Why is the concentration of plasma brain natriuretic peptide in elderly inpatients greater than normal?

Sayama, Harumi; Nakamura, Yasuyuki; Sakai, Noboru; Kinoshita, Masahiko

doi:10.1097/00019501-199910000-00016

Cited by 86 publications

(52 citation statements)

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“…A gender difference in natriuretic peptide concentrations has been shown in some studies, with higher values in women (17 ). Other studies showed no difference (28 ). We found no gender difference, in good agreement with the findings of Schulz et al (13 ), who used the same method as in our study, and those of Goetze et al (27 ).…”

Section: Discussionsupporting

confidence: 93%

Utility of the Amino-Terminal Fragment of Pro-Brain Natriuretic Peptide in Plasma for the Evaluation of Cardiac Dysfunction in Elderly Patients in Primary Health Care

et al. 2003

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Background:The aims of this study were to measure the N-terminal fragment of pro-brain natriuretic peptide (proBNP) in plasma in medical conditions commonly found in primary care and to evaluate the utility of these measurements in identifying impaired cardiac function in elderly patients with symptoms associated with heart failure. Methods: We studied 415 patients (221 men and 194 women; mean age, 72 years) who had contacted a primary healthcare center for dyspnea, fatigue, and/or peripheral edema. One cardiologist evaluated the patients in terms of history, physical examination, functional capacity, electrocardiography, and suspicion of heart failure. Plasma N-terminal proBNP was measured by an in-house RIA. An ejection fraction <40% by Doppler echocardiography was regarded as reduced cardiac function. Abnormal diastolic function was defined as an abnormal mitral inflow defined as reduced ratio of peak early diastolic filling velocity to peak filling velocity at atrial contraction (E/A ratio), or as abnormal pulmonary venous flow pattern. Results: Patients with impaired functional capacity, impaired systolic function, and/or impaired renal function had significantly increased N-terminal proBNP concentrations. By multiple regression analysis, N-terminal proBNP concentrations were also influenced by ischemic heart disease, cardiac enlargement, and certain medications but not by increased creatinine. No gender differences were observed. Patients with isolated diastolic dysfunction attributable to relaxation abnormali-

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Section: Discussionsupporting

confidence: 93%

Utility of the Amino-Terminal Fragment of Pro-Brain Natriuretic Peptide in Plasma for the Evaluation of Cardiac Dysfunction in Elderly Patients in Primary Health Care

et al. 2003

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“…NT-proBNP and BNP were influenced by age and renal dysfunction in accordance with other studies. [16][17][18][19] In contrast with other studies, they were not influenced by gender nor by the use of renin-angiotensin system blockers. [20][21][22] A limitation of the study is the small population of 103 nursing home residents, in one centre, which could lead to a selection bias in arriving at the prevalence of CHF of 23%.…”

Section: Discussioncontrasting

confidence: 71%

Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides

Barents¹,

Horst²,

Voors³

et al. 2008

NHJL

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Background/objectives. Without knowing the exact CHF prevalence, chronic heart failure (CHF) occurs frequently in elderly people both inside and outside nursing homes. For a diagnosis we have to rely on physical examination and additional tests. We therefore run the risk of missing CHF diagnoses or of diagnosing CHF when we should not. Natriuretic peptide assays have emerged as a diagnostic test but their use in nursing home residents is limited. We examined the number of misdiagnoses, the CHF prevalence and the role of natriuretic peptide. Method. Residents in one centre without aphasia, cognitive impairments or metastatic cancer were screened for CHF; the natriuretic peptide levels were measured separately.

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“…However, the plasma BNP level without CHD was 21.6 ± 1.8 pg mL -1 , and the value in patients over 80 years old reached only 27.1 ± 6.9 pg mL -1 , suggesting that BNP might be largely influenced by the presence of CHD in patients with Type 2 diabetes. Although the precise mechanism(s) whereby the plasma BNP level is elevated by age is not clarified, Sayama et al have suggested that the elevation may be due to a change in cardiac hypertrophy, renal dysfunction, or systolic and diastolic dysfunction by aging [25]. Then, we evaluated the effects of diabetic properties on the plasma BNP level.…”

Section: Discussionmentioning

confidence: 98%

Characterization of Plasma Brain Natriuretic Peptide Level in Patients with Type 2 Diabetes

et al. 2005

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Abstract. This study investigates whether the plasma brain natriuretic peptide (BNP) level is increased by the clinical traits of diabetes, including its complications, and whether these levels are affected by the presence of other combined diseases such as hypertension, hyperlipidemia, and coronary heart disease (CHD) in patients with diabetes. In 223 patients with Type 2 diabetes, the mean value of plasma BNP reached 32.3 ± 4.1 pg/mL. The levels significantly increased with age, hypertension, and CHD but not with the duration of diabetes, HbA1c level, or hyperlipidemia. With regard to the type of therapy, the BNP levels were significantly lower in the combinations of both sulfonylurea and metformin and sulfonylurea and pioglitazone than those in insulin alone. In addition, the BNP levels in the group with diabetic complications, including retinopathy and nephropathy, and macroalbuminuria were significantly elevated in comparison with those without these complications and macroalbuminuria. Interestingly, however, no difference was observed between these groups after removal of the values in patients with CHD. These results have clarified that the plasma BNP levels in diabetic patients could increase only by the progression of macrovascular diseases, such as CHD, but not by the current diabetic control or diabetic microvascular complications.

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Why is the concentration of plasma brain natriuretic peptide in elderly inpatients greater than normal?

Cited by 86 publications

References 0 publications

Utility of the Amino-Terminal Fragment of Pro-Brain Natriuretic Peptide in Plasma for the Evaluation of Cardiac Dysfunction in Elderly Patients in Primary Health Care

Utility of the Amino-Terminal Fragment of Pro-Brain Natriuretic Peptide in Plasma for the Evaluation of Cardiac Dysfunction in Elderly Patients in Primary Health Care

Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides

Characterization of Plasma Brain Natriuretic Peptide Level in Patients with Type 2 Diabetes

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