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Sample records for brain natriuretic peptide-immunoreactive

  1. Localization of Brain Natriuretic Peptide Immunoreactivity in Rat Spinal Cord

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    Essam M Abdelalim

    2016-12-01

    Full Text Available Brain natriuretic peptide (BNP exerts its functions through natriuretic peptide receptors. Recently, BNP has been shown to be involved in a wide range of functions. Previous studies reported BNP expression in the sensory afferent fibers in the dorsal horn of the spinal cord. However, BNP expression and function in the neurons of the central nervous system are still controversial. Therefore, in this study, we investigated BNP expression in the rat spinal cord in detail using RT-PCR and immunohistochemistry. RT-PCR analysis showed that BNP mRNA was present in the spinal cord and DRG. BNP immunoreactivity was observed in different structures of the spinal cord, including the neuronal cell bodies and neuronal processes. BNP immunoreactivity was observed in the dorsal horn of the spinal cord and in the neurons of the intermediate column and ventral horn. Double-immunolabeling showed a high level of BNP expression in the afferent fibers (laminae I-II labeled with calcitonin gene-related peptide (CGRP, suggesting BNP involvement in sensory function. In addition, BNP was co-localized with CGRP and choline acetyltransferase in the motor neurons of the ventral horn. Together, these results indicate that BNP is expressed in sensory and motor systems of the spinal cord, suggesting its involvement in several biological actions on sensory and motor neurons via its binding to NPR-A and/or NPR-B in the DRG and spinal cord.

  2. Relationship between atrial natriuretic peptide-immunoreactive cells and microvessels in rat gastric mucosa

    Institute of Scientific and Technical Information of China (English)

    Chun-hui LI; Zong-wei YANG; Zheng-ri YIN; Zheng JIN; De-gang XING; Lian-hua PIAO; Yong-chul KIM; Wen-xie XU

    2006-01-01

    Aim: To investigate the ultrastructural localization of atrial natriuretic peptide(ANP)-synthesizing cells and the relationship between ANP-synthesizing cells and microvessels in rat gastric mucosa. Methods: Immunohistochemistry techniques and postembedding immunoelectron microscopy techniques were used to validate the findings regarding the expression of ANP-synthesizing cells and the ultrastructural localization of ANP-synthesizing cells in the gastric mucosa. Histochemistry techniques and the tannic acid-ferric chloride method (TA-Fe staining method) were used to reveal microvessel density and the distribution of ANPsynthesizing cells in different regions of the stomach. Results: Cells expressing ANP were localized and ANP-synthesizing cells were identified as enterochromaffin (EC) cells in the gastric mucosa. ANP-synthesizing cells existed in different regions of the stomach. The percentage ANP-synthesizing cells in the mucosa was greatest in the fundus (46.7%±5.3%), intermediate in the antrum (40.1%±4.5%), and least in the body (21.6%±3.6%). There was a positive relationship between the percentage of ANP-synthesizing cells and the density of microvessels in the antral mucosa, but not in the fundus or body mucosa. Conclusion: ANP is synthesized by EC cells in rat gastric mucosa, and ANP-synthesizing cells are most dense in the gastric fundus. ANP may act not only as a regional autocrine and/or paracrine regulator, but also as an endocrine regulatory peptide in the gastrointestinal tract.

  3. Cocaine- and amphetamine-regulated transcript (CART) peptide immunoreactivity in feeding- and reward-related brain areas of young OLETF rats.

    NARCIS (Netherlands)

    Armbruszt, S.; Abraham, H.; Figler, M.; Kozicz, T.L.; Hajnal, A.

    2013-01-01

    Cocaine- and amphetamine-regulated transcript (CART) peptide is expressed in brain areas involved in the control of appetite, drug reward and homeostatic regulation and it has an overall anorexigenic effect. Recently, we have shown that CART peptide immunoreactivity was significantly reduced in the

  4. Natriuretic hormones in brain function

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    David eLichtstein

    2014-11-01

    Full Text Available Natriuretic hormones include three groups of compounds: the natriuretic peptides (ANP, BNP and CNP, the gastrointestinal peptides (guanylin and uroguanylin, and endogenous cardiac steroids. These substances induce the kidney to excrete sodium and therefore participate in the regulation of sodium and water homeostasis, blood volume and blood pressure. In addition to their peripheral functions, these hormones act as neurotransmitters or neuromodulators in the brain. In this review, the established information on the biosynthesis, release and function of natriuretic hormones is discussed, with particular focus on their role in brain function. The available literature on the expression patterns of each of the natriuretic hormones and their receptors in the brain will be summarized, followed by the evidence for their roles in modulating brain function. Although numerous open questions exist regarding this issue, the available data support the notion that natriuretic hormones participate in the central regulation of blood pressure, neuroprotection, satiety, and various psychiatric conditions, including: anxiety, addiction and depressive disorders. In addition, the interactions between the different natriuretic hormones in the periphery and the brain are discussed.

  5. Brain natriuretic peptide: Diagnostic potential in dogs

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    Spasojević-Kosić Ljubica

    2009-01-01

    Full Text Available The endocrine role of the heart is evident in the secretion of noradrenaline and natriuretic peptides. The secretion of natriuretic peptides presents a useful mechanism for different conditions of cardiac dysfunction. Brain natriuretic peptide (BNP has been accepted in human cardiology as a biomarker for cardiac insufficiency and coronary arterial disease. The specificity of the BNP structure is specie-specific, so that the testing of diagnostic and prognostic potential in dogs requires the existence of a test that is a homologue for that animal specie. The existence of an adequate method for measuring BNP concentration makes possible its implementation as a screening test in everyday clinical practice. .

  6. Brain natriuretic peptide measurement in pulmonary medicine.

    Science.gov (United States)

    Salerno, Daniel; Marik, Paul E

    2011-12-01

    Serum levels of natriuretic peptides are well established as important biomarkers in patients with cardiac disease. Less attention has been placed on the role of natriuretic peptides in patients with pulmonary conditions. In several well-defined groups of patients with pulmonary disease natriuretic peptides provide the clinician with clinically valuable information. A limitation of the interpretation of natriuretic peptides in pulmonary disease is the confounding effect of concurrent conditions such as heart failure, hypoxia, sepsis and renal failure. The present paper reviews the role of natriuretic peptides for diagnosis, risk stratification and prognosis of several pulmonary disorders.

  7. Increased circulating pro-brain natriuretic peptide (proBNP) and brain natriuretic peptide (BNP) in patients with cirrhosis: relation to cardiovascular dysfunction and severity of disease

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Gøtze, J P; Fuglsang, S;

    2003-01-01

    BACKGROUND AND AIMS: Cardiac dysfunction may be present in patients with cirrhosis. This study was undertaken to relate plasma concentrations of cardiac peptides reflecting early ventricular dysfunction (pro-brain natriuretic peptide (proBNP) and brain natriuretic peptide (BNP)) to markers...

  8. Porcine brain natriuretic peptide receptor in bovine adrenal cortex

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    Higuchi, K.; Hashiguchi, T.; Ohashi, M.; Takayanagi, R.; Haji, M.; Matsuo, H.; Nawata, H.

    1989-01-01

    The action of porcine brain natriuretic peptide (pBNP) on the steroidogenesis was investigated in cultured bovine adrenocortical cells. Porcine BNP induced a significant dose-dependent inhibition of both ACTH- and A II-stimulated aldosterone secretion. 10/sup /minus/8/M and 10/sup /minus/7/M pBNP also significantly inhibited ACTH-stimulated cortisol and dehydroepiandrosterone (DHEA) secretions. Binding studies of (/sup 125/I)-pBNP to bovine adrenocortical membrane fractions showed that adrenal cortex had high-affinity and low-capacity pBNP binding sites, with a dissociation constant (Kd) of 1.70 x 10/sup /minus/10/M and a maximal binding capacity (Bmax) of 19.9 fmol/mg protein. Finally, the 135 Kd radioactive band was specially visualized in the affinity labeling of bovine adrenal cortex with disuccinimidyl suberate (DSS). These results suggest that pBNP may have receptor-mediated suppressive actions on bovine adrenal steroidogenesis, similar to that in atrial natriuretic peptide (ANP).

  9. Effect of Professional Exercises on Brain Natriuretic Peptide

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    MA Babaee Beigi

    2009-12-01

    Full Text Available Background: Brain natriuretic peptide (BNP reflects myocardial wall stress. BNP activities are similar to those of atrial natriuretic peptide, including diuresis, natriuresis, hypotension and smooth muscle relaxation as well as ability to inhibit the rennin aldosterone system. It is mainly produced and released into the circulation by the ventricle in response to increased ventricular wall pressure or stretching. Therefore, BNP can be served as a marker of left ventricular dysfunction. The aim of this study was to investigate effect of various professional exercises on plasma BNP levels.Methods: We enrolled 20 consecutive healthy professional athletic males from different sporting disciplines including 5 football players, 5 volleyball players, 5 bodybuilders and 5 water- polo players. Plasma BNP samples were taken immediately before and 1 hour after exercise.Results: Plasma BNP level was significantly increased after exercise (30.01 ± 23.46 vs. 16.72 ± 10.86 pg/ml; P= 0.042. The highest increase in BNP level was found among volleyball players (mean values: 19.12 to 43.38 pg/ml; 126.3% increase after volleyball compared to other exercises. Conclusion: Exercise can increase plasma BNP levels, particularly among volleyball players.

  10. Brain natriuretic peptide and optimal management of heart failure

    Institute of Scientific and Technical Information of China (English)

    LI Nan; WANG Jian-an

    2005-01-01

    Aside from the important role of brain natriuretic peptide (BNP) in diagnosis, and differential diagnosis of heart failure, this biological peptide has proved to be an independent surrogate marker of rehospitalization and death of the fatal disease.Several randomized clinical trials demonstrated that drugs such as beta blocker, angiotensin converting enzyme inhibitor, spironolactone and amiodarone have beneficial effects in decreasing circulating BNP level during the management of chronic heart failure. The optimization of clinical decision-making appeals for a representative surrogate marker for heart failure prognosis. The serial point-of-care assessments of BNP concentration provide a therapeutic goal of clinical multi-therapy and an objective guidance for optimal treatment of heart failure. Nevertheless new questions and problems in this area remain to be clarified. On the basis of current research advances, this article gives an overview of BNP peptide and its property and role in the management of heart failure.

  11. Brain natriuretic peptide concentrations after aneurysmal subarachnoid hemorrhage : relationship with hypovolemia and hyponatremia

    NARCIS (Netherlands)

    Dorhout Mees, Sanne M; Hoff, Reinier G; Rinkel, Gabriel J E; Algra, Ale; van den Bergh, Walter M

    2011-01-01

    BACKGROUND: Hyponatremia and hypovolemia occur often after aneurysmal subarachnoid hemorrhage (SAH) and are associated with poor outcome. The authors investigated whether brain natriuretic peptide (BNP) is related to hypovolemia and hyponatremia after SAH and whether it can differentiate between hyp

  12. Association between plasma brain natriuretic peptide/N-terminal pro-brain natriuretic peptide levels and atrial fibrillation:evidence from a meta-analysis

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    Liu Yaowu; Xiao Yunyun; Chen Xinguang; Zhang Fengxiang

    2014-01-01

    Background Several small sample-size observational studies evaluated the association of plasma brain natriuretic peptide (BNP) or N-terminal pro-brain natriuretic peptide (NT-proBNP) with atrial fibrillation (AF),but the results were contradictory.We aimed to perform a meta-analysis of relevant studies to evaluate the availability of this association.Methods We performed an extensive literature search on PubMed,Web of Science (WOS) and the Cochrane Library databases.Pooled standardized mean difference (SMD) and 95% confidence interval (CI) were calculated to assess the strength of association using random effects models.We performed sensitivity and subgroup analyses to explore the potential sources of heterogeneity.We also estimated publication biases.Statistical analyses were performed using the STATA 12.0 software.Results A total of 11 studies including 777 cases and 870 controls were finally analyzed.Overall,the brain natriuretic peptide/N-terminal pro-brain natriuretic peptide levels were higher in atrial fibrillation patients than controls without atrial fibrillation.Results showed that the SMD in the natriuretic peptide levels between cases and controls was 2.68 units (95%CI 1.76 to 3.60); test for overall effect z-score=5.7 (P <0.001).There was significant heterogeneity between individual studies (I2=97.8%; P <0.001).Further analysis revealed that differences in the assay of natriuretic peptide possibly account for this heterogeneity.Conclusions Increased BNP/NT-proBNP levels were associated with the presence of atrial fibrillation.This finding indicates that BNP/NT-proBNP may prove to be a biomarker of an underlying predisposition to AF.

  13. Factors influencing brain natriuretic peptide levels in healthy pregnant women.

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    Mayama, Michinori; Yoshihara, Masato; Uno, Kaname; Tano, Sho; Takeda, Takehiko; Ukai, Mayu; Kishigami, Yasuyuki; Oguchi, Hidenori

    2017-02-01

    The normal range of plasma brain natriuretic peptide (BNP) in pregnant women is still unclear. Moreover, pregnant women experience dynamic body weight changes and suffer from anemia, but effects on maternal BNP have not been investigated. This study aimed to reveal the normal plasma BNP range and examine the effects of physiological changes on BNP among pregnant women. Plasma BNP, hemoglobin, plasma creatinine and BMI were measured in 58 non-pregnant control women and in 773 normal pregnant women at late pregnancy, early postpartum and 1-month postpartum. Mean plasma BNP (in pg/mL) was 11.8 (95% confidence interval: 0-27.5) in non-pregnant women, 17.9 (0-44.7, pchange during pregnancy (p=0.001) and post-delivery creatinine (p=0.010) but negatively associated with body weight loss at delivery (pchanges, creatinine and hemoglobin levels; therefore, these factors should be considered when analysing cardiac function and the physiological implications of BNP levels in pregnant women. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. The differential effects of recombinant brain natriuretic peptide, nitroglycerine and dihydralazine on systemic oxygen delivery and gastric mucosal microvascular oxygenation in dogs*

    NARCIS (Netherlands)

    Schwarte, L. A.; Schwartges, I.; Scheeren, T. W. L.; Schober, P.; Picker, O.

    Brain natriuretic peptide has vasodilatory properties and may thus increase splanchnic perfusion and oxygenation. We compared the effects of recombinant brain natriuretic peptide on gastric mucosal microvascular haemoglobin oxygenation (reflectance spectrophotometry) and systemic variables with

  15. Natriuretic Peptides, Diagnostic and Prognostic Biomarkers

    OpenAIRE

    Rutten, Joost

    2010-01-01

    textabstractIn humans, the natriuretic peptide family consists of three different types of peptides: atrial natriuretic peptide (synonym: atrial natriuretic factor), B-type natriuretic peptide (synonym: brain natriuretic peptide) and C-natriuretic peptide.1 Atrial natriuretic peptide (ANP) was the fi rst natriuretic peptide to be discovered and in humans ANP is predominantly formed in the cardiomyocytes of the atria.2 B-type natriuretic peptide (BNP) was fi rst discovered in porcine brain hen...

  16. Natriuretic Peptides, Diagnostic and Prognostic Biomarkers

    NARCIS (Netherlands)

    J.H.W. Rutten (Joost)

    2010-01-01

    textabstractIn humans, the natriuretic peptide family consists of three different types of peptides: atrial natriuretic peptide (synonym: atrial natriuretic factor), B-type natriuretic peptide (synonym: brain natriuretic peptide) and C-natriuretic peptide.1 Atrial natriuretic peptide (ANP) was the f

  17. Increased circulating pro-brain natriuretic peptide (proBNP) and brain natriuretic peptide (BNP) in patients with cirrhosis: relation to cardiovascular dysfunction and severity of disease

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Gøtze, J P; Fuglsang, Stefan;

    2003-01-01

    subjects (1.8 v 2.3; NS). Circulating proBNP and BNP were related to severity of liver disease (Child score, serum albumin, coagulation factors 2, 7, and 10, and hepatic venous pressure gradient) and to markers of cardiac dysfunction (QT interval, heart rate, plasma volume) but not to indicators......BACKGROUND AND AIMS: Cardiac dysfunction may be present in patients with cirrhosis. This study was undertaken to relate plasma concentrations of cardiac peptides reflecting early ventricular dysfunction (pro-brain natriuretic peptide (proBNP) and brain natriuretic peptide (BNP)) to markers...... of severity of liver disease, cardiac dysfunction, and hyperdynamic circulation in patients with cirrhosis. PATIENTS AND METHODS: Circulating levels of proBNP and BNP were determined in 51 cirrhotic patients during a haemodynamic investigation. RESULTS: Plasma proBNP and BNP were significantly increased...

  18. Increased brain and atrial natriuretic peptides in patients with chronic right ventricular pressure overload : correlation between plasma neurohormones and right ventricular dysfunction

    NARCIS (Netherlands)

    Tulevski, I.I.; Groenink, M; van der Wall, EE; van Veldhuisen, DJ; Boomsma, F; Hirsch, A; Lemkes, JS; Mulder, BJM; Stoker, J

    Objective-To evaluate the role of plasma neurohormones in the diagnosis of asymptomatic or minimally symptomatic right ventricular dysfunction. Setting-Tertiary cardiovascular referral centre. Methods-Plasma brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) concentrations were

  19. Clinical significance of N-terminal pro-brain natriuretic peptide

    Institute of Scientific and Technical Information of China (English)

    张向阳; 朱继红

    2004-01-01

    @@ Traditionally, it was believed that the natriuretic peptide family (NPs) was composed of four natural peptides, i.e., atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), C-type natriuretic peptide (CNP) and urodilatin. All of them have the same 17-amino acid ring connected by bisulfate bond, which is essential for their biological activity.1 There are C-terminal and N-terminal tails on the ring. Each peptide encoded by an independent gene has its own tissue specificity and regulation mechanism. It is now suggested that beside the four traditional peptides, their precursors and the peptide fragments released by the activation or hydrolysis of the precursors, such as precursor of ANP and N-terminal proANP (NTANP), precursor of BNP and N-terminal proBNP (NTBNP) are also NPs. Furthermore, an artificially synthesized NP, vasonatrin peptide, is also a new member of NP family. In fish like eel, another peptide named ventricular natriuretic peptide was found. We now have a review on the clinical significance of NTBNP.

  20. Independent effects of both right and left ventricular function on plasma brain natriuretic peptide

    DEFF Research Database (Denmark)

    Vogelsang, Thomas Wiis; Jensen, Ruben J; Monrad, Astrid L;

    2007-01-01

    BACKGROUND: Brain natriuretic peptide (BNP) is increased in heart failure; however, the relative contribution of the right and left ventricles is largely unknown. AIM: To investigate if right ventricular function has an independent influence on plasma BNP concentration. METHODS: Right (RVEF), left......, which is a strong prognostic marker in heart failure, independently depends on both left and right ventricular systolic function. This might, at least in part, explain why BNP holds stronger prognostic value than LVEF alone....

  1. Prognostic significance of brain natriuretic peptide obtained in the ED in patients with SIRS or sepsis.

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    Chen, Yunxia; Li, Chunsheng

    2009-07-01

    The study was conducted to know the significance of brain natriuretic peptide (BNP) for prognosis of septic patients. The subjects were 1000 patients selected in emergency department of Beijing Chaoyang Hospital of the Capital Medical University (Beijing, China) and were classified into 3 groups as follows: systemic inflammatory response syndrome (SIRS), non-SIRS, and sepsis groups. Plasma serum brain natriuretic peptide (BNP) levels and the positive detection rates of BNP were examined. The BNP level of 100 pg/mL or more was regarded as positive, and then the positive detection rates of BNP of these groups were compared. The prognostic values of BNP and APACHE (Acute physiology and chronic health evaluation) II score for the 28-day mortality were investigated, and their cutoff values for death were determined. There were significant differences in the positive detection rates of BNP between any 2 groups and in 28-day mortality between the patients with SIRS and non-SIRS groups. The BNP level had positive correlation to APACHE II score in 3 groups. Brain natriuretic peptide level of more than 113 pg/mL was independent predictor of death in septic patients. The positive rates of BNP in SIRS and septic patients were significantly higher than that of non-SIRS patients, and this is an index for unfavorable prognosis in septic patients.

