Plasma B-type natriuretic peptide reflects left ventricular hypertrophy and diastolic function in hypertension

Uusimaa, Paavo; Tokola, Heikki; Ylitalo, Antti; Vuolteenaho, Olli; Ruskoaho, Heikki; Risteli, Juha; Linnaluoto, Markku K.; Peuhkurinen, Keijo

doi:10.1016/j.ijcard.2003.10.015

Cited by 52 publications

(27 citation statements)

References 34 publications

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“…6,10 BNP was not only correlated with hypertrophy but also with diastolic dysfunction in hypertensive patients from a subgroup of the ASCOT trial. 13 In the present study, the severity of hypertension, cardiac hypertrophy and diastolic dysfunction were graded in each BNP subgroup of non-failing hypertensives. As a result, the importance of BNP for evaluating the risk of untreated hypertension was suggested.…”

Section: Bnp and Heart Diseasementioning

confidence: 82%

“…However, the role of BNP in the clinical assessment of hypertension has not been fully investigated and the actual meaning of a slight increase in BNP is still unclear. [11][12][13] The Framingham study demonstrated that an increase in BNP predicted the risk of death and cardiovascular events in community residents. 17 Neurohumoral factors become activated and play important roles in the pathophysiology of chronic heart disease.…”

mentioning

confidence: 99%

“…5 It has been reported that BNP is also increased in hypertensive patients without heart failure and in community residents with hypertension. [11][12][13][14] Hypertensive patients with cardiac hypertrophy have higher plasma BNP concentrations and the patients with increased BNP suffer from a higher incidence of cardiac events. 11,12 Recently, diastolic failure has attracted more attention in relation to hypertensive heart disease and this is associated with an increase in BNP.…”

mentioning

confidence: 99%

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Clinical Significance of B-Type Natriuretic Peptide in the Assessment of Untreated Hypertension

Seki

Tsurusaki

Kasai

et al. 2008

Circ J

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ypertension is widely recognized as a major risk factor for cardiovascular disease. 1,2 When initiating antihypertensive treatment, it is important to assess clinical characteristics and the severity of organ damage. [3][4][5] The plasma level of B-type natriuretic peptide (BNP) is well established as a useful marker of cardiac dysfunction, prognosis and response to treatment in patients with heart failure. [6][7][8][9] In patients with heart failure, secretion of BNP increases in proportion to the severity of left ventricular (LV) dysfunction, as indicated by the pulmonary capillary wedge pressure and LV end-diastolic pressure or the New York Heart Association class. 6,10 However, the measurement of BNP for clinical guidelines in hypertension is not recommended at present. 5 It has been reported that BNP is also increased in hypertensive patients without heart failure and in community residents with hypertension. 11-14 Hypertensive patients with cardiac hypertrophy have higher plasma BNP concentrations and the patients with increased BNP suffer from a higher incidence of cardiac events. 11,12 Recently, diastolic failure has attracted more attention in relation to hypertensive heart disease and this is associated with an increase in BNP. 15,16 Early and accurate diagnosis of diastolic failure is important to improve the prognosis of patients with heart failure. However, the role of BNP in the clinical assessment of hypertension has not been fully investigated and the actual meaning of a slight increase in BNP is still unclear. [11][12][13] The Framingham study demonstrated that an increase in BNP predicted the risk of death and cardiovascular events in community residents. 17 Neurohumoral factors become activated and play important roles in the pathophysiology of chronic heart disease. It would be helpful in general practice if BNP could be used as a marker of the risk of cardiovascular events in hypertensive patients.In the present study, we examined the relationship between plasma BNP levels and various clinical parameters to assess the usefulness of BNP as a marker for the severity of hypertension or organ damage in untreated hypertensives. The patients were clinically graded by BNP level. MethodsThe present study group comprised 154 persons with essential hypertension who attended our outpatient clinic (84 Circ J 2008; 72: 770 -777 (Received July 30, 2007; revised manuscript received October 22, 2007; accepted December 19, 2007 Methods and ResultsThe relationship between the plasma BNP level and various clinical parameters was examined in 154 untreated hypertensive patients without heart failure or atrial fibrillation (mean age: 58.0±10.7; mean blood pressure: 164.5±15.2/99.1±9.7 mmHg; mean BNP: 32.7±36.7 pg/ml). First, the patients were divided into 2 groups based on BNP: normal (<18.5 pg/ml, mean 9.7±5.7, n=69); or elevated (>18.5 pg/ml, mean 51.4± 40.4, n=85). The elevated BNP group had a significantly greater electrocardiographic voltage index (SV1+RV5; 3.7±1.2 vs 3.2±0.8 mV, p=0.0029), cardiothora...

