Atrial natriuretic peptide, B-type natriuretic peptide, and serum collagen markers after acute myocardial infarction

Abstract

Experimental data suggest that atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) act locally as antifibrotic factors in heart. We investigated the interrelationships of natriuretic peptides and collagen markers in 93 patients receiving thrombolytic treatment for their first acute myocardial infarction (AMI). Collagen formation following AMI, evaluated as serum levels of amino terminal propeptide of type III procollagen, correlated with NH(2)-terminal proANP (r = 0.45, P < 0.001), BNP (r = 0.55, P < 0.001) and NH(2)-terminal proBNP (r = 0.50, P < 0.01) on day 4 after thrombolysis. Levels of intact amino terminal propeptide of type I procollagen decreased by 34% (P < 0.001), and levels of carboxy terminal cross-linked telopeptide of type I collagen (ICTP) increased by 65% (P < 0.001). ICTP levels correlated with NH(2)-terminal proBNP (r = 0.25, P < 0.05) and BNP (r = 0.28, P < 0.05) on day 4. Our results suggest that ANP and BNP may act as regulators of collagen scar formation and left ventricular remodeling after AMI in humans. Furthermore, degradation of type I collagen is increased after AMI and may be regulated by BNP.

Thirty years of the heart as an endocrine organ: physiological role and clinical utility of cardiac natriuretic hormones

“…All natriuretic peptides share a direct diuretic, natriuretic, and vasodilator effect as well as an inhibitory action on the inflammatory processes of both myocardium and smooth muscle cells (19,40,62), thus exerting a protective effect on endothelial dysfunction and vascular remodeling (71,79,98). These effects are mediated by two different guanylate cyclasecoupled receptors, NPR-A (more specific for ANP and BNP) and NPR-B (more specific for CNP), whereas a third specific receptor NPR-C, not coupled to a guanylate cyclase, has essentially a clearance function for all natriuretic peptides (16).…”

Clinical and echocardiographic correlates of plasma procollagen type III amino-terminal peptide levels in the community

“…A significant relation between plasma PIIINP and BNP has been previously described in patients following acute myocardial infarction. 42 …”

Relationship of sustained brain natriuretic peptide release after reperfused acute myocardial infarction with gated SPECT infarct measurements and its connection with collagen turnover and left ventricular remodeling

“…Squire et al 9 reported a correlation between MMP-9 levels and N-terminal pro-B-type natriuretic peptide and between MMP-9 levels and echocardiographic LV dilation in patients soon after AMI. Magga et al 10 showed a significant relationship between BNP and serum products of type I collagen after AMI, and they suggest a possible regulatory role of BNP on ECM degradation. In patients with LV remodeling, we observed an increase in BNP and type I collagen turnover, which was apparently not influenced by enzymatic and echocardiographic estimates of infarct extent.…”

“…Studies in patients with postinfarction LV remodeling suggest a relationship between BNP and serum surrogate markers for ECM remodeling. [8][9][10] So far, this relationship has been interpreted as a consequence of their common association with infarct size. Recently, we reported that patients in whom LV remodeling developed after AMI had significantly higher levels of BNP and carboxy-terminal telopeptide of type I procollagen (ICTP), an ECM degradation product, than patients without remodeling, and that this correlation was independent of enzymatic and echocardiographic estimates of infarct extent.…”