  2. Brain natriuretic peptide in pulmonary arterial hypertension: biomarker and potential therapeutic agent

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    Brian Casserly

    2009-11-01

    Full Text Available Brian Casserly, James R KlingerDivision of Pulmonary and Critical Care Medicine, The Memorial Hospital of Rhode Island, Pawtucket, RI, Rhode Island Hospital, Providence, RI, Alpert Medical School of Brown University, Providence, RI, USAAbstract: B-type natriuretic peptide (BNP is a member of the natriuretic peptide family, a group of widely distributed, but evolutionarily conserved, polypeptide mediators that exert myriad cardiovascular effects. BNP is a potent vasodilator with mitogenic, hypertrophic and pro-inflammatory properties that is upregulated in pulmonary hypertensive diseases. Circulating levels of BNP correlate with mean pulmonary arterial pressure (mPAP and pulmonary vascular resistance (PVR in patients with pulmonary arterial hypertension (PAH. Elevated plasma BNP levels are associated with increased mortality in patients with PAH and a fall in BNP levels after therapy is associated with improved survival. These findings have important clinical implications in that a noninvasive blood test may be used to identify PAH patients at high-risk of decompensation and to guide pulmonary vasodilator therapy. BNP also has several biologic effects that could be beneficial to patients with PAH. However, lack of a convenient method for achieving sustained increases in circulating BNP levels has impeded the development of BNP as a therapy for treating pulmonary hypertension. New technologies that allow transdermal or oral administration of the natriuretic peptides have the potential to greatly accelerate research into therapeutic use of BNP for cor pulmonale and pulmonary vascular diseases. This review will examine the basic science and clinical research that has led to our understanding of the role of BNP in cardiovascular physiology, its use as a biomarker of right ventricular function and its therapeutic potential for managing patients with pulmonary vascular disease.Keywords: brain natriuretic peptide, pulmonary artery hypertension

  3. Science Letters: Brain natriuretic peptide: A potential indicator of cardiomyogenesis after autologous mesenchymal stem cell transplantation?

    Institute of Scientific and Technical Information of China (English)

    LI Nan; WANG Jian-an

    2006-01-01

    We observed in a pilot study that there was a transient elevation of brain natriuretic peptide (BNP) level shortly after the transplantation in the patient with ischemic heart failure, which is unexplainable by the simultaneous increase of the cardiac output and six-minute walk distance. Similar findings were observed in the phase I trial. We postulated on the basis of the finding of Fukuda in vitro that this transient elevation of BNP level against the improvement of cardiac function and exercise capacity might indicate cardiomyogenesis in patients after mesenchymal stem cell transplantation. Further study is warranted to verify the hypothesis.

  4. Circulating N-terminal brain natriuretic peptide and cardiac function in response to acute systemic hypoxia in healthy humans

    NARCIS (Netherlands)

    I. Heinonen (Ilkka); M. Luotolahti (Matti); O. Vuolteenaho (Olli); M. Nikinmaa (Mikko); A. Saraste (Antti); J. Hartiala (Jaakko); J. Koskenvuo (Juha); J. Knuuti (Juhani); O. Arjamaa (Olli)

    2014-01-01

    textabstractBackground: As it remains unclear whether hypoxia of cardiomyocytes could trigger the release of brain natriuretic peptide (BNP) in humans, we investigated whether breathing normobaric hypoxic gas mixture increases the circulating NT-proBNP in healthy male subjects.Methods: Ten healthy y

  5. The response of circulating brain natriuretic peptide to academic stress in college students.

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    Amir, Offer; Sagiv, Moran; Eynon, Nir; Yamin, Chen; Rogowski, Ori; Gerzy, Yishay; Amir, Ruthie E

    2010-01-01

    Brain natriuretic peptide (BNP), a cardiac peptide, has been implicated in the regulation of hypothalamic-pituitary-adrenocortical (HPA) responses to psychological stressors. The influence of academic stress on circulating concentration of the N-terminal fragment of BNP precursor (NT-proBNP), and in relation to the stress hormone (cortisol) response was studied in 170 college students undergoing major examinations. Just prior to the examination, we measured self-estimated stress level, systolic, and diastolic blood pressure (SBP, DBP), heart rate (HR), plasma levels of cortisol, and NT-proBNP. These parameters were compared to the participants' baseline measurements, taken at the same hour of a different 'control day', without a major examination to induce stress. Hemodynamic variables (SBP, DBP, and HR) increased on the examination day compared with baseline values ( p stress was marked by a significant decrease in plasma NT-proBNP concentration (-40%, p stress and the NT-proBNP reduction ( p = 0.02). In response to academic stress, the plasma cortisol elevation was accompanied by a marked reduction in plasma NT-proBNP level. These data may indicate that mental stress entails an interface between the HPA axis and the peripheral natriuretic peptide system, leading to reciprocating changes in circulating levels of the corresponding hormones.

  6. Brain natriuretic peptide is a potent vasodilator in aged human microcirculation and shows a blunted response in heart failure patients

    DEFF Research Database (Denmark)

    Edvinsson, Marie-Louise; Uddman, Erik; Edvinsson, Lars;

    2014-01-01

    BACKGROUND: Brain natriuretic peptide (BNP) is normally present in low levels in the circulation, but it is elevated in parallel with the degree of congestion in heart failure subjects (CHF). BNP has natriuretic effects and is a potent vasodilator. It is suggested that BNP could be a therapeutic...... in the forearm was measured by laser Doppler Flowmetry. Local heating (+44°C, 10 min) was used to evoke a maximum local dilator response. RESULTS: Non-invasive iontophoretic administration of either BNP or acetylcholine (ACh), a known endothelium-dependent dilator, elicited an increase in local flow. The nitric...

  7. Biological characteristics of brain natriuretic peptide and its association with central nervous system diseases

    Institute of Scientific and Technical Information of China (English)

    Yubao Huang; Changxiang Yan; Chunjiang Yu

    2007-01-01

    OBJECTIVE: To explain the mechanisms of tuhe synthesis, secretion and regulation of brain natriuretic peptide (BNP), and analyze its role in central nervous system diseases.DATA SOURCES: An online search of Pubmed was undertaken to identify articles related to BNP published in English from January 1990 to February 2007 by using the Key words of "brain natriuretic peptide (BNP), central nervous system, subarachnoid hemorrhage (SAH), brain edema, epilepsy". Other articles were searched in China Hospital Knowledge Database (CHKD) by concrete name of journals and title of articles.STUDY SELECTION: The collected articles were primarily screened, those about BNP and its association with central nervous system diseases were selected, whereas the obviously irrelative ones excluded, and the full-texts of the other literatures were searched manually.DATA EXTRACTION: Totally 96 articles were collected, 40 of them were enrolled, and the other 56 were excluded due to repetitive studies or reviews.DATA SYNTHESIS: At present, there are penetrating studies on BNP in the preclinical medicine and clinical medicine of cerebrovascular and cardiovascular diseases, and the investigative outcomes have been gradually applied in clinical practice, and satisfactory results have been obtained. However, the application of BNP in diagnosing and treating central nervous system diseases is still at the experimental phase without -outstanding outcomes, thus the preclinical and clinical studies should be enhanced.CONCLUSION: As a kind of central medium or modulator, BNP plays a certain role in the occurrence,development and termination of central nervous system diseases, the BNP level in serum has certain changing law in AH,brainedema,epilepsy,etc., but the specific mechanisms are unclear.

  8. Brain-natriuretic peptide and cyclic guanosine monophosphate as biomarkers of myxomatous mitral valve disease in dogs

    DEFF Research Database (Denmark)

    Moesgaard, Sophia Gry; Falk, Bo Torkel; Teerlink, Tom

    2011-01-01

    Elevations in the plasma concentrations of natriuretic peptides correlate with increased severity of myxomatous mitral valve disease (MMVD) in dogs. This study correlates the severity of MMVD with the plasma concentrations of the biomarkers N-terminal fragment of the pro-brain-natriuretic peptide...... (NT-proBNP) and its second messenger, cyclic guanosine monophosphate (cGMP). Furthermore, the l-arginine:asymmetric dimethylarginine (ADMA) ratio was measured as an index of nitric oxide availability. The study included 75 dogs sub-divided into five groups based on severity of MMVD as assessed...... by clinical examination and echocardiography. Plasma NT-proBNP and cGMP concentrations increased with increasing valve dysfunction and were significantly elevated in dogs with heart failure. The cGMP:NT-proBNP ratio decreased significantly in dogs with heart failure, suggesting the development of natriuretic...

  9. NT-brain natriuretic peptide levels in pleural fluid distinguish between pleural transudates and exudates.

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    Tomcsányi, János; Nagy, Erzsébet; Somlói, Miklós; Moldvay, Judit; Bezzegh, Attila; Bózsik, Béla; Strausz, János

    2004-10-01

    Pleural effusion is not pathognomic and distinguishing between transudates and exudates often presents a diagnostic dilemma. The purpose of our study was to examine whether the inclusion of pleural fluid brain natriuretic peptide (BNP) measurement into the analysis improves the diagnostic accuracy of pleural effusion. The pleural effusion of 14 patients with CHF (group A) and 14 subjects with different pleural pathology (group B) were analyzed. Samples of pleural fluid and serum were obtained from all patients on admission and biochemical analysis, bacterial and fungal culture, acid-fast bacilli smear and culture and cytology were performed on the pleural fluid. In vitro quantitative determination of N-terminal pro-Brain natriuretic peptide (NT-proBNP) in serum and pleural fluid were performed by electrochemiluminescence immunoassay proBNP method on an Elecsys 2010 (Roche) analyzer. The median NT-proBNP levels in groups A and B were 6295 pg/ml and 276 pg/ml, respectively: (P=0.0001). There was no overlap between the two groups. While the Light's criteria had a sensitivity of 93% and specificity of 43% for transudates, the pleural fluid NT-proBNP level accurately differentiated between the two groups. The pleural NT-proBNP levels were elevated in all patients who had transudate. Therefore if the NT-proBNP levels of pleural effusion are within the normal range, transudate resulting from congestive heart failure can be ruled out. Our results suggest that the inclusion of pleural fluid NT-proBNP measurement in the routine diagnostic panel would enhance discrimination among the different causes of pleural effusions.

  10. Plasma brain natriuretic peptide levels are elevated in patients with cancer.

    Science.gov (United States)

    Bando, Sachiko; Soeki, Takeshi; Matsuura, Tomomi; Tobiume, Takeshi; Ise, Takayuki; Kusunose, Kenya; Yamaguchi, Koji; Yagi, Shusuke; Fukuda, Daiju; Iwase, Takashi; Yamada, Hirotsugu; Wakatsuki, Tetsuzo; Shimabukuro, Michio; Muguruma, Naoki; Takayama, Tetsuji; Kishimoto, Ichiro; Kangawa, Kenji; Sata, Masataka

    2017-01-01

    Natriuretic peptides have been proposed as biomarkers of cardiovascular disease, especially heart failure. Brain natriuretic peptide (BNP) has also been shown to be upregulated at the transcriptional and translational levels by pro-inflammatory cytokines in cardiac myocytes. Although we often measure plasma BNP levels in cancer patients, it remains unknown whether cancer-related inflammation affects the plasma BNP levels. We investigated the relationship between the BNP and human cancers. We retrospectively studied 2,923 patients in whom the plasma BNP levels and serum C-reactive protein (CRP) were measured and echocardiography was performed. Patients with clinically evident heart failure (NYHA II or higher), heart disease requiring medical treatment or surgery, renal dysfunction, and inflammatory disease were excluded. There were 234 patients in the final analysis. Blood sampling was performed before surgery and chemotherapy. In addition, we evaluated the relationship between the inflammation and plasma BNP levels in mouse models of colon cancer. Of the 234 patients, 80 were diagnosed with cancer. Both the plasma BNP and serum CRP levels were significantly higher in cancer patients than those without. There were no significant differences in the echocardiographic parameters. There was a significant positive correlation between the plasma BNP and serum CRP levels in cancer patients (r = 0.360, P<0.01) but not in those without. In cancer patients, only the CRP correlated with the BNP independent of the age, creatinine level, hypertension, and body mass index. In addition, in nude mice with subcutaneous colon cancer, the plasma BNP level was elevated compared with that in non-cancer mice, and there was a significant relationship between the plasma BNP and serum levels of the inflammatory markers. In cancer patients, as well as colon cancer model mice, the plasma BNP levels were elevated, possibly due to cancer-related inflammation. The effect of cancer on the BNP

  11. Prevalence and prognosis of heart failure with preserved ejection fraction and elevated N-terminal pro brain natriuretic peptide

    DEFF Research Database (Denmark)

    Carlsen, Christian Malchau; Bay, Morten; Kirk, Vibeke

    2012-01-01

    The aim of this study was to assess the epidemiological features and prognosis of heart failure with preserved ejection fraction (HFPEF) and to compare these findings with those from patients with reduced ejection fraction. Furthermore the effects of N-terminal pro brain natriuretic peptide (NT-pro......BNP) requirement in the heart failure diagnosis were assessed by repeating the analyses in the subgroup of patients with elevated NT-proBNP....

  12. Systemic inflammatory response syndrome following burns is mediated by brain natriuretic peptide/natriuretic peptide A receptor-induced shock factor 1 signaling pathway.

    Science.gov (United States)

    Xu, Yang-Cheng; Luo, Cheng-Qun; Li, Xiong

    2016-10-01

    The aim of this study was to determine whether systemic inflammatory response syndrome (SIRS) in burn patients is mediated by the brain natriuretic peptide (BNP)/natriuretic peptide A receptor (NPRA)-induced heat shock factor 1 (HSF-1) signalling pathway. Mononuclear cells (MNCs) that were isolated from patients with burn injuries and SIRS mouse models and a RAW264.7 cell line were treated with normal serum or serum obtained from animals with burn injuries. In parallel, small hairpin RNAs (shRNAs) against BNP or NPRA were transfected in both cell types. Western blotting (WB) and enzyme-linked immunosorbent assay (ELISA) were used to detect protein expression and inflammatory factor levels, respectively. We found that interleukin (IL)-12, tumour necrosis factor (TNF)-α, C-reactive protein (CRP), and BNP levels were increased and IL-10 levels were decreased in the plasma and MNCs in vivo in the animal model of SIRS. Additionally, NPRA was upregulated, whereas HSF-1 was downregulated in monocytes in vivo. Treatment of RAW264.7 cells with burn serum or BNP induced IL-12, TNF-α, and CRP secretion as well as HSF-1 expression. Finally, silencing BNP with shRNA interrupted the effect of burn serum on RAW264.7 cells, and silencing NPRA blocked burn serum- and BNP-mediated changes in RAW264.7 cells. These results suggest that the interaction of NPRA with BNP secreted from circulatory MNCs as well as mononuclear macrophages leads to inflammation via HSF-1 during SIRS development following serious burn injury.

  13. Brain natriuretic peptide improves long-term functional recovery after acute CNS injury in mice.

    Science.gov (United States)

    James, Michael L; Wang, Haichen; Venkatraman, Talaignair; Song, Pingping; Lascola, Christopher D; Laskowitz, Daniel T

    2010-01-01

    There is emerging evidence to suggest that brain natriuretic peptide (BNP) is elevated after acute brain injury, and that it may play an adaptive role in recovery through augmentation of cerebral blood flow (CBF). Through a series of experiments, we tested the hypothesis that the administration of BNP after different acute mechanisms of central nervous system (CNS) injury could improve functional recovery by improving CBF. C57 wild-type mice were exposed to either pneumatic-induced closed traumatic brain injury (TBI) or collagenase-induced intracerebral hemorrhage (ICH). After injury, either nesiritide (hBNP) (8 microg/kg) or normal saline were administered via tail vein injection at 30 min and 4 h. The mice then underwent functional neurological testing via rotorod latency over the following 5 days and neurocognitive testing via Morris water maze testing on days 24-28. Cerebral blood flow (CBF) was assessed by laser Doppler from 25 to 90 min after injury. After ICH, mRNA polymerase chain reaction (PCR) and histochemical staining were performed during the acute injury phase (<24 h) to determine the effects on inflammation. Following TBI and ICH, administration of hBNP was associated with improved functional performance as assessed by rotorod and Morris water maze latencies (p < 0.01). CBF was increased (p < 0.05), and inflammatory markers (TNF-alpha and IL-6; p < 0.05), activated microglial (F4/80; p < 0.05), and neuronal degeneration (Fluoro-Jade B; p < 0.05) were reduced in mice receiving hBNP. hBNP improves neurological function in murine models of TBI and ICH, and was associated with enhanced CBF and downregulation of neuroinflammatory responses. hBNP may represent a novel therapeutic strategy after acute CNS injury.

  14. Resting and dobutamine stress test induced serum concentrations of brain natriuretic peptide in German Shepherd dogs.

    Science.gov (United States)

    Spasojević Kosić, Ljubica; Trailović, Dragiša R; Matunović, Radomir

    2012-12-01

    Studies of clinical uses of brain natriuretic peptide (BNP) represent one of the most important advances in cardiology since the introduction of echocardiography as a clinical diagnostic procedure. Defining the clinical potential of BNP in canine cardiology has not been completed yet. The aim of this study is to measure BNP concentrations in healthy German Shepherd dogs of different ages as a baseline in resting and when conventional protocol of the dobutamine stress test (DST) is applied to dogs. Concentrations of BNP were measured in blood serum by the radioimmunoassay method. The values of BNP concentrations were compared to cardiac parameters obtained by standard cardiac diagnostic procedures (radiology, electrocardiography and echocardiography). No significant differences in serum BNP concentrations existed in dogs of different ages. A statistically significant increase in BNP concentrations was registered after DST. These changes in BNP concentrations were related to ST/T electrocardiographic changes, and correlated to changes in the left ventricular internal diameter in systole (LVESD). These data suggest that BNP is not increased in aged dogs with normal cardiac systolic function and renal function, and that myocardial ischemia leads to a significant increase in BNP concentrations even in dogs with normal left ventricular function.

  15. Cortical Brain Connectivity and B-Type Natriuretic Peptide in Patients With Congestive Heart Failure.

    Science.gov (United States)

    Vecchio, Fabrizio; Miraglia, Francesca; Valeriani, Lavinia; Scarpellini, Maria Gabriella; Bramanti, Placido; Mecarelli, Oriano; Rossini, Paolo M

    2015-07-01

    The brain has a high level of complexity and needs continuous oxygen supply. So it is clear that any pathological condition, or physiological (aging) change, in the cardiovascular system affects functioning of the central nervous system. We evaluated linear aspects of the relationship between the slowness of cortical rhythms, as revealed by the modulation of a graph connectivity parameter, and congestive heart failure (CHF), as a reflection of neurodegenerative processes. Eyes-closed resting electroencephalographic (EEG) data of 10 patients with CHF were recorded by 19 electrodes positioned according the international 10-20 system. Graph theory function (normalized characteristic path length λ) was applied to the undirected and weighted networks obtained by lagged linear coherence evaluated by eLORETA software, therefore getting rid of volumetric propagation influences. The EEG frequency bands of interest were: delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13 Hz), beta 1 (13-20 Hz), beta 2 (20-30 Hz), and gamma (30-40 Hz). The analysis between B-type natriuretic peptide (BNP) values and λ showed positive correlation in delta, associated with a negative correlation in alpha 2 band. Namely, the higher the severity of the disease (as revealed by the BNP vales), the higher the λ in delta, and lower in alpha 2 band. Results suggest that delta and alpha λ indices are good markers of the severity of CHF.

