Brain natriuretic peptide is a marker associated with thrombus in stroke patients with atrial fibrillation

Okada, Yôko; Shibazaki, Kensaku; Kimura, Kazumi; Matsumoto, Noriko; Iguchi, Yasuyuki; Aoki, Junya; Kobayashi, Kazuto; Sakai, Kennichiro

doi:10.1016/j.jns.2010.10.017

Cited by 38 publications

(24 citation statements)

References 18 publications

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“…In contrast to normally circulating forms of NPs, a mutant form of ANP has been associated with familiar AF [34]. Although the causal relationship between BNP and thrombogenesis remains unknown, studies have reported that high levels of circulating immuno-reactive BNP is associated with increased risk of thromboembolic events [35, 36]. Further studies are needed to investigate whether the observed atrial thrombosis was induced by BNP overexpression or it was primarily related to aging.…”

Section: Discussionmentioning

confidence: 99%

Cardiac BNP gene delivery prolongs survival in aged spontaneously hypertensive rats with overt hypertensive heart disease

Tonne

Holditch

Oehler

et al. 2014

Aging

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BackgroundHypertension is a highly prevalent disease associated with cardiovascular morbidity and mortality. Recent studies suggest that patients with hypertension also have a deficiency of certain cardiac peptides. Previously we demonstrated that a single intravenous injection of the myocardium-tropic adeno-associated virus (AAV) 9-based vector encoding for proBNP prevented the development of hypertensive heart disease (HHD) in spontaneously hypertensive rats (SHRs). The current study was designed to determine the duration of cardiac transduction after a single AAV9 injection and to determine whether cardiac BNP overexpression can delay the progression of previously established HHD, and improve survival in aged SHRs with overt HHD.Methods and ResultsTo evaluate the duration of cardiac transduction induced by the AAV9 vector, we used four week old SHRs. Effective long-term selective cardiac transduction was determined by luciferase expression. A single intravenous administration of a luciferase-expressing AAV9 vector resulted in efficient cardiac gene delivery for up to 18-months. In aged SHRs (9-months of age), echocardiographic studies demonstrated progression of HHD in untreated controls, while AAV9-BNP vector treatment arrested the deterioration of cardiac function at six months post-injection (15-months of age). Aged SHRs with established overt HHD were further monitored to investigate survival. A single intravenous injection of the AAV9-vector encoding rat proBNP was associated with significantly prolonged survival in the treated SHRs (613±38 days, up to 669 days) compared to the untreated rats (480±69 days, up to 545 days)(p<0.05).ConclusionsA single intravenous injection of AAV9 vector elicited prolonged cardiac transduction (up to 18 months post-injection). AAV9 induced cardiac BNP overexpression prevented development of congestive heart failure, and significantly prolonged the survival of aged SHRs with previously established overt HHD. These findings support the beneficial effects of chronic supplementation of BNP in a frequent and highly morbid condition such as HHD.

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Section: Discussionmentioning

confidence: 99%

Cardiac BNP gene delivery prolongs survival in aged spontaneously hypertensive rats with overt hypertensive heart disease

Tonne

Holditch

Oehler

et al. 2014

Aging

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“…Okada et al30 found BNP concentration of more than Elevated BNP levels association with stroke subtypes before and after adjustment of logistic regression analysis (in stepwise method)…”

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confidence: 99%

Association of Plasma Brain Natriuretic Peptide Levels in Acute Ischemic Stroke Subtypes and Outcome

Chaudhuri

Sharma

Mridula

et al. 2015

Journal of Stroke and Cerebrovascular Diseases

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“…It was reported that in AF, BNP elevation is of atrial origin [38]. It was also reported that BNP level was significantly correlated with left atrial thrombi in AIS with AF [39]. Another study reported that BNP level was significantly correlated with left atrial appendage thrombi, and a stepwise increase in thrombi was significantly associated with a rise in BNP level [40].…”

Section: Discussionmentioning

confidence: 99%

Brain Natriuretic Peptide Is a Powerful Predictor of Outcome in Stroke Patients with Atrial Fibrillation

Maruyama

Uchiyama

Shiga

et al. 2017

Cerebrovasc Dis Extra

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Background: Since stroke patients with nonvalvular atrial fibrillation (NVAF) have poor outcomes in general, the prediction of outcomes following discharge is of utmost concern for these patients. We previously reported that brain natriuretic peptide (BNP) levels were significantly higher in NVAF patients with larger infarcts, higher modified Rankin Scale (mRS) score, and higher CHADS₂ score. In the present study, we evaluated an array of variables, including BNP, in order to determine significant predictors for functional outcome in patients with NVAF after acute ischemic stroke (AIS). Methods: A total of 615 consecutive patients with AIS within 48 h of symptom onset, admitted to our hospital between April 2010 and October 2015, were retrospectively searched. Among these patients, we enrolled consecutive patients with NVAF. We evaluated the mRS score 3 months after onset of stroke and investigated associations between mRS score and the following clinical and echocardiographic variables. Categorical variables included male sex, current smoking, alcohol intake, hypertension, diabetes mellitus, dyslipidemia, coronary artery disease, peripheral artery disease, use of antiplatelet drugs, anticoagulants, or tissue plasminogen activator (tPA), and infarct size. Continuous variables included age, systolic blood pressure (SBP), diastolic blood pressure, hemoglobin, creatinine, D-dimer, brain natriuretic peptide (BNP), left atrial diameter, left ventricular ejection fraction (EF), and early mitral inflow velocity/diastolic mitral annular velocity (E/e’). We also analyzed the association of prestroke CHADS₂, CHA₂DS₂-VASc, and R₂CHADS₂ scores, and National Institutes of Health Stroke Scale (NIHSS) score on admission with mRS score 3 months after the onset of stroke. Patients were classified into 2 groups according to mRS score: an mRS score ≤2 was defined as good outcome, an mRS score ≥3 was defined as poor outcome. To clarify the correlations between categorical or continuous variables and mRS score, uni- and multivariate logistic regression models using the stepwise variable selection method were applied. Results: Among 157 patients with NVAF after AIS, 63.7% were male and the mean age was 75.9 years. In univariate regression analysis, poor outcome (mRS score ≥3) was associated with use of tPA, infarct size, age, SBP, BNP, EF, and NIHSS score. In multivariate regression analysis, BNP levels (odds ratio [OR] 6.40; 95% confidence interval [CI] 1.26–32.43; p = 0.0235) and NIHSS score (OR 2.87; 95% CI 1.84–4.47; p < 0.001) were significantly associated with poor outcome (mRS score ≥3) after adjusting for use of tPA, infarct size, age, BNP, EF, and NIHSS score. Conclusions: Apart from NIHSS score, BNP was a very useful predictor for long-term outcomes of patients with NVAF after AIS.

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Brain natriuretic peptide is a marker associated with thrombus in stroke patients with atrial fibrillation

Cited by 38 publications

References 18 publications

Cardiac BNP gene delivery prolongs survival in aged spontaneously hypertensive rats with overt hypertensive heart disease

Cardiac BNP gene delivery prolongs survival in aged spontaneously hypertensive rats with overt hypertensive heart disease

Association of Plasma Brain Natriuretic Peptide Levels in Acute Ischemic Stroke Subtypes and Outcome

Brain Natriuretic Peptide Is a Powerful Predictor of Outcome in Stroke Patients with Atrial Fibrillation

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