Direct Comparison of Transcardiac Increase in Brain Natriuretic Peptide (BNP) and N-Terminal ProBNP and Prognosis in Patients With Chronic Heart Failure
Open Access
- 1 January 2007
- journal article
- research article
- Published by Japanese Circulation Society in Circulation Journal
- Vol. 71 (12), 1873-1878
- https://doi.org/10.1253/circj.71.1873
Abstract
Background No previous study has compared the transcardiac gradient of cardiac natriuretic peptides and prognosis. Methods and Results To compare the prognostic value of the transcardiac increase in brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) in patients with chronic heart failure (CHF), the hemodynamic parameters and plasma levels of BNP and NT-proBNP were measured in the aortic root (AO) and coronary sinus (CS) in 353 consecutive patients with CHF. During a median follow-up of 2.8 years, 35 patients died. The molar ratio of (CS-AO) NT-proBNP to (CS-AO) BNP correlated with hemodynamic abnormalities and it was significantly higher in non-survivors than in survivors (median value =0.702 vs 0.437, respectively; p=0.0009), suggesting that NT-proBNP is superior to BNP in terms of transcardiac increase. After adjustment for clinical variables associated with CHF, including hemodynamics and an estimated glomerular filtration rate, it was found that only the plasma NT-proBNP level was an independent prognostic predictor, even after considering the transcardiac increases in BNP and NT-proBNP. Conclusion These findings suggest that the transcardiac gradient of NT-proBNP to BNP molar ratio increases with the severity of left ventricular dysfunction, and that plasma NT-proBNP level may be more useful than BNP for evaluating the prognosis of patients with CHF. (Circ J 2007; 71: 1873 - 1878)Keywords
This publication has 23 references indexed in Scilit:
- Direct Comparison of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP in a Large Population of Patients with Chronic and Symptomatic Heart Failure: The Valsartan Heart Failure (Val-HeFT) DataClinical Chemistry, 2006
- Relationship Between Renal Function and Plasma Brain Natriuretic Peptide in Patients With Heart FailureJournal of the American College of Cardiology, 2006
- Effect of Compensated Renal Dysfunction on Approved Heart Failure MarkersHypertension, 2005
- Risk of cardiovascular death in elderly patients with possible heart failure: B-type natriuretic peptide (BNP) and the aminoterminal fragment of ProBNP (N-terminal proBNP) as prognostic indicators in a 6-year follow-up of a primary care populationInternational Journal of Cardiology, 2005
- Changes in Brain Natriuretic Peptide and Norepinephrine Over Time and Mortality and Morbidity in the Valsartan Heart Failure Trial (Val-HeFT)Circulation, 2003
- Plasma N-terminal pro-brain natriuretic peptide and adrenomedullin: Prognostic utility and prediction of benefit from carvedilol in chronic ischemic left ventricular dysfunctionJournal of the American College of Cardiology, 2001
- The Impact of Cardiac Natriuretic Peptide Determination on the Diagnosis and Management of Heart Failurecclm, 2001
- Immunoreactive amino‐terminal pro‐brain natriuretic peptide (NT‐PROBNP): a new marker of cardiac impairmentClinical Endocrinology, 1997
- Attenuation of Compensation of Endogenous Cardiac Natriuretic Peptide System in Chronic Heart FailureCirculation, 1997
- Concentrations and molecular forms of human brain natriuretic peptide in plasmaBiochemical and Biophysical Research Communications, 1992