  16. Changes of Plasma Levels of Brain Natriuretic Peptide in Patients with Chronic Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Pei Xiaoyang; Pan Ying; Hu Xuesong; Li Song; Xu Yawei; Yu Xuejing

    2006-01-01

    Objectives To investigate the changes of plasma brain natriuretic peptide (BNP) levels in patients with chronic heart failure (CHF).Methods Plasma BNP concentrations in patients with CHF (n=56) and in normal controls (n=60) were measured with specific radioimmunoassay. Left ventricular ejection fraction in patients with chronic heart failure was measured with 99mTc gated cardiac blood pool scintigraphy. Results The results showed that Plasma BNP concentrations in patients with CHF were significantly higher than normal controls (223±79 ng/L vs 40±15 ng/L, P < 0.01). Plasma BNP concentrations had a significant negative correlation with left ventricular ejection fractions(r=-0.68, P <0.01 ). Conclusions These results indicates that Plasma BNP levels are increased in patients with CHF, and they markedly increased according to the severity of heart failure classified by NYHA classification. The plasma BNP levels may be a biochemical parameter for evaluating the left ventricular function.

  17. Anemia as a factor that elevates plasma brain natriuretic peptide concentration in apparently healthy subjects.

    Science.gov (United States)

    Matsumoto, Mika; Tsujino, Takeshi; Naito, Yoshiro; Lee-Kawabata, Masaaki; Ezumi, Akira; Yamamoto, Kazuhiro; Mano, Toshiaki; Masuyama, Tohru

    2008-09-01

    Plasma brain natriuretic peptide (BNP) is widely used as a biomarker of heart failure (HF); however, its concentration is often found to be high even in apparently healthy subjects and little is known about which factors contribute to physiological change in plasma BNP concentration in subjects without HF. We examined the effects of gender, age, and anemia on plasma BNP concentration in apparently healthy subjects. The study population consisted of 1036 healthy subjects who underwent an annual health examination at their company in 2005. There were 874 women, ranging in age from 30 to 63 years (mean, 41 years). Plasma BNP concentration was abnormal (> 18.4 pg/mL) in 292 subjects. The incidence was significantly higher in women than in men (31% versus 14%, P < 0.01). Mean plasma BNP concentration was higher in women than in men. The difference in plasma BNP concentration was associated with the difference in blood hemoglobin and age. Logarithmically transformed BNP concentration correlated inversely with blood hemoglobin (r = -0.30, P < 0.01 for all; r = -0.21, P < 0.01 for women; r = -0.20, P < 0.01 for men). By multiple regression analysis, logarithmically transformed BNP concentration correlated with hemoglobin, age, and gender. In conclusion, anemia is likely a critical determinant that elevates plasma BNP concentration in apparently healthy subjects.

  18. Biologic variability of N-terminal pro-brain natriuretic peptide in adult healthy cats.

    Science.gov (United States)

    Harris, Autumn N; Estrada, Amara H; Gallagher, Alexander E; Winter, Brandy; Lamb, Kenneth E; Bohannon, Mary; Hanscom, Jancy; Mainville, Celine A

    2017-02-01

    Objectives The biologic variability of N-terminal pro-brain natriuretic peptide (NT-proBNP) and its impact on diagnostic utility is unknown in healthy cats and those with cardiac disease. The purpose of this study was to determine the biologic variation of NT-proBNP within-day and week-to-week in healthy adult cats. Methods Adult cats were prospectively evaluated by complete blood count (CBC), biochemistry, total thyroxine, echocardiography, electrocardiography and blood pressure, to exclude underlying systemic or cardiac disease. Adult healthy cats were enrolled and blood samples were obtained at 11 time points over a 6 week period (0, 2 h, 4 h, 6 h, 8 h, 10 h and at weeks 2, 3, 4, 5 and 6). The intra-individual (coefficient of variation [CVI]) biologic variation along with index of individuality and reference change values (RCVs) were calculated. Univariate models were analyzed and included comparison of the six different time points for both daily and weekly samples. This was followed by a Tukey's post-hoc adjustment, with a P value of cats. Further research is warranted to evaluate NT-proBNP variability, particularly how serial measurements of NT-proBNP may be used in the diagnosis and management of cats with cardiac disease.

  19. The evaluation of brain natriuretic peptide changes and difficult airway predictors during perioperative period of pregnancy.

    Science.gov (United States)

    Basaranoglu, G; Umutoglu, T; Bakan, M; Esen, A; Ates, S; Bacaksiz, A; Salihoglu, Z

    2016-02-01

    Airway changes, difficult ventilation, and intubation are the leading causes of morbidity and mortality in pregnancy, but no prospective study has evaluated the relationship between airway changes and brain natriuretic peptide (BNP) before and after cesarean section operations. The purpose of this study was to evaluate the relationship between BNP and airway changes in women undergoing delivery and during the postoperative period. Included in this prospective study were a total of 35 pregnant females with ASA I physical status who were scheduled for cesarean section under general anesthesia. BNP levels, Mallampati classification, mouth opening, thyromental distance, sternomental distance, and the degree of neck extension were recorded before cesarean section and 24 h after the operation. Laryngeal views were also documented after intubation. Significant differences in BNP levels, Mallampati classification, mouth opening, thyromental distance, sternomental distance, and the degree of neck extension measurements arose between initial measurements and those measurements made 24 h postoperatively. Pre-delivery Mallampati I, II, III, IV scores of 6, 18, 7, 4 had by 24 h after cesarean section changed to 13, 13, 6, 3, respectively (p < 0.05). Initial BNP levels were 7.59 ± 6.30; postoperative levels were 52.39 ± 48.17. In this study we found a correlation between perioperative BNP levels and difficult intubation parameters. Within 24 h postpartum, Mallampati scores changed in 13 patients (30.95 %). Besides the correlation between BNP levels and difficult intubation parameters, we also found significant differences in initial and postoperative BNP values.

  20. Brain Natriuretic Peptide Stimulates Lipid Metabolism through Its Receptor NPR1 and the Glycerolipid Metabolism Pathway in Chicken Adipocytes.

    Science.gov (United States)

    Huang, H Y; Zhao, G P; Liu, R R; Li, Q H; Zheng, M Q; Li, S F; Liang, Z; Zhao, Z H; Wen, J

    2015-11-03

    Brain natriuretic peptide (BNP) is related to lipid metabolism in mammals, but its effect and the molecular mechanisms underlying it in chickens are incompletely understood. We found that the level of natriuretic peptide precursor B (NPPB, which encodes BNP) mRNA expression in high-abdominal-fat chicken groups was significantly higher than that of low-abdominal-fat groups. Partial correlations indicated that changes in the weight of abdominal fat were positively correlated with NPPB mRNA expression level. In vitro, compared with the control group, preadipocytes with NPPB interference showed reduced levels of proliferation, differentiation, and glycerin in media. Treatments of cells with BNP led to enhanced proliferation and differentiation of cells and glycerin concentration, and mRNA expression of its receptor natriuretic peptide receptor 1 (NPR1) was upregulated significantly. In cells exposed to BNP, 482 differentially expressed genes were identified compared with controls without BNP. Four genes known to be related to lipid metabolism (diacylglycerol kinase; lipase, endothelial; 1-acylglycerol-3-phosphate O-acyltransferase 1; and 1-acylglycerol-3-phosphate O-acyltransferase 2) were enriched in the glycerolipid metabolism pathway and expressed differentially. In conclusion, BNP stimulates the proliferation, differentiation, and lipolysis of preadipocytes through upregulation of the levels of expression of its receptor NPR1 and key genes enriched in the glycerolipid metabolic pathway.

  1. Alteration of Plasma Brain Natriuretic Peptide Level After Acute Moderate Exercise in Professional Athletes

    Directory of Open Access Journals (Sweden)

    Homa Sheikhani

    2011-12-01

    Full Text Available Background: Cardiac fatigue or myocardial damage following exercise until complete exhaustion can increase blood levels of brain natriuretic peptide (BNP in athletes. Objectives: The aim of the present study was to investigate the effect of resistance and acute moderate aerobic exercise on alterations in BNP levels in professional athletes. Materials and Methods: Forty professional athletes who had at least 3 years of a championship background in track and field (aerobic group or body building (resistance group volunteered to participate in the present study. Track and field athletes (n = 20 were requested to run 8 km at 60% to 70% of maximum heart rate. Body building athletes (n = 20 performed a resistance training session of 5 exercises in 3 sets of 10 repetitions at 75% of 1 RM (bench press, seated row, leg extension, leg curl, and leg press. Before and immediately after the exercise, plasma BNP levels of both groups of athletes were measured by PATHFASTTM NT-proBNP assay, an immunochemiluminescent assay using two polyclonal antibodies in sandwich test format, on a PATHFASTTM automated analyzer. Results: Plasma BNP levels immediately following exercise increased significantly as compared with baseline values. Plasma BNP concentrations in the aerobic group were significantly higher than in the resistance group before and after exercise. Moreover, the increase in mean BNP concentrations in aerobic athletes was 7 times more than in resistance athletes. Conclusions: BNP levels in athlete who performed distance exercises increased significantly compared with resistance training. Possibly exercise program type, intensity of exercise, volume of exercise program, and field sport can be factors of changes in BNP levels

  2. Brain natriuretic peptide correlates with troponin T in patients with renal failure.

    Science.gov (United States)

    Sahinarslan, Asife; Guz, Galip; Okyay, Kaan; Torer, Nihan; Bali, Musa; Sindel, Sükrü; Cengel, Atiye

    2007-04-01

    In patients with chronic renal failure, the main cause of mortality is cardiovascular disease. Cardiac troponin T (cTnT) and brain natriuretic peptide (BNP) are found to be related with decreased survival in both the normal population and in patients with chronic renal failure in different studies. Our aim is to investigate the relationship between cTnT and BNP in patients with chronic renal failure. 58 chronic haemodialysis patients were enrolled prospectively for the study. Blood samples for measurement of cTnT and BNP were collected after the haemodialysis. The patients are divided into 3 groups according to cTnT measurements. Group I included the patients with cTnT 0. 1 ng/ml. We performed echocardiography in all patients to measure the left ventricular ejection fraction and thickness of septum and posterior wall. When BNP levels were compared among the 3 groups, we found that the BNP level was lowest in group I and highest in group III (165.13 +/- 125.44 pg/dl; 236.0 +/- 107.83 pg/dl; 280.71 +/- 153.25 pg/dl, respectively) (P = 0.01).The difference in BNP levels among groups was statistically significant and independent from left ventricular hypertrophy, left ventricular ejection fraction and volume overload in multiple regression analysis. We also searched the relationship between plasma cTnT and BNP levels and found a positive correlation (r = 0.3; P = 0.023). cTnT and BNP levels were related to each other in patients with chronic renal failure.These parameters can help to identify the patients with a high risk for cardiovascular diseases.

  3. The association between brain natriuretic peptide and tissue Doppler parameters in children with hypertrophic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Taliha Öner

    2016-01-01

    Full Text Available In this study, we investigated the association between brain natriuretic peptide (BNP levels and tissue Doppler imaging measurements and also screening for deadly mutations in patients with hypertrophic cardiomyopathy (HCM. We enrolled 20 patients diagnosed with HCM (age:10.7±5 years (1-17, 85% male, weight:42.25±23.10 kg, height:141.80±32.45 cm and 20 age, gender and body weight-matched control subjects. We performed electrocardiography, transthoracic echocardiography, and tissue Doppler echocardiography in each group, as well as genetic tests (for Arg403Gln, Arg453Cys, Arg719Trp and Arg719Gln mutations in MYH7 Exons 13, 14, 19 and BNP in the patients. The patients were divided into two groups according to the presence (Group 1 or absence (Group 2 of left ventricular (LV outflow tract obstruction. QTc dispersion and the LV ejection fraction and left atrial (LA volume index were increased in Group 1. The LA volume index and the mitral and septal E/Ea ratio and septum Z-score were increased while the mitral lateral annulus and septal annulus Ea wave velocities and the mitral and tricuspid E/A ratio were decreased in patients with high levels of BNP compared to those with normal BNP levels. There were no mutations that are associated with increased risk of sudden death found in patients included in this study. In the light of our data, we conclude that such parameters BNP levels above the 98 pg/mL, septal thickness Z-score ˃6, and higher mitral and septal E/Ea ratios can be used for management of patients with HCM according to life-threatening conditions.

  4. Permeability and contractile responses of collecting lymphatic vessels elicited by atrial and brain natriuretic peptides

    Science.gov (United States)

    Scallan, Joshua P; Davis, Michael J; Huxley, Virginia H

    2013-01-01

    Atrial and brain natriuretic peptides (ANP and BNP, respectively) are cardiac hormones released into the bloodstream in response to hypervolaemia or fluid shifts to the central circulation. The actions of both peptides include natriuresis and diuresis, a decrease in systemic blood pressure, and inhibition of the renin–angiotensin–aldosterone system. Further, ANP and BNP elicit increases in blood microvessel permeability sufficient to cause protein and fluid extravasation into the interstitium to reduce the vascular volume. Given the importance of the lymphatic vasculature in maintaining fluid balance, we tested the hypothesis that ANP or BNP (100 nm) would likewise elevate lymphatic permeability (Ps) to serum albumin. Using a microfluorometric technique adapted to in vivo lymphatic vessels, we determined that rat mesenteric collecting lymphatic Ps to rat serum albumin increased by 2.0 ± 0.4-fold (P= 0.01, n= 7) and 2.7 ± 0.8-fold (P= 0.07, n= 7) with ANP and BNP, respectively. In addition to measuring Ps responses, we observed changes in spontaneous contraction amplitude and frequency from the albumin flux tracings in vivo. Notably, ANP abolished spontaneous contraction amplitude (P= 0.005) and frequency (P= 0.006), while BNP augmented both parameters by ∼2-fold (P < 0.01 each). These effects of ANP and BNP on contractile function were examined further by using an in vitro assay. In aggregate, these data support the theory that an increase in collecting lymphatic permeability opposes the absorptive function of the lymphatic capillaries, and aids in the retention of protein and fluid in the interstitial space to counteract volume expansion. PMID:23897233

  5. A novel bioassay for the activity determination of therapeutic human brain natriuretic peptide (BNP.

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    Lei Yu

    Full Text Available BACKGROUND: Recombinant human brain natriuretic peptide (rhBNP is an important peptide-based therapeutic drug indicated for the treatment of acute heart failure. Accurate determination of the potency of therapeutic rhBNP is crucial for the safety and efficacy of the drug. The current bioassay involves use of rabbit aortic strips, with experiments being complicated and time-consuming and markedly variable in results. Animal-less methods with better precision and accuracy should be explored. We have therefore developed an alternative cell-based assay, which relies on the ability of BNP to induce cGMP production in HEK293 cells expressing BNP receptor guanylyl cyclase-A. METHODOLOGY/PRINCIPAL FINDINGS: An alternative assay based on the measurement of BNP-induced cGMP production was developed. Specifically, the bioassay employs cells engineered to express BNP receptor guanylyl cyclase-A (GCA. Upon rhBNP stimulation, the levels of the second messager cGMP in these cells drastically increased and subsequently secreted into culture supernatants. The quantity of cGMP, which corresponds to the rhBNP activity, was determined using a competitive ELISA developed by us. Compared with the traditional assay, the novel cell-based assay demonstrated better reproducibility and precision. CONCLUSION/SIGNIFICANCE: The optimized cell-based assay is much simpler, more rapid and precise compared with the traditional assay using animal tissues. To our knowledge, this is the first report on a novel and viable alternative assay for rhBNP potency analysis.

  6. Prognostic Importance of Exercise Brain Natriuretic Peptide in Asymptomatic Chronic Organic Severe Mitral Regurgitation: An Observational Study

    Science.gov (United States)

    Sinha, Santosh Kumar; Garg, Shalini; Thakur, Ramesh; Krishna, Vinay; Singh, Karandeep; Sachan, Mohit; Goel, Amit; Razi, Mahamdula; Pandey, Umeshwar; Varma, Chandra Mohan

    2016-01-01

    Background The optimal timing of surgery in patients with chronic organic severe mitral regurgitation (MR) continues to be debated, especially for those who are asymptomatic. The aim of the study was to determine independent and additive prognostic value of exercise brain natriuretic peptide (eBNP) in patients with severe asymptomatic MR and normal left ventricular ejection fraction (LVEF). Methods Two hundred twenty-three consecutive patients with severe MR defined by effective regurgitant orifice (ERO) area ≥ 40 mm2 and/or residual volume ≥ 60 mL, LVEF > 60%, and normal LV end-systolic diameter free survival and might be considered for early MVR.

  7. Association between brain natriuretic peptide, markers of inflammation and the objective and subjective response to cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Brouwers, Corline; Versteeg, Henneke; Meine, Mathias;

    2014-01-01

    Introduction: Studies suggest that cardiac resynchronization therapy (CRT) can induce a decrease in brain natriuretic peptide (BNP) and systemic inflammation, which may be associated with CRT-response. However, the evidence is inconclusive. We examined levels of BNP and inflammatory markers from...... ventricular end systolic volume; subjective CRT-response was defined as an improvement of ⩾10 points in patient-reported health status assessed with the Kansas City Cardiomyopathy Questionnaire. Plasma BNP and markers of inflammation (CRP, IL-6, TNFα, sTNFr1 and sTNFr2) were measured at three time points......=27.31, pinflammation. This indicates that response to CRT...

  8. Prognostic usefulness of anemia and N-terminal pro-brain natriuretic peptide in outpatients with systolic heart failure

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Kistorp, Caroline N

    2007-01-01

    N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and anemia are predictors of outcome in systolic heart failure. It is currently unclear how these 2 markers interact in particular with regard to the prognostic information carried by each risk marker. We therefore tested the hypothesis...... that anemia (World Health Organization criteria, hemoglobin levels ... prospectively at the baseline visit to our heart failure clinic (inclusion criterion left ventricular ejection fraction anemia was 27%. In a multivariate logistic regression model, anemia (p = 0...

  9. Plasma pro-brain natriuretic peptide and electrocardiographic changes in combination improve risk prediction in persons without known heart disease

    DEFF Research Database (Denmark)

    Jørgensen, Peter G; Jensen, Jan S; Appleyard, Merete

    2015-01-01

    BACKGROUND: Though the electrocardiogram(ECG) and plasma pro-brain-natriuretic-peptide (pro-BNP) are widely used markers of subclinical cardiac injury and can be used to predict future cardiovascular disease(CVD), they could merely be markers of the same underlying pathology. We aimed to determine...... cohort study. Median follow-up was 10.4 years. High pro-BNP was defined as above 90th percentile of age and sex adjusted levels. The end-points were all-cause mortality and the combination of admission with ischemic heart disease, heart failure or CVD death. RESULTS: ECG changes were present in 907...

  10. Heart murmur and N-terminal pro-brain natriuretic peptide as predictors of death in 2977 consecutive hospitalized patients

    DEFF Research Database (Denmark)

    Iversen, Kasper; Nielsen, O.W.; Kirk, V.

    2008-01-01

    Background: Little is known about the prognostic importance of murmur in unselected patients. It is difficult to distinguish between innocent and significant murmurs. N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and BNP have recently been shown to be useful in small series of patients......-pro-BNP, discovery of valvular heart disease by echocardiography yielded no additional prognostic information. Conclusions: Detection of a cardiac murmur during routine medical examination of hospitalized patients is associated with increased risk of death within a year. A blood test for NT-pro-BNP gives significant...

