© 2001 by European Society of Cardiology
Copyright © 2000, European Society of Cardiology
Measurement of plasma brain natriuretic peptide level as a guide for cardiac overload
aDepartment of Cardiovascular Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
bDivision of Cardiovascular Diseases, the Institute for Adult Disease Asahi Life Foundation, Tokyo, Japan
cDepartment of Cardiology, JR Tokyo General Hospital, Tokyo, Japan
dDivision of Cardiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
eDepartment of Cardiology, Nissay Hospital, Tokyo, Japan
* Corresponding author. Fax: +81-3-3814-0021 hirata-2im{at}h.u-tokyo.ac.jp
Objectives: We examined whether measurement of the plasma BNP concentrations might be useful for the early diagnosis of the existence and severity of disease in patients with heart disease in daily clinical practice. Methods and Results: The plasma BNP and ANP concentrations in 415 patients with heart disease and hypertension and 65 control subjects were measured. Patients with heart disease had higher plasma BNP and ANP concentrations than did those with hypertension or control subjects. Among the etiology of cardiac diseases, specifically dilated cardiomyopathy and hypertrophic cardiomyopathy, was associated with the highest plasma BNP concentrations, whereas dilated cardiomyopathy was associated with the highest plasma ANP concentrations. Plasma BNP concentrations showed an increase as the severity of the heart disease, as graded according to the NYHA classification of cardiac function, increased. In both patients with heart disease and hypertension, the plasma BNP values were higher in those who had abnormalities in their echocardiogram and electrocardiogram as compared to those without any abnormalities. The plasma BNP levels also showed a significant correlation with left ventricular wall thickness and left ventricular mass. On the other hand, the plasma ANP levels showed significant correlations with left ventricular dimension. Receiver operative characteristic analysis revealed that plasma BNP levels showed substantially high sensitivity and specificity to detect the existence of heart diseases. Conclusion: Measurements of the plasma BNP concentrations is useful to detect the existence of the diseases, and abnormalities of left ventricular function and hypertrophy in patients with heart disease in daily clinical practice.
KEYWORDS Heart failure; Hypertension; Hypertrophy; Natriuretic peptide
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