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Section: Bnp and Heart Diseasementioning

confidence: 82%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical Significance of B-Type Natriuretic Peptide in the Assessment of Untreated Hypertension

Seki

Tsurusaki

Kasai

et al. 2008

Circ J

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“…In addition, we show that only the male and O-Ovx ANP C/K mice exhibited a significant increase (204 and 78% respectively) in LV BNP expression under HS conditions. As BNP is an important marker of cardiac dysfunction, higher BNP expression is often related to more severe cardiac damage (Gardner 2003, Uusimaa et al 2004. Nevertheless, what remains unclear is whether the expression of ANP and BNP, which are markedly increased in patients and animals with CH or failing hearts, are induced to normalize cardiac structure or their expression is simply a consequence of the CH itself (Chien et al 1991).…”

Section: Discussionmentioning

confidence: 99%

Estrogen protects against the development of salt-induced cardiac hypertrophy in heterozygous proANP gene-disrupted mice

Sangaralingham¹,

Tse²,

Pang³

2007

Journal of Endocrinology

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Cardiovascular disease is the leading cause of morbidity and mortality in both men and women, but the incidence for women rises sharply after menopause. This has been mainly attributed in the reduction of the female sex hormone estrogen during menopause, suggesting that estrogen may have cardioprotective effects, although how estrogen exerts its cardioprotective effects is not fully understood. Moreover, the beneficial effect of estrogen on end-organ damage such as cardiac hypertrophy (CH) remains unclear. The aim of the present study was to examine the interaction between estrogen and the natriuretic peptide system (NPS) and their possible roles during the development of CH by using the proANP heterozygous atrial natriuretic peptide (ANP C/K) mouse as a model of salt-sensitive CH. Male, female ANP C/K mice, and also ovariectomized (Ovx) female ANP C/K mice treated with oil or estrogen were fed either a normal or high salt (HS) diet. After a 5-week treatment period, marked CH was noted in the male and oil-injected Ovx female ANP C/K mice treated with HS. The cardiac NPS, i.e. ANP, B-type natriuretic peptide, and natriuretic peptide receptor-A, was activated in these ANP C/K mice. Interestingly, the female and estrogen-injected Ovx female ANP C/K mice did not exhibit CH, and the cardiac NPS remained unchanged. Collectively, we provide direct evidence that estrogen has the ability to resist the induction of salt-induced CH in ANP C/K mice. Furthermore, the development of hypertrophy may be activating the cardiac NPS in an attempt to blunt these structural changes.

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“…The discrepancy between serum markers for cardiac fibrosis and echocardiographic parameters for diastolic dysfunction have been also described previously. 5 The present study had limitations. First, there was lack of tissue samples to assess the extent of myocardial fibrosis.…”

mentioning

confidence: 80%

The relation between serum level of amioterminal propeptide of type I procollagen and diastolic dysfunction in hypertensive patients without diabetes mellitus: a pilot study

et al. 2006

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Plasma B-type natriuretic peptide reflects left ventricular hypertrophy and diastolic function in hypertension

Cited by 52 publications

References 34 publications

Clinical Significance of B-Type Natriuretic Peptide in the Assessment of Untreated Hypertension

Clinical Significance of B-Type Natriuretic Peptide in the Assessment of Untreated Hypertension

Estrogen protects against the development of salt-induced cardiac hypertrophy in heterozygous proANP gene-disrupted mice

The relation between serum level of amioterminal propeptide of type I procollagen and diastolic dysfunction in hypertensive patients without diabetes mellitus: a pilot study

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