  11. Brain natriuretic peptide as a predictor of heart failure in patients with permanent pacemaker

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    Jelić Vera

    2007-01-01

    Full Text Available Introduction: Brain natriuretic peptide (BNP has a role in control of cardiovascular and renal functions. Objective The objective was to assess the predictive value of BNP levels for development of heart failure in patients with permanent pacemakers. Method In patients with implanted DDD pacemakers, BNP levels were measured at rest and after exercise testing, on DDD and VVI modes. There were 42 patients (25 males; 59.5%, without symptoms or signs of coronary disease or heart failure, and with normal echocardiograms. According to BNP levels, the patients were divided into three groups: with BNP levels lower than 80 pg/ml, BNP ranging from 81-150 pg/ml, and BNP levels over 151 pg/ml. Results In the first group (27 patients, BNP levels were significantly higher on VVI compared to DDD mode, both at rest and after exercise (p<0.01, with all BNP levels within normal range. In the second group (5 pts, BNP levels at rest were also significantly higher on VVI than on DDD mode, p<0.05. After exercise, these values were also higher on VVI compared to DDD mode, but without statistical significance. The third group (10 pts as a whole had higher BNP values on VVI compared to DDD mode, with no statistical significance. In patients from this group who later developed heart failure, BNP levels were found to be significantly lower on DDD as opposed to VVI mode at rest, p<0.05, and even higher significance was found after exercise, p<0.01. After 6-year follow-up, 2 out of 5 patients from the second group developed dilated cardiomyopathy, and 8/10 patients in the third group experienced heart failure with LV EF 34.1±10%, LV EDD 6.1±0.42 cm, LV ESD 4.8±0.45 cm. Five of these patients died within the follow-up period. Conclusion The increased BNP levels can be valuable for early screening of patients with higher risk of heart failure. In patients with increased BNP at the time of pacemaker implantation, DDD pacing is a modality of choice.

  12. Predicting Successful Pulmonary Vein Isolation In Patients With Atrial Fibrillation By Brain Natriuretic Peptide Plasma Levels

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    Dong-In Shin

    2009-09-01

    Full Text Available Background: Catheter ablation for atrial fibrillation is a clinically established treatment by now while success rate varies between 60% and 85%. Interventional treatment of atrial fibrillation is still a challenging technique associated with a long procedure time and risk of major complications in up to 6 % of treated patients. The aim of this study was to investigate the predictive value of plasma brain natriuretic peptide (BNP in patients undergoing pulmonary vein isolation concerning stable sinus rhythm after ablation.Methods: In 68 consecutive patients with atrial fibrillation (AF and normal left ventricular ejection fraction, BNP was measured at baseline before pulmonary vein isolation (PVI. All patients received a 7-days-holter monitoring 3 months after radiofrequency (RF ablation in order to detect recurrent AF episodes. Results: 48 patients with paroxysmal and 20 patients with persistent AF were enrolled. Baseline BNP was significantly higher in patients with persistent AF compared to patients with paroxysmal AF (145,5 pg/ml vs. 84,4 pg/ml; p<0,05. 3 months after PVI 38 patients (79,1% with paroxysmal AF had a stable sinus rhythm documented on 7-days-holter monitoring, where as in 10 patients (20,9% AF episodes were detected. Patients with a successful PVI showed significantly lower BNP plasma levels at baseline compared to patients with AF recurrrence (68,7 pg/ml vs. 144,1 pg/ml; p<0,05. In patients with persistent AF 55% (11 cases had no recurrence of AF at 3 months 7-days holter and in 9 patients (45% AF recurred. BNP plasma levels at baseline were lower in patients with stable sinusrhythm after 3 months compared to the group of recurrent AF (105,8 pg/ml vs. 193,3 pg/ml; p=0,11. Conclusion: Patients with AF and low preprocedural BNP plasma levels showed a better outcome after PVI. Thus BNP may be helpful in patient selection for a successful treatment of AF by PVI.

  13. Detection of left ventricular enlargement and impaired systolic function with plasma N-terminal pro brain natriuretic peptide concentrations

    DEFF Research Database (Denmark)

    Grønning, Bjørn Aaris; Nilsson, Jens C.; Søndergaard, Lars

    2002-01-01

    BACKGROUND: Brain- and N-terminal pro brain natriuretic peptide (NT-proBNP) have been identified as promising markers for heart failure. However, previous studies have revealed that they may hold insufficient diagnostic power for implementation into clinical practice because of a significant...... to investigate the diagnostic potential of NT-proBNP with magnetic resonance imaging as the reference method for the cardiac measurements. METHODS: Forty-eight patients with stable symptomatic heart failure in New York Heart Association functional classifications II to IV were examined once with blood samples...... and magnetic resonance imaging along with 20 age-matched and gender-matched healthy control subjects. RESULTS: NT-proBNP was associated with LV end-diastolic (r = 0.69; P

  14. The influence of anaemia on stroke prognosis and its relation to N-terminal pro-brain natriuretic peptide

    DEFF Research Database (Denmark)

    Nybo, M; Kristensen, S R; Mickley, H;

    2007-01-01

    Anaemia is a negative prognostic factor for patients with heart failure and impaired renal function, but its role in stroke patients is unknown. Furthermore, anaemia has been shown to influence the level of N-terminal pro-brain natriuretic peptide (NT-proBNP), but this is only investigated...... in patients with heart failure, not in stroke patients. Two-hundred-and-fifty consecutive, well-defined ischemic stroke patients were investigated. Mortality was recorded at 6 months follow-up. Anaemia was diagnosed in 37 patients (15%) in whom stroke severity was worse than in the non-anaemic group, whilst...... the prevalence of renal affection, smoking and heart failure was lower. At 6 months follow-up, 23 patients were dead, and anaemia had an odds ratio of 4.7 when adjusted for age, Scandinavian Stroke Scale and a combined variable of heart and/or renal failure and/or elevation of troponin T using logistic...

  15. 脑钠肽临床应用进展%Advances in Clinical Application of Brain Natriuretic Peptide

    Institute of Scientific and Technical Information of China (English)

    金涛; 戴晓莉; 胡玉霞

    2012-01-01

    Brain natriuretic peptide (BNP) is one of the most attentive cardiovascular physiological biomarkers in recent years, It is a major peptide hormone secreted by the heart, and it plays an important compensatory role in maintaining heart normal structure and function. It's has satisfaction row, urination, vasodilators, and lowering blood pressure and so on in the human body, inhibitting RAAS system and sympathetic nervous system. BNP has a closing relationship with differential diagnosis of dyspnea, myocardial infarction, hypertension, fibrillation, cardiomyopathy, pulmonary embolism and so on. Now this paper will reviewe on BNP's research progress.%脑钠肽(brain natriuretic peptide,BNP)是近年倍受关注的心血管生物标记物,BNP是一种主要由心脏分泌的肽类激素,在心脏维持其正常结构和功能的中起着重要的作用,它具有利钠、利尿、扩血管、降压、拮抗RAAS系统、抑制交感神经兴奋等作用.它已超过原来仅作为心衰的诊断检测指标范畴.研究表明BNP与呼吸困难的鉴别诊断、心肌梗死、高血压、心房颤动、心肌病、肺栓塞等关系密切,现就BNP的临床研究进展作一综述.

  16. Effect of recombinant human brain natriuretic peptide-assisted interventional treatment on prognosis of acute myocardial infarction patients complicated with cardiogenic shock

    Institute of Scientific and Technical Information of China (English)

    Xi-Zhou Chen

    2016-01-01

    Objective:To analyze the effect of recombinant human brain natriuretic peptide-assisted interventional treatment on prognosis of acute myocardial infarction patients complicated with cardiogenic shock.Methods: A total of 112 cases of inpatients treated in Cardiology Department of our hospital from March 2013 to March 2015 were selected, all of whom had acute myocardial infarction within 12 hours of onset and received direct PCI treatment. They were divided into observation group and control group according to random number table, each group with 56 cases, control group received conventional interventional treatment and observation group received recombinant human brain natriuretic peptide-assisted interventional treatment. Then differences of regional myocardial deformability, myocardial enzyme spectrum indicators, brain natriuretic peptide and inflammatory factors, blood sugar and stress hormones as well as myocardial infarction prognosis-associated indexes, etc, between two groups after treatment were compared.Results:After treatment, LVEF, SRs, SRe and Sra levels of observation group were higher than those of control group, WMSI level was lower than that of control group; serum myocardial enzyme spectrum indicators CK, CK-MB, AST and LDH values were lower than those of control group; serum BNP, CRP, TNF-α and IL-6 levels were lower than those of control group; serum cortisol, growth hormone and glucagon levels were lower than those of control group, insulin level was higher than that of control group; FT3 and IGF-1 levels were higher than those of control group, sPLA2 and Hcy levels were lower than those of control group.Conclusion: Recombinant human brain natriuretic peptide-assisted interventional treatment for acute myocardial infarction patients complicated with cardiogenic shock can reduce myocardial function injury, protect normal myocardial function and optimize patients' long-term prognosis; it has active clinical significance.

  17. Effect of compound danshen dropping pill on angina as well as serum c-reactive protein (CRP) and brain natriuretic peptide (BNP)

    Institute of Scientific and Technical Information of China (English)

    Jing Ye

    2016-01-01

    Objective:To study the effect of Compound Danshen Dropping Pill on angina as well as serum C-reactive protein (CRP) and brain natriuretic peptide (BNP) so as to provide reference for clinical treatment.Methods: Patients with angina treated in our hospital from February 2010 to August 2015 were enrolled in this research. The effect of Compound Danshen Dropping Pill on angina as well as serum C reaction protein (CRP) and brain natriuretic peptide (BNP) were analyzed. 110 cases of healthy subjects receiving physical examination in our hospital during the same period were taken as control.Results: After treatment, the duration of angina significantly decreased, the frequency of angina pectoris attack significantly decreased, and serum inflammatory factors IL1, IL2 and IL6 as well as Hcy, TG, TC and LDL levels significantly decreased while HDL, folic acid and vitamin B12 levels significantly increased, and compared with before treatment, differences were with notable statistical significance. Conclusion: Compound Danshen Dropping Pill can effectively treat angina, which is related to its regulation of serum C-reactive protein, brain natriuretic peptide and inflammatory factor levels.

  18. Effect of recombinant human brain natriuretic peptide combined with sodium nitroprusside therapy on hemodynamics and cardiac in patients with acute decompensated heart failure

    Institute of Scientific and Technical Information of China (English)

    Qiao-Li Xing; Xian-Hong Ma; Lu Wang

    2016-01-01

    Objective:To evaluate the effect of recombinant human brain natriuretic peptide combined with sodium nitroprusside therapy on hemodynamics and cardiac function levels in patients with acute decompensated heart failure.Methods:A total of 118 patients with acute decompensated heart failure were randomly divided into observation group and the control group (n=59). Control group received clinical conventional therapy for heart failure, observation group received recombinant human brain natriuretic peptide combined with sodium nitroprusside therapy, and the differences in hemodynamics, cardiac function and circulation factor levels were compared between two groups after 12 hours of treatment. Results: After 12 hours of treatment, central venous pressure, right atrial pressure and pulmonary capillary wedge pressure values as well as circulating blood IL-6, hsCRP, ST2, NT-proBNP and cTnⅠlevels of observation group were lower than those of control group, and left heart GLS, GCS, GSRs, GSRe, GSRa, ROT and ROTR levels were higher than those of control group (P<0.05).Conclusions:Recombinant human brain natriuretic peptide combined with sodium nitroprusside therapy for patients with acute decompensated heart failure has significant advantages in optimizing hemodynamics, cardiac function and other aspects.

  19. The relationship between N-terminal pro-brain natriuretic peptide and risk for hospitalization and mortality is curvilinear in patients with chronic heart failure

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Corell, Pernille

    2007-01-01

    BACKGROUND: N-terminal pro-brain natriuretic peptide (NT-proBNP) carries prognostic information in patients with chronic heart failure and predicts risk for mortality and cardiovascular events. It is unknown whether NT-proBNP predicts risk for hospitalization for any cause. Furthermore, a clinica......BACKGROUND: N-terminal pro-brain natriuretic peptide (NT-proBNP) carries prognostic information in patients with chronic heart failure and predicts risk for mortality and cardiovascular events. It is unknown whether NT-proBNP predicts risk for hospitalization for any cause. Furthermore...... of doubling NT-proBNP on adjusted hazard ratios was 1.56 (95% CI 1.32-1.85) for mortality and 1.19 (95% CI 1.09-1.31) for hospitalization. We observed a curvilinear relationship between NT-proBNP and risk for mortality and hospitalization in the whole range of NT-proBNP. CONCLUSIONS: N-terminal pro-brain...... natriuretic peptide predicts risk for hospitalization and mortality. A simple algorithm indicates that every time NT-proBNP is doubled, estimated hazard ratio for death increases by a factor of 1.56 (56%) and by a factor of 1.19 (19%) for hospitalization. Finally, the relationship between NT-proBNP and risk...

  20. 脑利钠肽BNP的临床应用进展%Clinical Research Progress of Brain Natriuretic Peptide

    Institute of Scientific and Technical Information of China (English)

    杨欣; 任斌辉; 许林

    2013-01-01

    脑利钠肽(BNP)是利钠肽系统中的重要成员之一.BNP是一种包含了32个氨基酸的多肽,于1998年被日本学者从猪脑中发现并提取出来.它主要由心室肌细胞受压分泌,故可以反映左心室壁承受的压力大小.BNP可产生排钠利尿效应,参与调节水、电解质平衡,减少血浆容量;同时还可扩张血管,从而降低体循环血管阻力.有大量研究显示,血浆BNP水平在充血性心力衰竭中增高,因此它可作为心衰的有效监测指标之一,并且在临床上得到了广泛应用.此外,BNP还可作为早期心血管疾病的筛查高危因素.近年来BNP在诊疗心血管疾病、呼吸困难、肺栓塞、慢性阻塞性肺疾病和肺癌过程中均显示出重要作用.现就BNP在上述多学科领域中运用的新进展作一综述.%BNP (Brain natriuretic peptide) is an important member of natriuretic peptide system. It is a 32-amino acid polypep-tide. It was firstly discovered and extracted in porcine brain in Japan. It is mainly from secretion in the cardiac ventricles in response to dilatation or an increase of pressure, so it can reflect the pressure of the left ventricular wall. Its biological function is a tension-decreasing effect based on natriuresis, diuresis and vasodilatation effects. A lot of experimental evidences revealed that the plasma concentration of BNP was raised in congestive heart failure, so it is an effective marker for monitoring heart failure, widely used in clinical practice. Further, BNP could be used to identify patients who are at higher risk for developing cardiovascular events. This article reviews the current state of the BNP in diagnosing and treating cardiovascular disease, dyspnea, pulmonary embolism, chronic obstructive pulmonary disease and lung cancer.

  1. Blood N-terminal Pro-brain Natriuretic Peptide and Interleukin-17 for Distinguishing Incomplete Kawasaki Disease from Infectious Diseases.

    Science.gov (United States)

    Wu, Ling; Chen, Yuanling; Zhong, Shiling; Li, Yunyan; Dai, Xiahua; Di, Yazhen

    2015-06-01

    To explore the diagnostic value of blood N-terminal pro-brain natriuretic peptide (NT-proBNP) and interleukin-17(IL-17) for incomplete Kawasaki disease. Patients with Kawasaki disease, Incomplete Kawasaki disease and unclear infectious fever were included in this retrospective study. Their clinical features, and laboratory test results of blood NT-proBNP and IL-17 were collected and compared. 766 patients with complete clinical information were recruited, consisting of 291 cases of Kawasaki disease, 74 cases of incomplete Kawasaki disease, and 401 cases of unclear infectious diseases. When the consistency with indicator 2 and 3 in Kawasaki disease diagnosis criteria was assessed with blood IL-17 ?11.55 pg/mL and blood NT-proBNP ? 225.5 pg/dL as the criteria, the sensitivity and specificity for distinguishing incomplete Kawasaki disease and infectious diseases reached 86.5% and 94.8%, respectively. When we chose the consistency with indicator 1 and 2 in Kawasaki disease diagnosis criteria, the appearance of decrustation and/or the BCG erythema, blood IL-17 ?11.55 pg/mL and blood NT-Pro BNP ?225.5 pg/dL as the criteria, the sensitivity and specificity for distinguishing incomplete Kawasaki disease and infectious diseases was 43.2% and 100%, respectively. Blood NT-proBNP and IL-17 are useful laboratory indicators for distinguishing incomplete Kawasaki disease and infectious diseases at the early stage.

  2. Diagnostic utility of C-reactive Protein combined with brain natriuretic peptide in acute pulmonary edema: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Murakami Junji

    2011-06-01

    Full Text Available Abstract Introduction Discriminating acute lung injury (ALI or acute respiratory distress syndrome (ARDS from cardiogenic pulmonary edema (CPE using the plasma level of brain natriuretic peptide (BNP alone remains controversial. The aim of this study was to determine the diagnostic utility of combination measurements of BNP and C-reactive protein (CRP in critically ill patients with pulmonary edema. Methods This was a cross-sectional study. BNP and CRP data from 147 patients who presented to the emergency department due to acute respiratory failure with bilateral pulmonary infiltrates were analyzed. Results There were 53 patients with ALI/ARDS, 71 with CPE, and 23 with mixed edema. Median BNP and CRP levels were 202 (interquartile range 95-439 pg/mL and 119 (62-165 mg/L in ALI/ARDS, and 691 (416-1,194 pg/mL (p Conclusions Measurement of CRP is useful as well as that of BNP for distinguishing ALI/ARDS from CPE. Furthermore, a combination of BNP and CRP can provide higher accuracy for the diagnosis.

  3. Elevated pro-brain natriuretic peptide, troponin T and malnutrition inflammatory score in chronic hemodialysis patients with overt cardiovascular disease.

    Science.gov (United States)

    Trimarchi, Hernán; Muryan, Alexis; Campolo-Girard, Vicente; Dicugno, Mariana; Barucca, Nanci; Lombi, Fernando; Young, Pablo; Pomeranz, Vanesa; Forrester, Mariano; Alonso, Mirta; Iriarte, Romina; Díaz, Marisa Luisa; Lindholm, Bengt

    2011-01-01

    We assessed the relationship between pro-brain natriuretic peptide (pro-BNP), troponin T (TropT) and nutritional status. A total of 48 chronic hemodialysis patients were grouped according to the presence [group A (GA); n = 24] or not [group B (GB)] of cardiovascular disease. Compared to GB subjects, GA subjects were older, had been on hemodialysis for a longer period and had higher prevalences of vascular grafts, hypertension and elevated C-reactive protein (CRP) [GA vs. GB: 1.1 (range 0.1-32.9) vs. 0.4 (0-28.1) mg/dl; p = 0.028], malnutrition inflammatory score (MIS) (GA vs. GB: 7.50 vs. 4.00; p = 0.001), pro-BNP [GA vs. GB: 6,760 (601-103,200) vs. 686 (75-83,700) pg/ml; p malnutrition and inflammation were associated with vascular prostheses, while pro-BNP was lower in obese patients. Copyright © 2010 S. Karger AG, Basel.

  4. 脑钠肽在儿科疾病的应用%The use of brain natriuretic peptide in pediatric diseases

    Institute of Scientific and Technical Information of China (English)

    章阿元

    2015-01-01

    脑钠肽(brain natriuretic peptide,BNP)是利钠肽家族中的一员,主要由心室肌细胞分泌,有利钠、利尿、扩张血管、抑制肾素-血管紧张素-醛固酮系统和交感神经系统活性作用.近年来,BNP检测多用于成人疾病领域,尤其是其在心血管疾病的临床应用已形成广泛共识.但目前BNP在儿科领域的相关研究及应用仍相对较少,本文就目前BNP在儿科领域的研究现状作一综述.%Brain natriuretic peptide (BNP) is one member of natriuretic peptide family and mainly secreted by ventricular myocardium.BNP has many functions such as natriuresis,diuresis,dilation of blood vessels,inhibition of renin-angiotensin-aldosterone system and sympathetic nervous system activity.In recent years,BNP analysis widely used in fields of adult diseases,especially in cardiovascular disease.But research and application of BNP in pediatrics diseases is still relatively small.This article reviewed biology character and the progress of BNP in pediatric diseases.

