Circulating N-terminal atrial natriuretic peptide as a marker for symptomless left-ventricular dysfunction

Lerman, Amir; Gibbons, Raymond J.; Rodeheffer, Richard J.; Bailey, Kent R.; McKinley, Linda J.; Heublein, Denise M.; Burnett, John C.

doi:10.1016/0140-6736(93)93125-k

Cited by 297 publications

(150 citation statements)

References 23 publications

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“…ANP , by contrast, has found to be a much more stable peptide with a longer halflife and higher plasma concentrations [11,12]. Therefore, ANP (1-98) measurements may be more suitable for assessment of cardiac patients [13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Associations between atrial natriuretic peptides, echocardiographic findings and mortality in an elderly population sample

Iivanainen

Tikkanen

Tilvis

et al. 1997

Journal of Internal Medicine

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Section: Introductionmentioning

confidence: 99%

Associations between atrial natriuretic peptides, echocardiographic findings and mortality in an elderly population sample

Iivanainen

Tikkanen

Tilvis

et al. 1997

Journal of Internal Medicine

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“…In patients with the suspicion of heart failure several other studies showed natriuretic peptides to be useful indicators for the detection of heart failure (Lerman et al, 1993;Davidson et al, 1996;Cowie et al, 1997;Hammerer-Lercher et al, 2001;Maisel et al, 2002Maisel et al, , 2003. In the follow-up of patients with an acute cardiac event levels of natriuretic peptides were proved to be of prognostic value for outcome (Hall et al, 1994;Omland et al, 1996;de Lemos et al, 2001;Koglin et al, 2001;Richards et al, 2003).…”

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confidence: 99%

Role of natriuretic peptides in the diagnosis and treatment of patients with carcinoid heart disease

et al. 2004

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Carcinoid heart disease (CHD) occurs in 20 -70% of the patients with metastatic well-differentiated neuroendocrine tumours (NET). We evaluated whether natriuretic peptides (ANP or NT-proBNP) are useful in early detection of CHD. Blood samples from 32 patients with NET were compared with cardiac ultrasound follow-up. CHD was defined as thickening of the tricuspid valve in the presence of grade III -IV/IV tricuspid valve regurgitation. CHD was found in nine out of 32 patients (28%), all with symptoms of the carcinoid syndrome compared to 65% in the 23 patients without CHD (P ¼ 0.04). Median levels of NT-proBNP and 5-HIAA were significantly higher in patients with CHD (894 ng l À1 and 815 mmol 24 h À1 ) compared to those without (89 and 206 ng l À1 , Po0.001 and P ¼ 0.007). No significant differences were detected in ANP levels (P ¼ 0.11). Dilatation of the right atrium and ventricle as well as thickening of the tricuspid valve and degree of regurgitation were statistically significant correlated with NT-proBNP levels. The accuracy of NT-proBNP in the diagnosis of CHD was higher than that of ANP. A significantly better survival was observed in case of normal NT-proBNP values. In conclusion, NT-proBNP is helpful as a simple marker in the diagnosis of CHD. Survival is better in patients with normal levels of NT-proBNP.

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“…ANP is secreted into the blood by myocardial cells in response to atrial stretch [29], whereas the primary regulators of BNP release are left ventricular stretch or wall tension [30]. Because ANP is mainly secreted by the atria in response to the stretch that occurs as a result of the increased left atrial pressure associated with heart failure [31,32], the increased levels of ANP and BNP seen in this study after CPB might suggest a deterioration of haemodynamic status after CABG. Removal of ANP and BNP from the circulation, and therefore the regulation of their plasma concentrations, is achieved mainly via ligand-receptor internalisation and enzymatic degradation by neural endopeptidase [30], which is found in particularly high concentrations in the lung and kidney.…”

Section: Discussionmentioning

confidence: 86%

Changes in calcitonin gene‐related peptide, atrial natriuretic peptide and brain natriuretic peptide in patients undergoing coronary artery bypass grafting

et al. 2003

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SummaryThe initiation of cardiopulmonary bypass creates significant derangements in cardiovascular volume status and both endocrine and autonomic nervous system function. To examine whether such derangements might differ in patients with different pre-operative physical status scores, we measured the plasma concentrations of calcitonin gene-related peptide, atrial natriuretic peptide and brain natriuretic peptide, catecholamines and antidiuretic hormone, as well as haemodynamic variables, during and after cardiopulmonary bypass in 27 consecutive patients undergoing coronary artery bypass grafting. The pre-operative levels of atrial natriuretic peptide and brain natriuretic peptide differed significantly between ASA II patients and III and IV patients [mean (SD) brain natriuretic peptide levels ¼ 14 (8.2) vs. 129 (51) pg.ml )1 ]. Plasma calcitonin gene-related peptide increased significantly in both groups after the initiation of cardiopulmonary bypass, and remained increased throughout cardiopulmonary bypass. The changes in plasma epinephrine, norepinephrine and antidiuretic hormone were similar to those reported previously. The changes in plasma calcitonin gene-related peptide, atrial natriuretic peptide and brain natriuretic peptide did not correlate with any changes in haemodynamic variables before or after cardiopulmonary bypass. Measurement of plasma brain natriuretic peptide might usefully be included in the pre-operative evaluation of patients with cardiac disease.

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Circulating N-terminal atrial natriuretic peptide as a marker for symptomless left-ventricular dysfunction

Cited by 297 publications

References 23 publications

Associations between atrial natriuretic peptides, echocardiographic findings and mortality in an elderly population sample

Associations between atrial natriuretic peptides, echocardiographic findings and mortality in an elderly population sample

Role of natriuretic peptides in the diagnosis and treatment of patients with carcinoid heart disease

Changes in calcitonin gene‐related peptide, atrial natriuretic peptide and brain natriuretic peptide in patients undergoing coronary artery bypass grafting

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