Determinants of plasma brain natriuretic peptide levels in untreated hypertensive patients

Goda, Akiko; Nakao, Shinji; Tsujino, Takeshi; Yuba, Masao; Otsuka, Misato; Matsumoto, Mika; Yoshida, Chikako; Naito, Yoshiro; Lee-Kawabata, Masaaki; Ohyanagi, Mitsumasa; Masuyama, Tohru

doi:10.1007/s12574-011-0086-9

Cited by 4 publications

(8 citation statements)

References 15 publications

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“…Major findings in the current study are (1) subjects with LV diastolic dysfunction had a higher estimated LVFP and a higher prevalence of CH, which were not accompanied by elevated plasma BNP levels, than those without LV diastolic dysfunction; (2) both high estimated LVFP and low plasma BNP levels were independent factors associated with CH; and (3) CH with LV diastolic dysfunction predicted a poor prognosis. Unlike the well-known positive association between plasma BNP levels and LVH in HF patients and hypertension, 3 , 4 we found a negative association between plasma BNP levels and LVH in a subclinical population without heart disease, which might indicate a predisposition to diastolic dysfunction.…”

Section: Discussioncontrasting

confidence: 99%

“…A positive correlation between high plasma BNP levels, LVH, and diastolic dysfunction has been demonstrated in patients with heart failure (HF) or hypertension. 3 , 4 Considering the cardiovascular protective properties of NPs, such as their natriuretic, vasodilative, antihypertrophic, and antifibrotic effects, NPs are believed to be compensatorily released to relieve hemodynamic stress.…”

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confidence: 99%

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Relative B-Type Natriuretic Peptide Deficiency May Exist in Diastolic Dysfunction in Subclinical Population

Okamoto,

Tsukamoto,

Hasegawa

et al. 2024

Circ Rep

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Background: Heart failure patients are deficient in B-type natriuretic peptide (BNP) but the significance of subclinical BNP deficiency is unclear. Methods and Results: A total of 1,398 subjects without cardiovascular disease, with left ventricular ejection fraction (LVEF) ≥50% and BNP level <100 pg/mL, were selected from a 2005–2008 health checkup in Arita-cho, Japan, and divided into 2 groups: with and without LV diastolic dysfunction (DD+ or DD−). We performed propensity score matching on non-cardiac factors affecting BNP levels and analyzed 470 subjects in each group (372/940 men; median age, 66 years). The DD(+) group showed higher lateral E/e', an index of estimated left ventricular filling pressure, and greater prevalence of concentric hypertrophy (CH) despite similar BNP levels, suggesting a relative deficiency of BNP in DD(+) compared with DD(−). Multivariable logistic regression analysis revealed an increase in BNP correlated with decreased odds of CH (adjusted odds ratio [aOR] 0.663, 95% confidence interval (CI) 0.484–0.909, P=0.011), whereas an increase in lateral E/e' was associated with increased odds of CH (aOR, 2.881; 95% CI, 1.390–5.973; P=0.004). Furthermore, CH in combination with diastolic dysfunction independently predicted major adverse cardiovascular events (hazard ratio 3.272, 95% CI 1.215–8.809; P=0.019). Conclusions: Relative BNP deficiency was associated with CH, which had a poor prognosis in patients with diastolic dysfunction.

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Section: Discussioncontrasting

confidence: 99%

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confidence: 99%

Relative B-Type Natriuretic Peptide Deficiency May Exist in Diastolic Dysfunction in Subclinical Population

Okamoto,

Tsukamoto,

Hasegawa

et al. 2024

Circ Rep

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“…Cardiomyocytes secrete NPs into the systemic circulation in response to myocardial mechanical loading 2 ; thus, the elevation of plasma NP is essential to cardiac hypertrophy or failure 1 . Previous studies have shown that plasma BNP levels are well correlated with LVMI, that is, LV hypertrophy and LV diastolic function 27,28 . LV hypertrophy is an established independent risk factor for cardiovascular morbidity and mortality 29 .…”

Section: Discussionmentioning

confidence: 99%

“… 1 Previous studies have shown that plasma BNP levels are well correlated with LVMI, that is, LV hypertrophy and LV diastolic function. 27 , 28 LV hypertrophy is an established independent risk factor for cardiovascular morbidity and mortality. 29 However, LV concentric remodelling, defined as increased RWT and normal LVMI, is also associated with poorer prognoses compared with the normal LV geometry.…”

Section: Discussionmentioning

confidence: 99%

Lower B‐type natriuretic peptide levels predict left ventricular concentric remodelling and insulin resistance