  5. Involvement of insulin-degrading enzyme in insulin- and atrial natriuretic peptide-sensitive internalization of amyloid-β peptide in mouse brain capillary endothelial cells.

    Science.gov (United States)

    Ito, Shingo; Ohtsuki, Sumio; Murata, Sho; Katsukura, Yuki; Suzuki, Hiroya; Funaki, Miho; Tachikawa, Masanori; Terasaki, Tetsuya

    2014-01-01

    Cerebral clearance of amyloid-β peptide (Aβ), which is implicated in Alzheimer's disease, involves elimination across the blood-brain barrier (BBB), and we previously showed that an insulin-sensitive process is involved in the case of Aβ1-40. The purpose of this study was to clarify the molecular mechanism of the insulin-sensitive Aβ1-40 elimination across mouse BBB. An in vivo cerebral microinjection study demonstrated that [125I]hAβ1-40 elimination from mouse brain was inhibited by human natriuretic peptide (hANP), and [125I]hANP elimination was inhibited by hAβ1-40, suggesting that hAβ1-40 and hANP share a common elimination process. Internalization of [125I]hAβ1-40 into cultured mouse brain capillary endothelial cells (TM-BBB4) was significantly inhibited by either insulin, hANP, other natriuretic peptides or insulin-degrading enzyme (IDE) inhibitors, but was not inhibited by phosphoramidon or thiorphan. Although we have reported the involvement of natriuretic peptide receptor C (Npr-C) in hANP internalization, cells stably expressing Npr-C internalized [125I]hANP but not [125I]hAβ1-40, suggesting that there is no direct interaction between Npr-C and hAβ1-40. IDE was detected in plasma membrane of TM-BBB4 cells, and internalization of [125I]hAβ1-40 by TM-BBB4 cells was reduced by IDE-targeted siRNAs. We conclude that elimination of hAβ1-40 from mouse brain across the BBB involves an insulin- and ANP-sensitive process, mediated by IDE expressed in brain capillary endothelial cells.

  6. Preoperative Echocardiographic Indices of Diastolic Dysfunction and Brain Natriuretic Peptide in Predicting Postoperative Atrial Fibrillation After Noncardiac Surgery.

    Science.gov (United States)

    Brecher, Oren; Gulati, Harleena; Roistacher, Nancy; Zhang, Hao; Shi, Weiji; Thaler, Howard T; Amar, David

    2017-04-01

    We have shown previously that either echocardiographic indices of diastolic dysfunction or increased preoperative brain natriuretic peptide (BNP) predict postoperative atrial fibrillation (POAF). Because these 2 predictors of POAF have not been evaluated together, our goal was to further elucidate their concurrent role in patients undergoing noncardiac thoracic surgery. We retrospectively identified 191 patients who had a preoperative transthoracic echocardiogram and serum BNP level collected as part of routine care before major lung or esophageal resection. Clinical and echocardiographic data were compared between patients who did or did not develop POAF (>5 minutes), and prognostic factors for POAF were identified. Univariate associations with POAF (41 of 191; 22% patients) included older age (P = .04), male sex (P = .01), hypertension (P = .03), increased body mass index (P = .01), and prolonged transmitral flow deceleration time (P < .0001), whereas BNP was not statistically significant (P = .07). Stepwise logistic regression analysis showed that both increasing transmitral flow deceleration time (continuous data log base 2 transformed; odds ratio, 16.05; 95% confidence interval, 3.74-68.96; P = .0002) and left atrial diastolic volume index (continuous data log base 2 transformed; odds ratio, 3.29; 95% confidence interval, 1.22-8.91; P = .02) were independent risk factors of POAF (area under the receiver operating characteristic curve = 0.73). There was no significant interaction between BNP and the 2 independent variables (P = .60, and P = .90), respectively. In a cohort of patients who had echocardiography and BNP measurements before undergoing major thoracic surgery, this study showed that when evaluated together greater preoperative left atrial diastolic volume index and transmitral flow deceleration time but not BNP levels were independent predictors for POAF.

  7. One-year prognosis and the role of brain natriuretic peptide levels in patients with chronic cor pulmonale.

    Science.gov (United States)

    Park, So Young; Lee, Chang Youl; Kim, Changhwan; Jang, Seung Hun; Park, Yong Bum; Park, Sunghoon; Hwang, Yong Il; Lee, Myung Goo; Jung, Ki-Suck; Kim, Dong-Gyu

    2015-04-01

    Data on the clinical outcomes and role of brain natriuretic peptide (BNP) levels in patients with chronic cor pulmonale are limited. A total of 69 patients with chronic cor pulmonale, admitted for dyspnea (January 2007 to September 2011) to three university hospitals, were retrospectively reviewed. All of the patients had right ventricular (RV) dysfunction on echocardiography. The median age was 70.0 yr, and chronic obstructive pulmonary disease (40.6%) and tuberculosis-destroyed lung (TDL, 27.5%) were the leading causes of chronic cor pulmonale. At the 1-yr follow-up, the mortality rate was 15.9%, and the readmission rate was 53.7%; patients with TDL had higher mortality (31.6% vs. 10.0%; P=0.059) and readmission rates (78.9% vs. 43.8%; P=0.009) than those with non-TDL diseases. The area under the receiver operating characteristic curve for admission BNP levels to predict readmission was 0.788 (95% confidence interval [CI], 0.673-0.904), and the sensitivity and specificity of the cut-off value were 80.6% and 77.4%, respectively. In multivariate analysis, high admission BNP levels were a significant risk factor for subsequent readmission (hazard ratio, 1.049; 95% CI, 1.005-1.094). Additionally, admission BNP levels were well correlated with cardiac troponin I (r=0.558), and delta BNP also correlated with delta RV systolic pressure (n=25; r=0.562). In conclusion, among hospitalized patients with chronic cor pulmonale, admission high BNP levels are a significant risk factor for subsequent readmission. Therefore, more intensive monitoring and treatment are needed in patients with higher BNP levels.

  8. Brain natriuretic peptide and copeptin levels are associated with cardiovascular disease in patients with chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    LI Xin; YANG Xin-chun; SUN Qian-mei; CHEN Xiang-dong; LI Yan-chun

    2013-01-01

    Background Cardiovascular disease (CVD) is the leading cause of death in patients with end-stage renal disease (ESRD).We explored the relationship between CVD,plasma brain natriuretic peptide (BNP) and copeptin in non-dialysis patients with chronic kidney disease (CKD).Methods BNP and copeptin were measured using ELISA in 86 non-dialysis patients with different degrees of CKD and in 20 control patients.The effects of BNP,copeptin levels and other biochemical indices on carotid ultrasound echocardiography and CVD history were determined using correlation analysis.Results BNP and copeptin levels were significantly higher in the CKD group than in the control group.Both indices increased progressively,in parallel with the decline in glomerular filtration rate (GFR).BNP levels were (184.25±65.18)ng/L in early phase CKD,(975.245±354.09) ng/L in middle phase CKD,and (1463.51±614.92) ng/ml in end phase CKD compared with levels of (101.56±42.76) ng/L in the control group (all P <0.01).Copeptin levels in the middle phase ((20.36±9.47) pmol/L) and end phase groups ((54.26±18.23) pmol/L were significantly higher than in the control group ((9.21±2.64) pmol/L; both P <0.01).There was no difference in copeptin levels between early phase CKD ((10.09±5.23)pmol/L) and control patients.Stepwise multiple regression analysis identified GFR,intima-media thickness (IMT),left ventricular hypertrophy (LVH),and previous history of CVD as independent risk factors for elevated BNP and copeptin levels.Conclusion BNP and copeptin appear to provide sensitive biological markers for the evaluation of atherosclerosis in non-dialysis patients with CKD.

  9. Chagas cardiomyopathy: the potential of diastolic dysfunction and brain natriuretic peptide in the early identification of cardiac damage.

    Directory of Open Access Journals (Sweden)

    Ana Garcia-Alvarez

    Full Text Available INTRODUCTION: Chagas disease remains a major cause of mortality in several countries of Latin America and has become a potential public health problem in non-endemic countries as a result of migration flows. Cardiac involvement represents the main cause of mortality, but its diagnosis is still based on nonspecific criteria with poor sensitivity. Early identification of patients with cardiac involvement is desirable, since early treatment may improve prognosis. This study aimed to assess the role of diastolic dysfunction, abnormal myocardial strain and elevated brain natriuretic peptide (BNP in the early identification of cardiac involvement in Chagas disease. METHODOLOGY/PRINCIPAL FINDINGS: Fifty-four patients divided into 3 groups--group 1 (undetermined form: positive serology without ECG or 2D-echocardiographic abnormalities; N = 32, group 2 (typical ECG abnormalities of Chagas disease but normal 2D-echocardiography; N = 14, and group 3 (regional wall motion abnormalities, left ventricular [LV] end-diastolic diameter >55 mm or LV ejection fraction 37 pg/ml were noted in 0%, 13%, 29% and 63% in controls and groups 1 to 3, respectively. Half of patients in the undetermined form had impaired relaxation patterns, whereas half of patients with ECG abnormalities suggestive of Chagas cardiomyopathy had normal diastolic function. In group 1, BNP levels were statistically higher in patients with diastolic dysfunction as compared to those with normal diastolic function (27 ± 26 vs. 11 ± 8 pg/ml, p = 0.03. CONCLUSION/SIGNIFICANCE: In conclusion, the combination of diastolic function and BNP measurement adds important information that could help to better stratify patients with Chagas disease.

  10. A fast and sensitive enzyme immunoassay for brain natriuretic peptide based on micro-magnetic probes strategy.

    Science.gov (United States)

    Liu, Ruping; Liu, Juntao; Xie, Li; Wang, Mixia; Luo, Jinping; Cai, Xinxia

    2010-05-15

    In this paper, a simple, rapid and low-cost method for the high-sensitivity detection of brain natriuretic peptide (BNP) was developed, which adopted three amplification steps: (a) biotin-streptavidin amplification; (b) micro-magnetic probe amplification; (c) HRP (horseradish peroxidase) signal amplification. In the present strategy, the streptavidin-coated micro-magnetic particles (MMPs) were first conjugated with biotin-labeled capture antibody via the biotin-streptavidin interaction, which formed bio-functional micro-magnetic probes. Then, the analyte (antigen) is sandwiched by HRP-labeled antibody and capture antibody bound to MMPs. Finally, the HRP at the surface of sandwich structures catalytically oxidized the substrate and generated optical signals that reflected the amount of the target BNP. The influence of some important parameters such as the size of magnetic particles, the working concentration of HRP-labeled BNP antibody, the stability of magnetic probes, and the assay medium of serum BNP, etc. on the detection ability of present method was investigated in details. It is found that the detection limit of the proposed method could reach 10pg/mL for BNP, which is much lower than that of sandwich-type ELISA. Furthermore, this detection time for the proposed method just takes about 30min (two reaction steps and one wash step), which is faster than that of conventional sandwich-type ELISA (taking about 4h, three reaction steps and three wash steps). Inspired by these advantages, it is expected that this method can probably be applicable to the detection of other hormones and tumor markers that are present in only low concentrations within the human body.

  11. Non-linear Equation using Plasma Brain Natriuretic Peptide Levels to Predict Cardiovascular Outcomes in Patients with Heart Failure

    Science.gov (United States)

    Fukuda, Hiroki; Suwa, Hideaki; Nakano, Atsushi; Sakamoto, Mari; Imazu, Miki; Hasegawa, Takuya; Takahama, Hiroyuki; Amaki, Makoto; Kanzaki, Hideaki; Anzai, Toshihisa; Mochizuki, Naoki; Ishii, Akira; Asanuma, Hiroshi; Asakura, Masanori; Washio, Takashi; Kitakaze, Masafumi

    2016-11-01

    Brain natriuretic peptide (BNP) is the most effective predictor of outcomes in chronic heart failure (CHF). This study sought to determine the qualitative relationship between the BNP levels at discharge and on the day of cardiovascular events in CHF patients. We devised a mathematical probabilistic model between the BNP levels at discharge (y) and on the day (t) of cardiovascular events after discharge for 113 CHF patients (Protocol I). We then prospectively evaluated this model on another set of 60 CHF patients who were readmitted (Protocol II). P(t|y) was the probability of cardiovascular events occurring after >t, the probability on t was given as p(t|y) = -dP(t|y)/dt, and p(t|y) = pP(t|y) = αyβP(t|y), along with p = αyβ (α and β were constant); the solution was p(t|y) = αyβ exp(-αyβt). We fitted this equation to the data set of Protocol I using the maximum likelihood principle, and we obtained the model p(t|y) = 0.000485y0.24788 exp(-0.000485y0.24788t). The cardiovascular event-free rate was computed as P(t) = 1/60Σi=1,…,60 exp(-0.000485yi0.24788t), based on this model and the BNP levels yi in a data set of Protocol II. We confirmed no difference between this model-based result and the actual event-free rate. In conclusion, the BNP levels showed a non-linear relationship with the day of occurrence of cardiovascular events in CHF patients.

  12. Elevated pulmonary artery pressure and brain natriuretic peptide in high altitude pulmonary edema susceptible non-mountaineers

    Science.gov (United States)

    Gupta, Rajinder K.; Himashree, G.; Singh, Krishan; Soree, Poonam; Desiraju, Koundinya; Agrawal, Anurag; Ghosh, Dishari; Dass, Deepak; Reddy, Prassana K.; Panjwani, Usha; Singh, Shashi Bala

    2016-01-01

    Exaggerated pulmonary pressor response to hypoxia is a pathgonomic feature observed in high altitude pulmonary edema (HAPE) susceptible mountaineers. It was investigated whether measurement of basal pulmonary artery pressure (Ppa) and brain natriuretic peptide (BNP) could improve identification of HAPE susceptible subjects in a non-mountaineer population. We studied BNP levels, baseline hemodynamics and the response to hypoxia (FIo2 = 0.12 for 30 min duration at sea level) in 11 HAPE resistant (no past history of HAPE, Control) and 11 HAPE susceptible (past history of HAPE, HAPE-S) subjects. Baseline Ppa (19.31 ± 3.63 vs 15.68 ± 2.79 mm Hg, p < 0.05) and plasma BNP levels (52.39 ± 32.9 vs 15.05 ± 9.6 pg/ml, p < 0.05) were high and stroke volume was less (p < 0.05) in HAPE-S subjects compared to control. Acute hypoxia produced an exaggerated increase in heart rate (p < 0.05), mean arterial pressure (p < 0.05) and Ppa (28.2 ± 5.8 vs 19.33 ± 3.74 mm Hg, p < 0.05) and fall in peripheral oxygen saturation (p < 0.05) in HAPE-S compared to control. Receiver operating characteristic (ROC) curves showed that Ppa response to acute hypoxia was the best variable to identify HAPE susceptibility (AUC 0.92) but BNP levels provided comparable information (AUC 0.85). BNP levels are easy to determine and may represent an important marker for the determination of HAPE susceptibility. PMID:26892302

  13. In hemodialysis, adiponectin, and pro-brain natriuretic peptide levels may be subjected to variations in body mass index.

    Science.gov (United States)

    Trimarchi, Hernan; Muryan, Alexis; Dicugno, Mariana; Forrester, Mariano; Lombi, Fernando; Young, Pablo; Pomeranz, Vanesa; Iriarte, Romina; Barucca, Nanci; Campolo-Girard, Vicente; Alonso, Mirta; Lindholm, Bengt

    2011-10-01

    Adiponectin exerts cardiovascular protective actions, although some studies have shown the opposite. In hemodialysis, obese subjects display lower mortality rates despite hypoadiponectinemia, while higher adiponectin concentrations correlate with an elevated cardiovascular risk in nonobese subjects. The aim of the study is to suggest that adiponectin level variations are associated with differences in the body mass index (BMI). The interplay between adiponectin and pro-brain natriuretic peptide (Pro-BNP) levels may vary according to body fat mass. Fifty-two chronic hemodialysis patients were divided into three groups. Group A, BMI30 (n=11). Diabetics: Group A 10%; Group B 6 29%; Group C 55%, P=0.027. Determinations: Adiponectin, Pro-BNP, insulin, insulin resistance (HOMA), troponin T, nutritional status, ultrafiltration rates, C-reactive protein (CRP), vascular accesses, and echocardiography. Group A: adiponectinemia positively and significantly correlated with Pro-BNP, CRP, and troponin T. As BMI increased, adiponectin, Pro-BNP, and malnutrition significantly decreased, while insulin, HOMA, and ultrafiltration rates significantly increased. Cardiac restriction was significantly higher in obese patients. In all groups, Pro-BNP and troponin T displayed a strong positive correlation. In low-BMI subjects, high Pro-BNP and adiponectin, low myocardial restriction, and worse nutritional status were prevalent. In obesity, hypoadiponectinemia stimulates cardiac remodeling, cardiac hypertrophy, and decreased stretching, rendering Pro-BNP levels low despite high ultrafiltration rates. Thus, adiponectin correlates inversely with BMI, probably playing different cardiovascular roles as BMI changes. © 2011 The Authors. Hemodialysis International © 2011 International Society for Hemodialysis.

  14. High circulating N-terminal pro-brain natriuretic peptide and tumor necrosis factor-α in mixed cryoglobulinemia

    Institute of Scientific and Technical Information of China (English)

    Alessandro Antonelli; Clodoveo Ferri; Silvia Martina Ferrari; Fabio Galetta; Ferdinando Franzoni; Gino Santoro; Salvatore De Marco; Emiliano Ghiri; Poupak Fallahi

    2009-01-01

    AIM: To evaluate serum levels of N-terminal pro-brain natriuretic peptide (NTproBNP) and tumor necrosis factor α (TNF-α) in a large series of patients with hepatitis C associated with mixed cryoglobulinemia (MC+HCV).METHODS: Serum NTproBNP and TNF-α levels were assayed in 50 patients with MC+HCV, and in 50 sex-and age-matched controls.RESULTS: Cryoglobulinemic patients showed significantly higher mean NTproBNP and TNF-α levels than controls ( P < 0.001; Mann-Whitney U test). By defining high NTproBNP level as a value higher than 125 pg/mL (the single cut-off point for outpatients under 75 years of age), 30% of MC+HCV and 6% of controls had high NTproBNP (χ~2, P < 0.01). With a cut-off point of 300 pg/mL (used to rule out heart failure (HF) in patients under 75 years of age), 8% of MC+HCV and 0 controls had high NTproBNP (χ~2, P < 0.04). With a cut-off point of 900 pg/mL (used for ruling in HF in patients aged 50-75 years; such as the patients of our study), 6% of MC+HCV and 0 controls had high NTproBNP (χ~2, P = 0.08).CONCLUSION: The study demonstrates high levels of circulating NTproBNP and TNF-α in MC+HCV patients.The increase of NTproBNP may indicate the presence of a subclinical cardiac dysfunction.

  15. Association of menopause age and N-terminal pro brain natriuretic peptide: the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Ebong, Imo A; Watson, Karol E; Goff, David C; Bluemke, David A; Srikanthan, Preethi; Horwich, Tamara; Bertoni, Alain G

    2015-05-01

    Menopause age can affect the risk of developing cardiovascular disease (CVD). The purpose of this study was to investigate the associations of early menopause (menopause occurring before age 45 y) and menopause age with N-terminal pro brain natriuretic peptide (NT-proBNP), a potential risk marker of CVD and heart failure. Our cross-sectional study included 2,275 postmenopausal women, aged 45 to 85 years and without clinical CVD (2000-2002), from the Multi-Ethnic Study of Atherosclerosis. Participants were classified as having or not having early menopause. NT-proBNP was log-transformed. Multivariable linear regression was used for analysis. Five hundred sixty-one women had early menopause. The median (25th-75th percentiles) NT-proBNP value was 79.0 (41.1-151.6) pg/mL for all participants, 83.4 (41.4-164.9) pg/mL for women with early menopause, and 78.0 (40.8-148.3) pg/mL for women without early menopause. The mean (SD) age was 65 (10.1) and 65 (8.9) years for women with and without early menopause, respectively. No significant interactions between menopause age and ethnicity were observed. In multivariable analysis, early menopause was associated with a 10.7% increase in NT-proBNP levels, whereas each 1-year increase in menopause age was associated with a 0.7% decrease in NT-proBNP levels. Early menopause is associated with greater NT-proBNP levels, whereas each 1-year increase in menopause age is associated with lower NT-proBNP levels, in postmenopausal women.

