Plasma Levels of Brain Natriuretic Peptide as an Index for Evaluation of Cardiac Function in Female Gene Carriers of Duchenne Muscular Dystrophy.

Abstract

The level of plasma brain natriuretic peptide (BNP) was elevated in 8 of15 female gene carriers ofDuchenne muscular dystrophy (DMD), and the level correlated with indices of cardiac function. In one of these carriers, whose clinical course was followed for one year, the plasma BNPlevel was elevated before the development of cardiac symptoms, further increased with the evolution of cardiac symptoms, and then decreased after treatment for cardiac failure. These results suggest that the plasma BNPlevel may be useful for the early detection of cardiac dysfunction and for evaluating the efficacy of cardiac treatment in female DMDcarriers. (Internal Medicine 36: 497-500, 1997) Key words: Duchenne muscular dystrophy (DMD), female gene carrier, brain natriuretic peptide (BNP), atrial natriuretic peptide (ANP), cardiac failure the manufacturer' s instructions.

Cardiac Involvement of Female Carrier of Duchenne Muscular Dystrophy

“…The levels of brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) in plasma, revealed a higher level of BNPthan ANPdespite the lack of symptoms indicating heart failure. This result supported the important investigation of Adachi et al which showed that plasma BNPlevels more accurately reflect cardiac dysfunction than do plasma ANPlevels (8). In DMDpatients, myocardial damage starts at a preclinical stage without symptomsbut is recognizable by minor electrocardiographic and echocardiographic signs (9).…”

Diagnostic utility of cardiac magnetic resonance for detection of cardiac involvement in female carriers of Duchenne muscular dystrophy

“…The diagnosis of carrier was made on the basis of detection of mutations in the dystrophin gene, mosaic staining of dystrophin in muscle cells of skeletal muscle biopsy, highly elevated levels of serum creatine kinase (CK) activity, or genetic confirmation of definite carrier based on the pedigree, as reported previously 11. Investigations included a full medical history, routine physical examination, electrocardiography, echocardiography, CMR and measurements of brain natriuretic peptide (BNP) levels.…”

Cardiac assessment of patients with late stage Duchenne muscular dystrophy

“…In the literature there is some evidence by Adachi et al that carriers had elevated brain natriuretic peptide, which correlated with indices of cardiac function. 20 Further longitudinal follow-up studies are needed to determine whether early detection of subclinical cardiac dysfunction changes cardiac prognosis and whether early pharmaceutical interventions are useful in preventing progression of Duchenne muscular dystrophy.…”