Division, Department of Internal Medicine, Yongdong Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-dong, Kangnam-gu, Seoul, Korea. hmkwon@yumc.yonsei.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
B-type natriuretic peptide;
congestive heart failure;
myocardial wall stress
- MeSH:
Adult;
Aged;
Atrial Natriuretic Factor/*blood;
Echocardiography;
Female;
Heart Failure, Congestive/*blood/*complications/ultrasonography;
Human;
Male;
Middle Aged;
Natriuretic Peptide, Brain;
Prognosis;
Support, Non-U.S. Gov't;
Ventricular Dysfunction/*etiology
- From:Yonsei Medical Journal
2003;44(4):623-634
- CountryRepublic of Korea
- Language:English
-
Abstract:
Brain natriuretic peptide (BNP), a neurohormone secreted from the ventricular myocardium in response to hemodynamic load/wall stress, in congestive heart failure (CHF). This study was performed to evaluate the correlation between BNP level and clinical presentations and hemodynamic parameters obtained by echo-Doppler (echo-Doppler) analysis, and its relation with disease severity and ventricular load/wall stress. CHF patients (n=246) were subgrouped by clinical presentations and echo-Doppler findings into 4 groups: diastolic HF only, chronic HF, acute HF, and chronic HF with acute exacerbation. A BNP level of 81.2 pg/ml showed a sensitivity/ specificity of 53.3%/98.4% for detecting CHF (AUC, 0.882; p< 0.0001), and was found to be closely related with the NYHA classification (p< 0.0001). Log BNP was related with LVEF (r2=0.3015, p< 0.0001) and the Meridional wall stress index (r2=0.4052, p< 0.0001). The difference between the BNP levels of the subgroups and BNP control was significant (p< 0.0001), exept between the HF group and the controls; control (n=114, 20.9 +/- 31.4pg/ml), only diastolic HF (n=84, 89.8 +/- 117.6pg/ml), chronic HF (n=60, 208.2 +/- 210.2pg/ml), acute HF (n=28, 477.9 +/- 498.4 pg/ml), chronic HF with acute exacerbation (n= 74, 754.1 +/- 419.2pg/ml). The BNP level was significantly higher in the only diastolic HF group than in the asymptomatic control group with diastolic dysfunction (89.8 +/- 12.8 vs. 22.8 +/- 5.1pg/ml, p< 0.0001). BNP may be a good indicator for the differential diagnosis of a broad spectrum of heart failures. And, elevated BNP might help to diagnose diastolic HF in patients with diastolic dysfunction.