  16. Influence of recombinant human brain natriuretic peptide on myocardial enzymes, serum cardiac function indexes and oxygen metabolism of patients with open heart surgery with cardiopulmonary bypass

    Institute of Scientific and Technical Information of China (English)

    Shu-Tian Song; Ming Yang; Kun-Peng Li; Juan Xu; Chuan-Ming Bai; Ji-Wu Zhou

    2016-01-01

    Objective:To investigate and analyze the influence of recombinant human brain natriuretic peptide on myocardial enzymes, serum cardiac function indexes and oxygen metabolism of patients with open heart surgery with cardiopulmonary bypass.Methods:A total of 42 patients with open heart surgery with cardiopulmonary bypass during the period of June 2014 to January 2016 were randomly divided into the control group of 21 cases and the observation group of 21 cases. The control group was treated with routine postoperative treatment, and the observation group was treated with recombinant human brain natriuretic peptide on the basic treatment of control group, then the myocardial enzymes, serum cardiac function indexes and oxygen metabolism indexes of the two groups before the surgery and at 2 h, 12 h and 24 h after the surgery were respectively detected and compared.Results: There were no significant difference in myocardial enzymes, serum cardiac function indexes and oxygen metabolism indexes between two groups before the surgery (allP>0.05), while the myocardial enzymes and serum cardiac function indexes of the observation group at 2 h ,12 h and 24 h after the surgery were all significantly lower than those of control group, the oxygen metabolism indexes were significantly better than the levels of control group (allP<0.05).Conclusions:The recombinant human brain natriuretic peptide can effectively improve the myocardial enzymes, serum cardiac function indexes and oxygen metabolism state of patients with open heart surgery with cardiopulmonary bypass, and it has application value for the patients with the surgery is higher.

  17. Right and left cardiac function in HIV-infected patients investigated using radionuclide ventriculography and brain natriuretic peptide: a 5-year follow-up study

    DEFF Research Database (Denmark)

    Kristoffersen, U.S.; Lebech, A.M.; Gerstoft, J.

    2008-01-01

    ventricular ejection fraction (RVEF) and left ventricular ejection fraction (LVEF), as well as measurement of brain natriuretic peptide (BNP). Between July 2005 and January 2007, 63 patients (69%) agreed to participate in a follow-up study with a mean follow-up of 4.5 years. RESULTS: All patients had normal......, it seems that the improvement in immunocompetency and viral load has removed the problem of HIV-related cardiomyopathy. Although HAART has been suggested as a possible new cause of cardiomyopathy, we did not find any evidence of this Udgivelsesdato: 2008/3...

  18. Evaluation of proinflammatory cytokines and brain natriuretic peptide in patients with rheumatic heart diseases and coronary heart disease complicated by chronic heart insufficiency

    OpenAIRE

    2005-01-01

    Objective. To study proinflammatory cytokines and brain natriuretic peptide (BNP) in patients with rheumatic heart diseases (RHD) and coronary heart disease (CHD) complicated by chronic heart insufficiency (CHI). Material and methods. 54 pts with CHI (among them 16 with RHD and 38 with CHD with signs of CHI ofll-IV functional class according to NYHA that correspond to 11A-III stage according to N.D. Strazesko-V.H. \\frsilenko classification) and 30 healthy persons of control group were examine...

  19. Effect of natriuretic peptides on cerebral artery blood flow in healthy volunteers

    DEFF Research Database (Denmark)

    Guo, Song; Gøtze, Jens Peter; Jeppesen, Jørgen L;

    2015-01-01

    The natriuretic peptides (NPs), atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and C-type natriuretic peptide (CNP), have vasoactive functions that concern humans and most animals, but their specific effects on cerebral circulation are poorly understood. We therefore examined t...

  20. N-terminal pro-brain natriuretic peptide levels and short term prognosis in acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Vandanapu Naveen

    2015-01-01

    Full Text Available Background: Sparse published data are available regarding the prognostic importance of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP in patients with acute ischemic stroke. Materials and Methods: We prospectively studied 74 consecutive patients presenting with acute ischemic stroke within 24 hours of onset. All of them underwent laboratory and imaging evaluation and were treated as per guidelines. In all subjects, plasma NT-proBNP levels were measured at initial admission and again on day 7. Results: Their mean age was 54 ± 13.5years; there were 49 males; 18 (24% patients died during the hospital stay. A statistically significant negative correlation between log NT-proBNP and Glasgow coma scale (GCS score (P < 0.001; and a significant positive correlation between log NT-proBNP and National Institutes of Health Stroke Scale (NIHSS score (P < 0.001 were observed. Baseline log NT-proBNP levels were higher among non-survivors compared with survivors (6.7 ± 0.47 vs. 5.37 ± 0.62; P = 0.06; day 7 log NT-proBNP levels were significantly higher in non-survivors compared with survivors (7.3 ± 0.26 vs. 4.5 ± 0.4; P = 0.000. In survivors, there was a statistically significant decline in log NT-proBNP levels from baseline to day 7 (5.3710 ± 0.620 vs. 4.5320 ± 0.451; P < 0.001. In contrast, among non-survivors, log NT-proBNP levels showed a statistically significant increase from baseline to day 7 (4.5322 ± 0.451 vs. 7.2992 ± 0.263; P < 0.001. On receiver operator characteristic curve (ROC analysis, at a cut-off value of ≥ 6.0661, log NT-proBNP had a sensitivity and specificity of 98.2 and 88.9, respectively, in predicting death. Conclusions: Plasma log NT-pro-BNP level appears to be a useful biological marker for predicting in-hospital mortality inpatients presenting with acute ischemic stroke.

  1. N-terminal pro-brain natriuretic peptide for additional risk stratification in patients with non-ST-elevation acute coronary syndrome and an elevated troponin T: an Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) substudy.

    NARCIS (Netherlands)

    Windhausen, F.; Hirsch, A.; Sanders, G.T.B.; Cornel, J.H.; Fischer, J.; Straalen, J.P. van; Tijssen, J.G.P.; Verheugt, F.W.A.; Winter, R.J. de

    2007-01-01

    BACKGROUND: New evidence has emerged that the assessment of multiple biomarkers such as cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with non-ST-elevation acute coronary syndrome (nSTE-ACS) provides unique prognostic information. The purpose of this

  2. Natriuretic peptide drug leads from snake venom.

    Science.gov (United States)

    Vink, S; Jin, A H; Poth, K J; Head, G A; Alewood, P F

    2012-03-15

    Natriuretic peptides are body fluid volume modulators, termed natriuretic peptides due to a role in natriuresis and diuresis. The three mammalian NPs, atrial natriuretic peptide (ANP), brain or b-type natriuretic peptide (BNP) and c-type natriuretic peptide (CNP), have been extensively investigated for their use as therapeutic agents for the treatment of cardiovascular diseases. Although effective, short half-lives and renal side effects limit their use. In approximately 30 years of research, NPs have been discovered in many vertebrates including mammals, amphibians, reptiles and fish, with plants and, more recently, bacteria also being found to possess NPs. Reptiles have produced some of the more interesting NPs, with dendroaspis natriuretic peptide (DNP), which was isolated from the venom of the green mamba (Dendroaspis angusticeps), having greater potency and increased stability as compared to the mammalian family members, and taipan natriuretic peptide c (TNPc), which was isolated from the venom of the inland taipan (Oxyuranus microlepidotus) displaying similar activity to ANP and DNP at rat natriuretic peptide receptor A. Although promising, more research is required in this field to develop therapeutics that overcome receptor-mediated clearance, and potential toxicity issues. This review investigates the use of snake venom NPs as therapeutic drug leads. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Inhibition by atrial and brain natriuretic peptides of endothelin-1 secretion after stimulation with angiotensin II and thrombin of cultured human endothelial cells.

    Science.gov (United States)

    Kohno, M; Yasunari, K; Yokokawa, K; Murakawa, K; Horio, T; Takeda, T

    1991-01-01

    We examined the inhibition by atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) of endothelin-1 secretion stimulated by angiotensin II (ANGII) and thrombin using cultured human umbilical-vein endothelial cells. ANGII and thrombin dose-dependently stimulated immunoreactive (ir) endothelin-1 secretion. Human ANP(1-28) and human BNP-32 both inhibited such secretion in a dose-dependent way. Inhibition of this secretion by ANP and BNP was paralleled by an increase in the level of cyclic guanosine 5'-monophosphate (GMP). The addition of a cyclic GMP analogue, 8-bromo cyclic GMP, reduced this stimulated secretion. Rat ANP(5-25) was weaker than human ANP(1-28) at inhibiting ir-endothelin-1 secretion and increasing cyclic GMP in the cells. ir-Endothelin-1 in the medium consisted of two components separated by high pressure liquid chromatography; the major one corresponded to endothelin-1(1-21) and the minor one corresponded to big endothelin-1(1-38). Treatment with ANP and BNP did not affect this profile. These findings suggest that human ANP and BNP inhibit endothelin-1 secretion stimulated by ANGII and thrombin in these cells through a cyclic GMP-dependent process. Taken together with endothelin stimulation of ANP and BNP secretion from the heart, our results suggest the existence of a cardiac-endothelium feedback. PMID:1645748

  4. The usefulness of brain natriuretic peptide level in diagnosis and prognosis of patients admitted to critical care unit with shortness of breath

    Directory of Open Access Journals (Sweden)

    Yazan Abdeen

    2015-01-01

    Full Text Available Background: Brain Natriuretic Peptide (BNP is a polypeptide secreted by the ventricles as a response to cardio-myocyte stretching. Due to its cardiac origin and correlation with volume overload it has been successfully used for a long time in diagnosing and prognosticating Cardiogenic Pulmonary Edema. Materials and Methods: In this retrospective cohort study, an attempt was made to observe any correlation between admission BNP levels with APACHE II scores and length of ICU stay, in patients admitted with dyspnea to the ICU of a community based hospital. Results/Conclusion: This study showed no significant correlation between length of stay in an ICU and admission BNP levels in dyspneic patients. Independent variables such as age and gender failed to show any coorelation either.

  5. Cardiovascular risk prediction by N-terminal pro brain natriuretic peptide and high sensitivity C-reactive protein is affected by age and sex

    DEFF Research Database (Denmark)

    Olsen, M.H.; Hansen, T.W.; Christensen, M.K.

    2008-01-01

    BACKGROUND: Previous studies have shown that the urine albumin/creatinine ratio (UACR), high sensitivity C-reactive protein (hsCRP) and N-terminal pro brain natriuretic peptide (Nt-proBNP) predict cardiovascular events in a general population aged 41, 51, 61 or 71 years. This study investigated...... factors, UACR, hsCRP and Nt-proBNP. The composite cardiovascular endpoint (CEP) of cardiovascular death and non-fatal stroke or myocardial infarction was assessed after 9.5 years. RESULTS: In Cox regression analyses predicting CEP, the effects of log(hsCRP) and log(Nt-proBNP) were modulated by sex (P ....3-2.2; P proBNP)/SD predicted CEP in 61 plus 71-year-old women (HR 1.74; 1.2-2.5; P pro...

  6. Left ventricular remodeling in the first year after acute myocardial infarction and the predictive value of N-terminal pro brain natriuretic peptide

    DEFF Research Database (Denmark)

    Nilsson, Jens C; Groenning, Bjoern A; Nielsen, Gitte

    2002-01-01

    in compliance with daily clinical practice is unknown. The purpose of this study was to clarify this issue and to evaluate the predictive value of N-terminal pro brain natriuretic peptide (NT-proBNP). METHODS: Forty-two patients with a first transmural MI were examined after 1 week, 1 month, 3 months, 6 months......), whereas the remaining 18 patients (43%) had stable conditions regarding these LV measures. LV ejection fraction at baseline was significantly reduced in all patient categories but was unchanged over time. Elevated NT-proBNP level at baseline was identified as an independent predictor of increase in LVEDVI...... during follow-up examination (P =.007). A baseline level of NT-proBNP >115 pmol/L identified patients who later had LV dilatation develop with a sensitivity and specificity of 89% and 68% (area under curve = 0.77). CONCLUSION: In this 1-year follow-up study of patients with a first transmural MI...

  7. Effects of body mass index and age on N-terminal pro brain natriuretic peptide are associated with glomerular filtration rate in chronic heart failure patients

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Kistorp, Caroline N

    2007-01-01

    BACKGROUND: Obesity is a state characterized by glomerular hyperfiltration and age-related decreases in glomerular filtration rate (GFR). Body mass index (BMI), age, and GFR are associated with plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) in chronic heart failure...... (CHF) patients. We hypothesized that the effects of BMI and age on plasma concentrations of NT-proBNP are associated with GFR. METHODS: We obtained clinical data and laboratory test results from 345 CHF patients at the baseline visit in our heart failure clinic and examined the hypothesis using...... multiple linear regression models. RESULTS: Age (P = 0.0184), BMI (P = 0.0098), hemoglobin (P = 0.0043), heart rhythm (P proBNP). After adjustment for GFR estimated by the Cockcroft and Gault equation, the parameter...

  8. The N-terminal pro brain natriuretic peptide is the best predictor of mortality during hospitalization in patients with low risk of sepsis-related organ failure.

    Science.gov (United States)

    García Villalba, Eva; Bernal Morell, Enrique; Egea, Mari Paz; Marín, Irene; Alcaraz Garcia, Antonia; Muñoz, Angeles; Vera, MariCarmen; Valero, Salvador; Martinez, Monica; Callejo Hurtado, Victoria; Gomez Verdu, Jose Miguel; Santo, Angela; Cano Sanchez, Alfredo

    2017-09-08

    The purpose of this study was to investigate the value of N-terminal pro brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP) and procalcitonin (PCT) in predicting mortality in septic patients during hospitalization with mortality risk1,330pg/ml (OR=23.23; 95% CI 2.92-182.25; P=.003) and to have predisposing factors (OR=3.05; 95% CI 1.3-9.3; P=.044) CONCLUSIONS: In patients with low mortality risk according to SOFA score, NT-proBNP obtained in the first 72h after admission prove to be a powerful predictor of mortality. Their implementations in clinical practice would improve the predictive ability of clinical severity scores. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  9. N-terminal pro-brain natriuretic peptide can be an adjunctive diagnostic marker of hyper-acute phase of Kawasaki disease.

    Science.gov (United States)

    Kwon, Hyuksool; Lee, Jin Hee; Jung, Jae Yun; Kwak, Young Ho; Kim, Do Kyun; Jung, Jin Hee; Chang, Ikwan; Kim, Kyuseok

    2016-12-01

    The purpose of this study was to determine whether the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level could be a useful marker for Kawasaki disease in the pediatric emergency department (PED) and in the presence of fever duration of 4 days or less (hyper-acute phase of Kawasaki disease). Medical records of patients who were 1 month to 15 years old of age and presented at the PED with suspected Kawasaki disease from January 1, 2010, to December 31, 2014, were collected retrospectively. Two hundred thirty-nine patients with a history of fever for 4 days or less were diagnosed with Kawasaki disease, as well as 111 patients with other febrile diseases, and were enrolled. The NT-proBNP level was significantly higher in patients with Kawasaki disease (Kawasaki disease vs. other febrile disease group, 444.8 (189.7-951.5) vs. 153.4 (68.9-287.6) pg/mL; p Kawasaki disease was 0.763 (95 % CI 0.712-0.814). NT-proBNP might be an adjunctive laboratory marker for hyper-acute phase of Kawasaki disease in the PED. What is Known: • N-terminal pro-brain natriuretic peptide level has been reported as a useful marker for diagnosis in patients with the acute phase of Kawasaki disease. • But, in the cases of less than 5 days of fever, the appropriate level of NT-proBNP for differentiating Kawasaki disease in PED has not been yet evaluated. What is New: • NT-proBNP might be an adjunctive laboratory marker for hyper-acute phase of Kawasaki disease.

  10. Association between resting heart rate and N-terminal pro-brain natriuretic peptide in a community-based population study in Beijing

    Directory of Open Access Journals (Sweden)

    Cao R

    2014-12-01

    Full Text Available Ruihua Cao, Yongyi Bai, Ruyi Xu, Ping Ye Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China Background: N-terminal pro-brain natriuretic peptide (NT-proBNP is associated with an increased risk of cardiac insufficiency, which possibly leads to heart failure. However, the relationship between resting heart rate and NT-proBNP is unclear.Objective: This study focuses on this relativity between resting heart rate and plasma NT-proBNP levels in a surveyed community-based population.Methods: We evaluated the relativity between resting heart rate and plasma levels of NT-proBNP in 1,567 participants (mean age 61.0 years, range 21–96 years from a community-based population in Beijing, People’s Republic of China.Results: In patients with high resting heart rate (≥75 beats/min, NT-proBNP was higher than in those having low resting heart rate (<75 beats/min. In multiple linear stepwise regression analysis, plasma NT-proBNP was associated with resting heart rate (partial correlation coefficient, 0.82; 95% confidence interval, 0.18–1.51; P=0.011. A subsequent subgroup analysis revealed that the association between resting heart rate and plasma NT-proBNP was strengthened in subjects over 60 years old (partial correlation coefficient 1.28; 95% confidence interval, 0.49–2.36; P=0.031; while the relativity between resting heart rate and plasma NT-proBNP was not emerged in the younger subgroup (<60 years old.Conclusions: Resting heart rate was associated with plasma NT-proBNP in the elderly, which indicated a relationship between resting heart rate and cardiac function damage. Keywords: resting heart rate, N-terminal pro-brain natriuretic peptide, epidemiology, cardiac function, relationship

  11. Inefficient constitutive inhibition of P2X3 receptors by brain natriuretic peptide system contributes to sensitization of trigeminal sensory neurons in a genetic mouse model of familial hemiplegic migraine.

    Science.gov (United States)

    Marchenkova, Anna; Vilotti, Sandra; Ntamati, Niels; van den Maagdenberg, Arn Mjm; Nistri, Andrea

    2016-01-01

    On trigeminal ganglion neurons, pain-sensing P2X3 receptors are constitutively inhibited by brain natriuretic peptide via its natriuretic peptide receptor-A. This inhibition is associated with increased P2X3 serine phosphorylation and receptor redistribution to non-lipid raft membrane compartments. The natriuretic peptide receptor-A antagonist anantin reverses these effects. We studied whether P2X3 inhibition is dysfunctional in a genetic familial hemiplegic migraine type-1 model produced by introduction of the human pathogenic R192Q missense mutation into the mouse CACNA1A gene (knock-in phenotype). This model faithfully replicates several properties of familial hemiplegic migraine type-1, with gain-of-function of CaV2.1 Ca(2+) channels, raised levels of the algogenic peptide calcitonin gene-related peptide, and enhanced activity of P2X3 receptors in trigeminal ganglia. In knock-in neurons, anantin did not affect P2X3 receptor activity, membrane distribution, or serine phosphorylation level, implying ineffective inhibition by the constitutive brain natriuretic peptide/natriuretic peptide receptor-A pathway. However, expression and functional properties of this pathway remained intact together with its ability to downregulate TRPV1 channels. Reversing the familial hemiplegic migraine type-1 phenotype with the CaV2.1-specific antagonist, ω-agatoxin IVA restored P2X3 activity to wild-type level and enabled the potentiating effects of anantin again. After blocking calcitonin gene-related peptide receptors, P2X3 receptors exhibited wild-type properties and were again potentiated by anantin. P2X3 receptors on mouse trigeminal ganglion neurons are subjected to contrasting modulation by inhibitory brain natriuretic peptide and facilitatory calcitonin gene-related peptide that both operate via complex intracellular signaling. In the familial hemiplegic migraine type-1 migraine model, the action of calcitonin gene-related peptide appears to prevail over brain natriuretic

  12. Brain Natriuretic Peptide and Body Fluid Composition in Patients with Chronic Kidney Disease: A Cross-Sectional Study to Evaluate the Relationship between Volume Overload and Malnutrition.

