Capability of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP as Indicators of Cardiac Structural Disease in Asymptomatic Patients with Systemic Arterial Hypertension

Abstract

Background:The aim of the present study was to prospectively evaluate the diagnostic utility of B-type natriuretic peptide (BNP) and amino-terminal proBNP (NT-proBNP) measurements for the detection of cardiac structural disease in asymptomatic patients with systemic arterial hypertension and to test the hypothesis that the 2 analytes are equally useful in this clinical setting. Methods: We studied a consecutive series of 149 asymptomatic patients referred for echocardiographic evaluation of the cardiac effects of systemic arterial hypertension. Diagnosis of cardiac structural disease was based on the presence of systolic or diastolic dysfunction, left atrial dilatation, left ventricular dilatation or hypertrophy, pulmonary hypertension, and wall motion or valvular abnormalities. Blood concentrations of BNP and NT-proBNP were measured by 2 commercially available assays (Abbott AxSYM and Roche Elecsys, respectively). Diagnostic accuracies of BNP and NT-proBNP were assessed by ROC curve analysis. Areas under the curves were compared by analysis of equivalency. Results: In distinguishing between hypertensive patients with cardiac structural disease (n ‫؍‬ 118) and hypertensive patients without (n ‫؍‬ 31), areas under the curves were 0.740 (95% confidence interval, 0.662-0.808) for BNP and 0.762 (0.685-0.828) for NT-proBNP and

Hyperhomocysteinemia and Myocardial Expression of Brain Natriuretic Peptide in Rats

“…This study demonstrates a significant stimulation of BNP expression, a sensitive marker of myocardial dysfunction and increased wall stress (21,22 ), with a high negative predictive value (15)(16)(17) by intermediate HHcy (Hcy1 and Hcy2), but not by moderate HHcy (Meth). This Co1, control group 1st run; Co2, control group 2nd run; Meth, methionine group; Hcy1, homocystine 1% group; Hcy2, homocystine 2% group.…”

“…The discrepancy between BNP expression and cardiac remodeling is not surprising, since BNP probably represents a more sensitive indicator to detect cardiac changes. Increases of BNP and NT-proBNP can frequently be found in diastolic dysfunction (18,19,32 ) in which the ejection fraction is normal, as well as in mild systolic dysfunction (21,22 ). In addition, modern concepts consider the heart to be a multifunctional and interactive organ that is part of a complex network (33,34 ).…”

“…They are increased in systolic and diastolic dysfunction (18,19 ) and have been found to be useful for differential diagnosis of dyspnea in CHF and pulmonary diseases (20 ). Especially in early disease stages, NT-proBNP seems to be more sensitive than echocardiography (21,22 ). Moreover, measurements of BNP and NT-proBNP are free from subjective influences and have good reproducibility (23 ).…”

Comparison of the Diagnostic Accuracy of Brain Natriuretic Peptide (BNP) and the N-Terminal Part of the Propeptide of BNP Immunoassays in Chronic and Acute Heart Failure: A Systematic Review

“…Patients with chronic heart failure are usually enrolled and studied in cardiological outpatient clinics or during community screening of large general population studies performed with the collaboration of general practitioners. Dyshomogeneity also occurs as the result of differing inclusion (or exclusion) criteria for patient enrollment; in particular, for some studies exclusion criteria included the presence of some degree of renal failure (14,18,23,24,34,35 ). Thus, the prevalence and severity of heart failure varied greatly among the studies, a circumstance that clearly affected the diagnostic accuracy of the BNP and NT-proBNP assays (3,4 ).…”

N-Terminal Pro-B-Type Natriuretic Peptide and Echocardiographic Abnormalities in Severely Obese Patients: Correlation with Visceral Fat

“…Therefore, to gain further information on the utility of NT-proBNP as an indicator of possible preclinical cardiac disease in normotensive, severely obese individuals, we measured NT-proBNP concentrations in 27 severely obese women with no complications [mean (SD) body mass index, 43.5 (4.8) kg/m 2 (median, 41.7 kg/m 2 ); mean (SD) age, 33.3 (8.3) years (median, 31 years)] and 15 normal-weight patients. All participants were premenopausal, normotensive, normoglycemic, drug-free young women with normal renal function, who were not dyspneic; this excluded the possibility that high NT-proBNP concentrations might be associated with hypertension and diabetes (7,8 ). All patients and controls underwent echocardiography (M-mode color Doppler; VSF Vingmed-System Five; General Electric).…”