Okamoto

Tsukamoto

Hasegawa³

et al. 2021

ESC Heart Failure

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Aims Natriuretic peptides have reportedly been associated with cardiac hypertrophy and insulin resistance; however, it has not been established if B‐type natriuretic peptide (BNP) is associated with either insulin resistance or cardiac remodelling in a population with normal plasma BNP levels. We investigated the relationship among plasma BNP levels, insulin resistance, and left ventricular (LV) remodelling in a population with normal physiological plasma BNP levels. Methods and results Among 1632 individuals who participated in annual health checks between 2005 and 2008 in Arita‐cho, Saga, Japan, 675 individuals [median (interquartile range) for age 62 (51–69) years; 227 men (34%)] with LV ejection fraction 50% and BNP level <35 pg/mL were enrolled in this study. Insulin resistance was assessed using homeostatic model assessment of insulin resistance (HOMA‐IR). LV geometry, including LV concentric remodelling, was classified based on relative wall thickness (RWT) and LV mass index values derived from echocardiographic findings. Factors associated with insulin resistance and LV geometry were investigated using multiple logistic regression analysis. Tertiles of BNP were inversely associated with HOMA‐IR [1st tertile, 1.33 (0.76–1.74); 2nd tertile, 1.05 (0.72–1.59); 3rd tertile, 0.95 (0.66–1.58), P = 0.005]. Lower BNP was associated with the prevalence of insulin resistance, defined as HOMA‐IR ≥1.37, even after full multivariate adjustment [1 SD increment in BNP = adjusted odds ratio (aOR) 0.740; 95% confidence interval (CI) 0.601–0.912; P = 0.005]. LV concentric remodelling (RWT >0.42; LV mass index ≤115 g/m2 in men and ≤95 g/m2 in women) was observed in 107 (16%) participants, while normal LV geometry (RWT ≤0.42; LV mass index ≤115 g/m2 in men and ≤95 g/m2 in women) was seen in 423 (63%), and LV hypertrophy (LV mass index >115 g/m2 in men and >95 g/m2 in women) in 145 (21%). Both low BNP level and higher insulin resistance were independently linked to LV concentric remodelling after multivariate adjustment (1 SD increment in BNP = aOR 0.714, 95% CI 0.544–0.938, P = 0.015; HOMA‐IR ≥ 1.37 vs. <1.37: aOR 1.694, 95% CI 1.004–2.857, P = 0.048, respectively). Conclusions Lower BNP levels are linked to either insulin resistance or LV concentric remodelling in a population with normal plasma BNP levels, suggesting that participants with lower natriuretic peptide level might be vulnerable to the development of metabolic disorders and LV morphological abnormalities.

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“…Strain echocardiography has provided quantification of regional myocardial systolic function objectively and is less influenced by tethering effects and cardiac translational artifact than Doppler tissue imaging [14]. Along with echocardiography, other examinations as electrocardiography (ECG), radiography, computed tomography, magnetic resonance imaging, measurement of serum cardiac biomarkers including C-reactive protein (CRP), N-terminal pro-B-type natriuretic peptide (nt-proBNP), troponin T (TnT), creatine kinase MB (CK-MB), and lactate dehydrogenase (LDH) are important diagnostic tools in the evaluation of cardiac function [16–18]. Some reports have already shown differences between M-mode and strain parameters in Dox-cardiotoxicity models [19,20].…”

Section: Introductionmentioning

confidence: 99%

Doxorubicin Cardiotoxicity and Cardiac Function Improvement After Stem Cell Therapy Diagnosed by Strain Echocardiography

Oliveira

Melo²,

Carvalho³

et al. 2013

J Cancer Sci Ther

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Doxorubicin (Dox) is one of the most effective chemotherapeutic agents; however, it causes dose-dependent cardiotoxicity. Evaluation of left ventricular function relies on measurements based on M-mode echocardiography. A new technique based on quantification of myocardial motion and deformation, strain echocardiography, has been showed promising profile for early detection of cardiac dysfunction. Different therapy strategies, such as flavonoid plant extracts and stem cells, have been investigated to improve heart function in toxic cardiomyopathy. This work aimed to assess early cardiac function improvement after treatments with either flavonoid extract from Camellia sinensis or mesenchymal stem cells in Dox cardiotoxicity using strain echocardiography. Twenty Wistar rats were randomly assigned to four groups. They received water (control, Dox, Dox + stem cells) or 100 mg/kg C. sinensis extract (Dox + C. sinensis) via gavage, daily, for four weeks. Animals also received saline (control) or 5 mg/kg doxorubicin (Dox, Dox + C. sinensis, Dox + stem cells) via intraperitoneal injection, weekly, for four weeks. Stem cells were injected (3 × 106 cells) through tail vein prior the beginning of the experiment (Dox + stem cells). Animals were evaluated by hematological, electrocardiography, echocardiography, and histopathological examinations. Dox cardiotoxicity was only diagnosed with strain echocardiography, detecting a decrease in ventricular function. C. sinensis extract did not prevent ventricular dysfunction induced by Dox. However, strain echocardiography examination revealed that Dox cardiotoxicity was significantly suppressed in rats treated with stem cells. In conclusion, strain echocardiography was able to detect precocity signs of heart failure and stem cell therapy showed cardioprotection effect against Dox cardiotoxicity.

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Determinants of plasma brain natriuretic peptide levels in untreated hypertensive patients

Cited by 4 publications

References 15 publications

Relative B-Type Natriuretic Peptide Deficiency May Exist in Diastolic Dysfunction in Subclinical Population

Relative B-Type Natriuretic Peptide Deficiency May Exist in Diastolic Dysfunction in Subclinical Population

Lower B‐type natriuretic peptide levels predict left ventricular concentric remodelling and insulin resistance

Doxorubicin Cardiotoxicity and Cardiac Function Improvement After Stem Cell Therapy Diagnosed by Strain Echocardiography

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