    Science.gov (United States)

    Ohashi, Yasushi; Saito, Akinobu; Yamazaki, Keisuke; Tai, Reibin; Matsukiyo, Tatsuru; Aikawa, Atsushi; Sakai, Ken

    2016-08-01

    Fluid volume overload occurs in chronic kidney disease (CKD), leading to the compensatory release of natriuretic peptides. However, the elevated cardiac peptides may also be associated with malnutrition as well as volume overload. Body fluid composition was measured in 147 patients with CKD between 2009 and 2015, and its relationship to brain natriuretic peptide (BNP) levels was examined. Body fluid composition was separated into three components: (a) a water-free mass consisting of muscle, fat, and minerals; (b) intracellular water (ICW) content, and (c) extracellular water (ECW) content. Excess fluid mass was calculated using Chamney's formula. The measured BNP levels in the tertile groups were 10.9 ± 5.4, 36.3 ± 12.5, and 393 ± 542 pg/ml, respectively. Patients in a higher log-transformed BNP level tertile were more likely to be older, to have a higher frequency of cardiac comorbidities, pulse pressure, C-reactive protein levels, and proteinuria, and to have lower serum sodium, kidney function, and serum albumin (p < 0.05). In body fluid composition, decreased body mass was significantly associated with the ECW-to-ICW ratio in relation to the downward ICW slope (r = -0.235, p = 0.004) and was strongly correlated with excess fluid mass (r = -0.701, p < 0.001). The ECW-to-ICW ratio and excess fluid mass was independently associated with the BNP levels. Fluid volume imbalance between intra- and extracellular water regulated by decreased cell mass was independently associated with BNP levels, which may explain the reserve capacity for fluid accumulation in patients with CKD.

  13. Influence of training habits on exercise-induced changes in plasma atrial and brain natriuretic peptide and urinary excretion of aquaporin-2 in healthy man.

    Science.gov (United States)

    Bentzen, H; Pedersen, R S; Nyvad, O; Pedersen, E B

    2002-01-01

    The purpose of this study was to quantify the influence of training habits on the changes in plasma atrial natriuretic peptide (ANP), plasma brain natriuretic peptide (BNP) and urine aquaporin-2 (u-AQP2) during exercise by studying trained and untrained healthy subjects. Eleven trained subjects (7 males, 4 females) and 10 untrained subjects (8 males, 2 females) performed a maximal aerobic exercise test. ANP and BNP were determined every 3 min and at maximum exercise by radioimmunoassay (RIA), and u-AQP2 was determined before and after the exercise test by RIA. The absolute increase in ANP during exercise was higher in the trained subjects (trained subjects: 5.6 pmol/L; untrained subjects: 2.4 pmol/L, p exercise was the same in the two groups (trained subjects: 0.5 pmol/L; untrained subjects: 0.6 pmol/L, NS) and tended to correlate positively with resting BNP in the trained subjects (p = 0.07). Exercise did not change u-AQP2 excretion in either trained subjects (rest: 372 ng/mmol creatinine; exercise: 314 ng/mmol creatinine, NS) or untrained subjects (rest: 263 ng/mmol creatinine; exercise: 338 ng/mmol creatinine, NS). The absolute increase in ANP during exercise was higher in trained subjects than in untrained subjects and was positively correlated to ANP at rest. This might reflect the normal cardiovascular adaptation to exercise. The increase in BNP during exercise was unrelated to training habits. Training habits did not affect the u-AQP2 excretion during exercise.

  14. Urine albumin/creatinine ratio, high sensitivity C-reactive protein and N-terminal pro brain natriuretic peptide--three new cardiovascular risk markers--do they improve risk prediction and influence treatment?

    DEFF Research Database (Denmark)

    Olsen, Michael H; Sehestedt, Thomas; Lyngbaek, Stig

    2010-01-01

    In order to prioritize limited health resources in a time of increasing demands optimal cardiovascular risk stratification is essential. We tested the additive prognostic value of 3 relatively new, but established cardiovascular risk markers: N-terminal pro brain natriuretic peptide (Nt-proBNP), ......In order to prioritize limited health resources in a time of increasing demands optimal cardiovascular risk stratification is essential. We tested the additive prognostic value of 3 relatively new, but established cardiovascular risk markers: N-terminal pro brain natriuretic peptide (Nt...... death lower than 5% based on HeartScore and therefore not eligible for primary prevention, the actual 10-year risk of cardiovascular death exceeded 5% in a small subgroup of subjects with UACR higher than the 95-percentile of approximately 1.6 mg/mmol. Combined use of high UACR or high hsCRP identified...

  15. Relationship between the severity of mitral regurgitation, left ventricular dysfunction and plasma brain natriuretic peptide level: An observational strain imaging study

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    Mehmet Ali Elbey

    2012-12-01

    Full Text Available Objectives: The aim of the this study was to investigatethe relationship between the degree of mitral regurgitation(MR, left ventricular (LV dysfunction determined bystrain (S/strain rate (SR imaging and plasma brain natriureticpeptide (BNP levels.Materials and methods: This is an observational crosssectionalstudy which included 31 consecutive patients(15[48.4%] male who had applied to our outpatient clinicsand diagnosed as mitral regurgitation and 25 (12[48.0%] male healthy persons as control subjects. Themitral regurgitation patients were divided into two groups:those with moderate MR (n=14[45.2%] and those withsevere MR (n=17[54.8%], and maximum strain / strainrate measurements of left ventricular wall segments andplasma brain natriuretic peptide levels were determined inthese two groups and controls.Results: S/SR values of all wall segments of left ventriclewere found to be decreased in patient with severe MRwhen compared with the control subjects and patientswith moderate MR (p<0.001.Conclusions: Although left ventricle functions with conventionalechocardiography in patients with mitral valveregurgitation were normal, subclinic deteriorations ofleft ventricle were detected in patients with severe mitralvalve regurgitation. J Clin Exp Invest 2012; 3 (4: 451-456Key words: strain/strain rate, echocardiography, mitralregurgitation, left ventricular functions

  16. 重组人脑钠肽治疗失代偿性充血性心力衰竭的研究进展%Research progress on the treatment of compensatory Congestive Heart Failure with recombinant human brain natriuretic peptide

    Institute of Scientific and Technical Information of China (English)

    张麦叶; 姬秋和

    2009-01-01

    重组人脑钠肽(rhBNP)为一种合成肽,作用与内源性脑钠肽相似,具有扩张血管、利尿、利钠、抗交感神经系统、降低醛固酮和内皮素等作用,具有降压不加快心率,不激活肾素.血管紧张素.醛固酮系统等特点.现已有许多临床实验证实其在治疗充血性心力衰竭(CHF)方面,具有有效改善心功能、减轻心脏负荷及心室重构等优势,目前rhBNP已经上市,并且已经在临床上应用于充血性心力衰竭的治疗.本文就rhBNP的药理作用,与CHF的关系,以及其治疗失代偿性CHF的进展作一综述.%Recombinant human brain natriuretic peptide(rhBNP) is a synthetic peptide, its role is similar to endogenous brain natriuretic peptide, with effects on expanding blood vessel, diuretic, natriuretic, anti-sympathetic nervous system, decreasing plasma aldoste-rone and endothelin, also with characteristic of depress urization while neither speeding up the heart rate, nor activating the renin-angiotensin-aldosterone system. A number of studies had confirmed that recombinant human brain natriuretic peptide was effective in the treatment of Congestive Heart Failure (CHF), it could effectively improve the cardiac function, reduce the cardiac load and reverse left ventricular remodeling. It is now put on to market and applied in clinical treatment of Congestive Heart Failure. The article introduces rh-BNP pharmacologic action, the relationship with CHF, and the research progress on the treatment of CHF.

  17. C-reactive protein and N-terminal prohormone brain natriuretic peptide as biomarkers in acute exacerbations of COPD leading to hospitalizations

    Science.gov (United States)

    Chen, Virginia; Hollander, Zsuzsanna; Leipsic, Jonathon A.; Hague, Cameron J.; DeMarco, Mari L.; FitzGerald, J. Mark; McManus, Bruce M.; Ng, Raymond T.; Sin, Don D.

    2017-01-01

    There are currently no accepted and validated blood tests available for diagnosing acute exacerbations of chronic obstructive pulmonary disease (AECOPD). In this study, we sought to determine the discriminatory power of blood C-reactive protein (CRP) and N-terminal prohormone brain natriuretic peptide (NT-proBNP) in the diagnosis of AECOPD requiring hospitalizations. The study cohort consisted of 468 patients recruited in the COPD Rapid Transition Program who were hospitalized with a primary diagnosis of AECOPD, and 110 stable COPD patients who served as controls. Logistic regression was used to build a classification model to separate AECOPD from convalescent or stable COPD patients. Performance was assessed using an independent validation set of patients who were not included in the discovery set. Serum CRP and whole blood NT-proBNP concentrations were highest at the time of hospitalization and progressively decreased over time. Of the 3 classification models, the one with both CRP and NT-proBNP had the highest AUC in discriminating AECOPD (cross-validated AUC of 0.80). These data were replicated in a validation cohort with an AUC of 0.88. A combination of CRP and NT-proBNP can reasonably discriminate AECOPD requiring hospitalization versus clinical stability and can be used to rapidly diagnose patients requiring hospitalization for AECOPD. PMID:28328968

  18. NEW POSSIBILITIES FOR EVALUATION OF SEVERITY AND PROGNOSIS IN PATIENTS WITH CHRONIC HEART FAILURE BASED ON N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE PLASMA LEVEL

    Directory of Open Access Journals (Sweden)

    A. S. Galjavich

    2016-01-01

    Full Text Available Aim. To study an importance of plasma N-terminal pro-brain natriuretic peptide (N-proBNP in evaluation of severity and prognosis in patients with chronic heart failure (CHF of ischemic genesis.Material and methods. 77 patients (60 men and 17 women; 59,4±10,7 y.o. with CHF of ischemic genesis were included in the study. All patients had sinus rhythm and history of Q wave myocardial infarction. Standard examination was performed to all patients. Besides N-proBNP plasma level and patients yearly survival were evaluated.Results. N-proBNP plasma level had direct correlation with clinical indices (exercise tolerance, blood pressure, heart rate and echocardiographic heart sizes. N-proBNP plasma level had relationship with prognosis of CHF patients. Baseline N-proBNP level was more than 2 times higher in died patients in comparison with survived patients. The yearly survival rate of CHF patients was 51,3% if N-proBNP level had been more than 400 fmol/ml (>15% of normal value. The clinico-laboratory index (based on N-proBNP plasma level of severity and prognosis in CHF patients was developed.Conclusion. The clinico-laboratory index based on N-proBNP plasma level is easy to use and can improve medical practice.

  19. NEW POSSIBILITIES FOR EVALUATION OF SEVERITY AND PROGNOSIS IN PATIENTS WITH CHRONIC HEART FAILURE BASED ON N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE PLASMA LEVEL

    Directory of Open Access Journals (Sweden)

    A. S. Galjavich

    2009-01-01

    Full Text Available Aim. To study an importance of plasma N-terminal pro-brain natriuretic peptide (N-proBNP in evaluation of severity and prognosis in patients with chronic heart failure (CHF of ischemic genesis.Material and methods. 77 patients (60 men and 17 women; 59,4±10,7 y.o. with CHF of ischemic genesis were included in the study. All patients had sinus rhythm and history of Q wave myocardial infarction. Standard examination was performed to all patients. Besides N-proBNP plasma level and patients yearly survival were evaluated.Results. N-proBNP plasma level had direct correlation with clinical indices (exercise tolerance, blood pressure, heart rate and echocardiographic heart sizes. N-proBNP plasma level had relationship with prognosis of CHF patients. Baseline N-proBNP level was more than 2 times higher in died patients in comparison with survived patients. The yearly survival rate of CHF patients was 51,3% if N-proBNP level had been more than 400 fmol/ml (>15% of normal value. The clinico-laboratory index (based on N-proBNP plasma level of severity and prognosis in CHF patients was developed.Conclusion. The clinico-laboratory index based on N-proBNP plasma level is easy to use and can improve medical practice.

  20. Dynamics of electrocardiographic changes, brain-natriuretic peptide and cortisol levels in a patient with stress (takotsubo cardiomyopathy: A case report

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    Đurić Ivica

    2013-01-01

    Full Text Available Introduction. Takotsubo cardiomyopathy is a transient acute heart failure syndrome caused by stress that provokes left ventricular mid-apical akinesis and mimics acute coronary syndrome. Case report. A 66-year-old woman had chest pain and dispnoea a few hours before hospitalization. A sudden emotional stressful event preceded the symptoms. Electrocardiographic abnormalities - precordial ST elevation and modest increase of cardiac troponin mimiced acute myocardial infarction. However, echocardiographic examination showed apical ballooning with markedly diminished left ventricle ejection fraction and the obstruction in the outflow tract of the left ventricle. Coronary angiography at admission showed no coronary stenosis and slower blood flow through the left anterior descending artery. According to anamnesis, echocardiography and coronarography finding we established the diagnosis of stress cardiomyopathy - takotsubo cardiomyopathy. We described in details the slow but dynamic electrocardiographic changes, levels of brain natriuretic peptide, cortisol and echocardiography evolution of disease during a 4-month follow-up till the full recovery. Conclusion. Stress (takotsubo cardiomyopathy - became an important differential diagnosis of acute anterior myocardial infarction and it should be reconsidered every time when emotionally stressed patients with transient-apical akinesis or dyskinesis of the LV are present.

  1. Usefulness of early diastolic mitral annular velocity to predict plasma levels of brain natriuretic peptide and transient heart failure development after device closure of atrial septal defect.

    Science.gov (United States)

    Masutani, Satoshi; Taketazu, Mio; Mihara, Chihiro; Mimura, Yuko; Ishido, Hirotaka; Matsunaga, Tamotsu; Kobayashi, Toshiki; Senzaki, Hideaki

    2009-12-15

    Device closure of atrial septal defect (ASD) is sometimes followed by elevation of plasma brain natriuretic peptide (BNP), a marker of heart failure, and progression to heart failure. This study tested the hypothesis that the underlying diastolic dysfunction, assessed on tissue Doppler images (TDI) before device closure, can predict BNP level after ASD closure. The study subjects were 39 consecutive patients (age 27.5 +/- 16.3 years, range 5 to 63) who underwent device closure for ASD. Echocardiographic evaluation using TDI and 2-dimensional and pulse wave Doppler were performed, together with plasma BNP measurement 1 day before and 2 days after ASD closure. Before ASD closure, an age-dependent decrease was noted in left ventricular relaxation, assessed by early diastolic mitral annular velocity. ASD closure resulted in a decrease in early diastolic mitral annular velocity (from 14.7 to 12.3 cm/s, p linear regression identified early diastolic mitral annular velocity before ASD closure and age as independent predictors of BNP levels after ASD closure (p annular velocity developed exertional dyspnea after the procedure. In conclusion, our results indicate that TDI measurements could be useful to detect underlying diastolic dysfunction that can potentially cause heart failure after ASD closure and emphasize the importance of ASD closure at a young age before impairment of left ventricular relaxation.

  2. Relationship between the brain natriuretic peptide (BNP) level and remission of diabetic nephropathy with microalbuminuria: a 3-year follow-up study.

    Science.gov (United States)

    Seki, N; Matsumoto, T; Fukazawa, M

    2015-02-01

    The aim of the study was to examine the relationship between the brain natriuretic peptide (BNP) level and progression or remission of diabetic nephropathy with microalbuminuria for 3 years. The subjects were 100 Japanese type 2 diabetes mellitus outpatients with microalbuminuria. Associations between metabolic parameters at baseline [HbA1c, systolic blood pressure (SBP), urine albumin-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), and BNP] and the progression or remission of diabetic nephropathy were examined for 3 years. A total of 83 patients were examined at the end of the 3-year period, including 17 with remission to normoalbuminuria, 47 with continuing microalbuminuria, and 19 with progression to macroalbuminuria. HbA1c, ACR, and BNP differed significantly among the 3 groups (p=0.024, premission of diabetic nephropathy (p=0.029, p=0.012, respectively). ROC curve analysis gave a cutoff value for BNP of 14.9 pg/ml for prediction of remission of diabetic nephropathy (p=0.016). The BNP level has a relationship with diabetic nephropathy and a low BNP level predicts remission of diabetic nephropathy. Therefore, monitoring of BNP can play an important role in management of diabetic nephropathy.

  3. N-Terminal Pro-Brain Natriuretic Peptide Is Associated with a Future Diagnosis of Cancer in Patients with Coronary Artery Disease.

    Directory of Open Access Journals (Sweden)

    José Tuñón

    Full Text Available Several papers have reported elevated plasma levels of natriuretic peptides in patients with a previous diagnosis of cancer. We have explored whether N-terminal pro-brain natriuretic peptide (NT-proBNP plasma levels predict a future diagnosis of cancer in patients with coronary artery disease (CAD.We studied 699 patients with CAD free of cancer. At baseline, NT-proBNP, galectin-3, monocyte chemoattractant protein-1, soluble tumor necrosis factor-like weak inducer of apoptosis, high-sensitivity C-reactive protein, and high-sensitivity cardiac troponin I plasma levels were assessed. The primary outcome was new cancer diagnosis. The secondary outcome was cancer diagnosis, heart failure requiring hospitalization, or death.After 2.15±0.98 years of follow-up, 24 patients developed cancer. They were older (68.5 [61.5, 75.8] vs 60.0 [52.0, 72.0] years; p=0.011, had higher NT-proBNP (302.0 [134.8, 919.8] vs 165.5 [87.4, 407.5] pg/ml; p=0.040 and high-sensitivity C-reactive protein (3.27 [1.33, 5.94] vs 1.92 [0.83, 4.00] mg/L; p=0.030, and lower triglyceride (92.5 [70.5, 132.8] vs 112.0 [82.0, 157.0] mg/dl; p=0.044 plasma levels than those without cancer. NT-proBNP (Hazard Ratio [HR]=1.030; 95% Confidence Interval [CI]=1.008-1.053; p=0.007 and triglyceride levels (HR=0.987; 95%CI=0.975-0.998; p=0.024 were independent predictors of a new cancer diagnosis (multivariate Cox regression analysis. When patients in whom the suspicion of cancer appeared in the first one-hundred days after blood extraction were excluded, NT-proBNP was the only predictor of cancer (HR=1.061; 95%CI=1.034-1.088; p<0.001. NT-proBNP was an independent predictor of cancer, heart failure, or death (HR=1.038; 95%CI=1.023-1.052; p<0.001 along with age, and use of insulin and acenocumarol.NT-proBNP is an independent predictor of malignancies in patients with CAD. New studies in large populations are needed to confirm these findings.

  4. Atrial Natriuretic Peptide (ANP) in early pregnancy is associated with development of preeclampsia in type 1 diabetes

    DEFF Research Database (Denmark)

    Nielsen, Lene Ringholm; Pedersen-Bjergaard, Ulrik; Thorsteinsson, Birger

    2011-01-01

    The vasoactive markers of cardiac overload Atrial Natriuretic Peptide (ANP) and Brain Natriuretic Peptide (BNP) are elevated in preeclampsia. This study documents higher ANP concentrations as early as at 9 weeks in type 1 diabetic women subsequently developing preeclampsia suggesting that preecla......The vasoactive markers of cardiac overload Atrial Natriuretic Peptide (ANP) and Brain Natriuretic Peptide (BNP) are elevated in preeclampsia. This study documents higher ANP concentrations as early as at 9 weeks in type 1 diabetic women subsequently developing preeclampsia suggesting...

