Cardiovascular Research 1997 36(2):246-255; doi:10.1016/S0008-6363(97)00164-8
© 1997 by European Society of Cardiology
Copyright © 1997, European Society of Cardiology
Adrenomedullin, endothelin, neuropeptide Y, atrial, brain, and C-natriuretic prohormone peptides compared as early heart failure indicators1
aDepartments of Medicine, Physiology and Biophysics, James A. Haley Veterans Hospital, 151, 13000 Bruce B. Downs Blvd., Tampa, FL 33612, USA
bUniversity of South Florida Health Sciences Center, Tampa, FL, USA
* Corresponding author. Tel.: +1 813 9727624; Fax: +1 813 9727623.
Objectives: The present investigation was designed to determine the best endogenous plasma marker of early congestive heart failure (CHF). Methods: Forty volunteers with mild CHF (New York Heart Association Class I, n = 12), moderate (Class II, n = 8), or severe (Class III and Class IV, each=n of 5) and 10 age-matched healthy individuals had the simultaneous evaluation of their respective plasma samples by the following radioimmunoassays: atrial natriuretic peptide, ANP; three N-terminal ANP prohormone assays, i.e., proANPs 1–30, 31–67, and 79–98 with the numbers referring to their amino acid (a.a.) sequences in their 126 a.a. prohormone; brain (BNP) and C-natriuretic peptides; N-terminal BNP prohormone; adrenomedullin; neuropeptide Y and endothelin. Results: ProANPs 31–67, 1–30 and 79–98 had 100% (P = 0.01), 83% (P = 0.09) and 50% (P = 0.74) sensitivity in differentiating Class I CHF subjects from healthy subjects. The ANP, BNP, NT-proBNP, CNP, adrenomedullin, neuropeptide Y, and endothelin assays could not differentiate mild CHF subjects from healthy individuals. Logistic regression analysis revealed that only proANP 31–67 significantly (P = 0.0001) discriminated between early CHF (5226±377 pg/ml) and healthy individuals (1595±157 pg/ml). The positive and negative predictive values of proANP 31–67 were excellent (100% for each). The peptides measured in these assays were found to be independent markers of CHF with respect to left ventricular ejection fraction. Conclusions: ProANPs 31–67 is the most sensitive marker in discriminating NYHA Class I CHF subjects from healthy individuals. The ANP, BNP, NT-proBNP, CNP, adrenomedullin, neuropeptide Y and endothelin radioimmunoassays cannot discern mild CHF. These peptides are independent of left ventricular ejection fraction.
KEYWORDS Heart failure; Plasma; Endothelin; Neuropeptide-Y; Adrenomedullin; Humans
1 Presented in part at the American Society of Clinical Investigation Meeting, Washington, DC, April 25–27, 1997.
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Cardiovasc Res 1999 44: 452-453.
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