N-terminal pro-atrial natriuretic peptide reflects cardiac remodelling in stage 1 hypertension

Abstract

Early detection of left ventricular hypertrophy (LVH) is beneficial, since treatment-induced regression of LVH has been unequivocally associated with a better prognosis. Our aim was to study the relation of cardiac remodelling and natriuretic peptides (NPs) in stage 1 hypertension. We studied 175 (46 ± 7 years, 87 women and 88 men) apparently healthy middle-aged that had never been treated for hypertension. Left ventricular and atrial parameters were determined by magnetic resonance imaging. Systolic blood pressure (BP) correlated with left ventricular mass index (LVMI) (r ¼ 0.23, Po0.01) and ventricular septum thickness index (IVSI) (r ¼ 0.29, Po0.001). N-terminal pro-B-type NP (NT-proBNP) or N-terminal pro-atrial NP (NT-proANP) did not correlate with BP, LVMI or IVSI. NT-proANP correlated with left atrial area index (LAAI) (r ¼ 0.38, Po0.001), and subjects with LVH had higher LAAI than subjects with normal left ventricular geometry and no LVH (11.2±0.3 vs 10.0 ± 0.2 cm 2 m -2 , Po0.001). In conclusion, measurement of NT-proBNP or NT-proANP does not appear to discriminate LVH in middle-aged, never treated and apparently healthy hypertensives. NT-proANP, but not NT-proBNP, reflects early cardiac remodelling in hypertensive heart disease.

The diagnostic performance of mid-regional portion of pro-atrial natriuretic peptide for the detection of left ventricular hypertrophy in Caucasian hypertensive patients

“…A study by Zachariah et al 5 showed that plasma ANP levels were not elevated in patients with uncomplicated essential hypertension. Furthermore, a recent study by Partanen et al 6 reported that ANP failed to discriminate LVH determined by magnetic resonance imaging in patients with stage 1 hypertension. These differences in diagnostic utility may be related to differences in assay design.…”