  5. N-terminal pro-brain natriuretic peptide, C-reactive protein, and urinary albumin levels as predictors of mortality and cardiovascular events in older adults

    DEFF Research Database (Denmark)

    Kistorp, Caroline; Raymond, Ilan; Pedersen, Frants;

    2005-01-01

    B-type natriuretic peptides have been shown to predict cardiovascular disease in apparently healthy individuals but their predictive ability for mortality and future cardiovascular events compared with C-reactive protein (CRP) and urinary albumin/creatinine ratio is unknown.......B-type natriuretic peptides have been shown to predict cardiovascular disease in apparently healthy individuals but their predictive ability for mortality and future cardiovascular events compared with C-reactive protein (CRP) and urinary albumin/creatinine ratio is unknown....

  6. Influence of preoperative serum N-terminal pro-brain type natriuretic peptide on the postoperative outcome and survival rates of coronary artery bypass patients

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    Thomas Schachner

    2010-01-01

    Full Text Available BACKGROUND: The N-terminal fragment of pro-brain type natriuretic peptide (NT-proBNP is an established biomarker for cardiac failure. OBJECTIVE: To determine the influence of preoperative serum NT-proBNP on postoperative outcome and mid-term survival in patients undergoing coronary artery bypass grafting (CABG. METHODS: In 819 patients undergoing isolated CABG surgery preoperative serum NT-proBNP levels were measured. NT-proBNP was correlated with various postoperative outcome parameters and survival rate after a median follow-up time of 18 (0.5-44 months. Risk factors of mortality were identified using χ2, Mann-Whitney test, and Cox regression. RESULTS: NT-proBNP levels >430 ng/ml and >502 ng/ml predicted hospital and overall mortality (p502 ng/ml (p=0.001. Age, preoperative serum creatinine, diabetes, chronic obstructive pulmonary disease, low left ventricular ejection fraction and BNP levels >502 ng/ml were isolated as risk factors for overall mortality. Multivariate Cox regression analysis, including the known factors influencing NT-proBNP levels, identified NT-proBNP as an independent risk factor for mortality (OR = 3.079 (CI = 1.149-8.247, p = 0.025. Preoperative NT-proBNP levels >502 ng/ml were associated with increased ventilation time (p=0.005, longer intensive care unit stay (p=0.001, higher incidence of postoperative hemofiltration (p=0.001, use of intra-aortic balloon pump (p502 ng/ml predict mid-term mortality after isolated CABG and are associated with significantly higher hospital mortality and perioperative complications.

  7. Changes in cardiac aldosterone and its synthase in rats with chronic heart failure: an intervention study of long-term treatment with recombinant human brain natriuretic peptide

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, X.Q. [Fujian Medical University Union Hospital, Fuzhou, Fujian (China); Department of Cardiology, The Central Hospital of Enshi Autonomous Prefecture, Enshi, Hubei (China); Hong, H.S. [Department of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian (China); Lin, X.H. [Department of Emergency Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian (China); Chen, L.L. [Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian (China); Li, Y.H. [Department of Cardiology, The Central Hospital of Enshi Autonomous Prefecture, Enshi, Hubei (China)

    2014-07-11

    The physiological mechanisms involved in isoproterenol (ISO)-induced chronic heart failure (CHF) are not fully understood. In this study, we investigated local changes in cardiac aldosterone and its synthase in rats with ISO-induced CHF, and evaluated the effects of treatment with recombinant human brain natriuretic peptide (rhBNP). Sprague-Dawley rats were divided into 4 different groups. Fifty rats received subcutaneous ISO injections to induce CHF and the control group (n=10) received equal volumes of saline. After establishing the rat model, 9 CHF rats received no further treatment, rats in the low-dose group (n=8) received 22.5 μg/kg rhBNP and those in the high-dose group (n=8) received 45 μg/kg rhBNP daily for 1 month. Cardiac function was assessed by echocardiographic and hemodynamic analysis. Collagen volume fraction (CVF) was determined. Plasma and myocardial aldosterone concentrations were determined using radioimmunoassay. Myocardial aldosterone synthase (CYP11B2) was detected by quantitative real-time PCR. Cardiac function was significantly lower in the CHF group than in the control group (P<0.01), whereas CVF, plasma and myocardial aldosterone, and CYP11B2 transcription were significantly higher than in the control group (P<0.05). Low and high doses of rhBNP significantly improved hemodynamics (P<0.01) and cardiac function (P<0.05) and reduced CVF, plasma and myocardial aldosterone, and CYP11B2 transcription (P<0.05). There were no significant differences between the rhBNP dose groups (P>0.05). Elevated cardiac aldosterone and upregulation of aldosterone synthase expression were detected in rats with ISO-induced CHF. Administration of rhBNP improved hemodynamics and ventricular remodeling and reduced myocardial fibrosis, possibly by downregulating CYP11B2 transcription and reducing myocardial aldosterone synthesis.

  8. N-terminal pro-brain natriuretic peptide and cardiovascular or all-cause mortality in the general population: A meta-analysis

    Science.gov (United States)

    Geng, Zhaohua; Huang, Lan; Song, Mingbao; Song, Yaoming

    2017-01-01

    The prognostic role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the general population remains controversial. We conducted this meta-analysis to investigate the association between baseline NT-proBNP concentrations and cardiovascular or all-cause mortality in the general population. PubMed and Embase databases were systematically searched from their inception to August 2016. Prospective observational studies that investigated the association between baseline NT-proBNP concentrations and cardiovascular or all-cause mortality in the general population were eligible. A summary of the hazard ratio (HR) and 95% confidence interval (CI) of mortality were calculated by the highest versus the lowest category of NT-proBNP concentrations. Eleven studies with a total of 25,715 individuals were included. Compared individuals in the highest with those in the lowest category of NT-proBNP, the pooled HR was 2.44 (95% CI 2.11–2.83) for all-cause mortality, 3.77 (95% CI 2.85–5.00) for cardiovascular mortality, and 2.35 (95% CI 1.45–3.82) for coronary heart disease mortality, respectively. Subgroup analyses indicated that the effects of NT-proBNP on the risk of cardiovascular mortality (RR 2.27) and all-cause mortality (RR 3.00) appeared to be slightly lower among men. Elevated NT-proBNP concentrations appeared to be independently associated with increased risk of cardiovascular and all-cause mortality in the general population. PMID:28134294

  9. The Relationship between Serum Pro‐Brain Natriuretic Peptide (Pro‐BNP Levels and Pulmonary Arterial Hypertension (PAH in Patients with Limited Scleroderma

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    Seyedeh Zahra Mirfeizi

    2014-08-01

    Full Text Available Introduction: Pulmonary arterial hypertension (PAH is a late progressive sclerodermarelated complication, which can lead to right heart failure and cor pulmonale. Given that cardiac catheterization is a diagnostic method of choice for PAH, and considering the high risks of this method, the purpose of this study was to evaluate the relationship between serum Pro‐Brain natriuretic peptide (Pro‐BNP Levels and PAH in patients with limited scleroderma. Materials and Methods: In this cross sectional study , during June 2011‐ Dec 2013, referring patients to two major educational hospitals, Mashhad‐ Iran, with scleroderma, who were afflicted with the disease for at least two years (or more, were enrolled in the study if they met the inclusion and exclusion criteria. All the patients underwent echocardiography to determine the pulmonary artery pressure (PAP. Afterwards, the subjects were referred to a lung center for performing body plethysmography, carbon monoxide diffusing capacity (DLCO, and 6‐ minute walk test (6MWT. Pro‐BNP Serum level was determined using flourescent immune assay method. Results: The present study included 20 patients (18 female subjects with the mean age of 43.28±9.56 yrs, and the mean pro‐BNP level of 138 pg/ml. The logarithmic correlation between PAP values, Forced Vital Capacity /DLCO ratio, and pro‐BNP level, which was measured using Pearson's correlation coefficient, showed a significant association among these variables( respectively, r=0.76, P0.001; r=0.677, P=0.011. Moreover, the DLCO decrease was associated with increasing pro‐BNP level, though this relationship was not significant. Conclusion: This study showed that there was a significant relationship between the serum levels of pro‐BNP marker and increased PAP in the echocardiography, DLCO reduction, and FVC/DLCO increase. In fact, this serum marker can be used in patients with systemic scleroderma (SSc to evaluate the status of PAH.

  10. Changes of plasma norepinephrine and serum N-terminal pro-brain natriuretic peptide after exercise training predict survival in patients with heart failure.

    Science.gov (United States)

    Rengo, Giuseppe; Pagano, Gennaro; Parisi, Valentina; Femminella, Grazia Daniela; de Lucia, Claudio; Liccardo, Daniela; Cannavo, Alessandro; Zincarelli, Carmela; Komici, Klara; Paolillo, Stefania; Fusco, Flavia; Koch, Walter J; Perrone Filardi, Pasquale; Ferrara, Nicola; Leosco, Dario

    2014-02-15

    Short-term changes of neurohormones can give important prognostic information in heart failure (HF) patients. In this study, we evaluate whether changes in plasma Norepinephrine (NE) and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) after exercise training predict cardiac mortality in HF patients. We enrolled 221 HF patients (mean age 72.5 ± 10.2 year) followed-up for a mean period of 27.64 ± 10.7 months. All pts underwent a 3-month exercise training. Before training, clinical examination, echocardiography, peak VO2 determination, and blood draw for NT-proBNP and NE measurements were performed. Primary end-point was cardiac related mortality. Eighty-six-nine percent of patients were in NYHA class III, mean left ventricular ejection fraction (LVEF) was 32.5 ± 10.4%, and mean peak VO2 was 12.36 ± 1.45 ml/kg/min. At baseline, mean NT-proBNP was 2111.4 ± 1145.6 pg/ml and mean NE was 641.8 ± 215.3 pg/ml. One hundred-one subjects died for cardiac causes. Training was associated with a significant increase of peak VO2 and LVEF, whereas NE, NT-proBNP, and heart rate decreased. Multiple Cox proportional hazards regression analysis was performed using delta% values (post vs pre-training) of LVEF, heart rate, NE, and NT-proBNP along with baseline covariates, revealing delta value of NE as the strongest predictor of cardiac mortality. Noteworthy, training reduced NT-proBNP in both survivor and non-survivor patients, while a lack of reduction of NE was observed in non survivors. In our HF population, short-term changes of NE after exercise training independently predicted long-term cardiac mortality. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. N-terminal pro-brain natriuretic peptide improves the C-ACS risk score prediction of clinical outcomes in patients with ST-elevation myocardial infarction.

    Science.gov (United States)

    He, Peng-Cheng; Duan, Chong-Yang; Liu, Yuan-Hui; Wei, Xue-Biao; Lin, Shu-Guang

    2016-12-12

    It remained unclear whether the combination of the Canada Acute Coronary Syndrome Risk Score (CACS-RS) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) could have a better performance in predicting clinical outcomes in acute ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention. A total of 589 consecutive STEMI patients were enrolled. The potential additional predictive value of NT-pro-BNP with the CACS-RS was estimated. Primary endpoint was in-hospital mortality and long-term poor outcomes. The incidence of in-hospital death was 3.1%. Patients with higher NT-pro-BNP and CACS-RS had a greater incidence of in hospital death. After adjustment for the CACS-RS, elevated NT-pro-BNP (defined as the best cutoff point based on the Youden's index) was significantly associated with in hospital death (odd ratio = 4.55, 95%CI = 1.52-13.65, p = 0.007). Elevated NT-pro-BNP added to CACS-RS significantly improved the C-statistics for in-hospital death, as compared with the original score (0.762 vs. 0.683, p = 0.032). Furthermore, the addition of NT-pro-BNP to CACS-RS enhanced net reclassification improvement (0.901, p pro-BNP and CACS-RS are risk predictors for in hospital poor outcomes in patients with STEMI. A combination of them could derive a more accurate prediction for clinical outcome s in these patients.

  12. Right ventricular function and N-terminal pro-brain natriuretic peptide levels in adult patients with simple dextro-transposition of the great arteries.

    Science.gov (United States)

    Martínez-Quintana, Efrén; Marrero-Negrín, Natalia; Gopar-Gopar, Silvia; Rodríguez-González, Fayna

    2017-06-01

    Dextro-transposition of the great arteries (d-TGA) patients is at high risk of developing right ventricular dysfunction and tricuspid regurgitation in adulthood. Determining the relation between echocardiographic parameters, N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels and the New York Heart Association (NYHA) functional class may help determining the best time to operate them. Patients with simple d-TGA operated in infancy with an atrial switch procedure (Mustard or Senning operation) were followed up in our Adult Congenital Heart Disease Unit. Analytical, echocardiographic, and clinical parameters were determined to evaluate the correlation between right echocardiographic ventricular function, NT-pro-BNP levels, and NYHA functional class. Twenty-four patients with d-TGA were operated in infancy of whom 17 alive patients had simple d-TGA. Nine patients had NT-pro-BNP levels lower than 200 pg/mL and eight patients were above 200 pg/mL. Patients with lower hemoglobin concentration, higher right ventricular diameter or under diuretic treatment showed significant higher NT-pro-BNP levels (above 200 pg/dL). The Spearman test showed a positive correlation between basal right ventricular diameter and tricuspid regurgitation with pro NT BNP levels (correlation coefficient of .624; P=.017 and .490; P=.046, respectively) and a negative correlation with the right ventricle fractional area change (-.508, P=.045). No correlation was seen between NT-pro-BNP levels and the rest of echocardiographic parameters or the NYHA functional class. NT-pro-BNP levels showed a positive correlation with basal right ventricular diameter and tricuspid regurgitation but not with NYHA association functional class in d-TGA patients. © 2017, Wiley Periodicals, Inc.

  13. N-terminal pro-brain natriuretic peptide is related with coronary flow velocity reserve and diastolic dysfunction in patients with asymmetric hypertrophic cardiomyopathy.

    Science.gov (United States)

    Tesic, Milorad; Seferovic, Jelena; Trifunovic, Danijela; Djordjevic-Dikic, Ana; Giga, Vojislav; Jovanovic, Ivana; Petrovic, Olga; Marinkovic, Jelena; Stankovic, Sanja; Stepanovic, Jelena; Ristic, Arsen; Petrovic, Milan; Mujovic, Nebojsa; Vujisic-Tesic, Bosiljka; Beleslin, Branko; Vukcevic, Vladan; Stankovic, Goran; Seferovic, Petar

    2017-10-01

    The relations of elevated N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and cardiac ischemia in hypertrophic cardiomyopathy (HCM) patients is uncertain. Therefore we designed the study with the following aims: (1) to analyze plasma concentrations of NT-pro-BNP in various subsets of HCM patients; (2) to reveal the correlations of NT-pro-BNP, myocardial ischemia, and diastolic dysfunction; (3) to assess predictors of the elevated plasma levels of NT-pro-BNP. In 61 patients (mean age 48.9±16.3 years; 26 male) with asymmetric HCM plasma levels of NT-pro-BNP were obtained. Standard transthoracic examination, tissue Doppler echocardiography with measurement of transthoracic coronary flow velocity reserve (CFVR) in left anterior descending artery (LAD) was done. Mean natural logarithm value of NT-pro-BNP was 7.11±0.95pg/ml [median value 1133 (interquartile range 561-2442)pg/ml]. NT-pro-BNP was significantly higher in patients with higher NYHA class, in obstructive HCM, more severe mitral regurgitation, increased left atrial volume index (LAVI), presence of calcified mitral annulus, elevated left ventricular (LV) filling pressure and in decreased CFVR. Levels of NT-pro-BNP significantly correlated with the ratio of E/e' (r=0.534, ppro-BNP. Plasma levels of NT-pro-BNP were significantly higher in HCM patients with more advanced disease. Elevated NT-pro-BNP not only reflects the diastolic impairment of the LV, but it might also be the result of cardiac ischemia in patients with HCM. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  14. Association of Atrial Fibrillation and Amino-terminal Pro-brain Natriuretic Peptide Concentrations in Patients After Off-Pump Coronary Artery Bypass Grafting

    Institute of Scientific and Technical Information of China (English)

    Junquan Li; Qinghua Zhang; Weichen Tian; Hongyu Liu

    2008-01-01

    Objectives To investigate the possible role of amino-terminal pro-brain natriuretic peptide (NT-proBNP) in the occurrence of atrial fibrillation (AF) after coronary artery bypass grafting (CABG).Methods This study group included 70 consecutive patients scheduled for elective off-pump CABG.The patients with ejection fraction (EF) less than 0.30,history of AF,use of class Ⅰor Ⅲ antiarrhythmic drug,implanted pacemaker,postoperative myocardial infarction or chest reopening for pericardial tamponade were excluded.Preoperative and postoperative serum NT-proBNP levels were measured by radioimmunoassay technique.Results Postoperative AF occurred in 15 patients (21.4%);these patients had significantly higher median NT-proBNP levels when compared with those without AF after the operation (P<0.01).Using multivariate logistic regression analyses,an increase in NT-proBNP level after CABG was found to be independently associated with AF (OR=3.78,95% IC=1.81~4.89,P<0.01 ).Increased age,diabetes mellitus,preoperative use of β-blocker,proximal right coronary artery involvement,and longer operation time were also associated with AF.Conclusions These results indicated that AF was associated with higher NT-proBNP concentrations after off pump CABG;the increase in NT-proBNP after CABG may play an important role in the occurrence of AF after the operation.The further studies are needed to define the reason that lead to higher NT-proBNP concentrations among the patients who present AF after off pump CABG.

  15. Relation between plasma brain natriuretic peptide, serum indexes of collagen type I turnover, and left ventricular remodeling after reperfused acute myocardial infarction.

    Science.gov (United States)

    Cerisano, Giampaolo; Pucci, Paolo Domenico; Sulla, Antonio; Tommasi, Mariasilvia; Raspanti, Silvia; Santoro, Giovanni Maria; Antoniucci, David

    2007-03-01

    The aim of the study is to investigate the relation between plasma brain natriuretic peptide (BNP), collagen type I turnover, and left ventricular (LV) remodeling after primary angioplasty. Echo-Doppler, BNP, carboxy-terminal telopeptide of procollagen type I (ICTP), C-terminal propeptide of procollagen type I (PICP), and their ratio PICP/ICTP (as an index of coupling between the synthesis and degradation of collagen type I) were evaluated at days 1 and 3 and months 1 and 6 after primary angioplasty in 56 consecutive patients with a first large acute myocardial infarction (AMI). During the 6 months after AMI, a direct relation was shown between BNP and ICTP (day 1, r = 0.54, p = 0.000; day 3, r = 0.64, p = 0.000; month 1, r = 0.64, p = 0.000; month 6, r = 0.41, p = 0.005) and BNP and PICP/ICTP (day 1, r = -0.54, p = 0.003; day 3, r = -0.58, p = 0.000; month 1, r = -0.50, p = 0.000; month 6, r = -0.30, p = 0.043), but not between BNP and PICP. Using analysis of covariance, relations between BNP and ICTP and PICP/ICTP were independent from infarct size. Patients with LV remodeling had significantly higher plasma ICTP and BNP levels and lower PICP/ICTP than patients without LV remodeling. Day-1 ICTP independently predicted 6-month remodeling (exp beta = 2.14, 95% confidence interval 1,120 to 3,550, p = 0.01). In conclusion, a relation exists between plasma BNP collagen type I turnover and LV remodeling after reperfused AMI.

  16. Predictive value of N-terminal pro-brain natriuretic peptide in combination with the sequential organ failure assessment score in sepsis

    Institute of Scientific and Technical Information of China (English)

    JU Min-jie; ZHU Du-ming; TU Guo-wei; HE Yi-zhou; XUE Zhang-gang; LUO Zhe; WU Zhao-guang

    2012-01-01

    Background The prognostic power of n-terminal pro-brain natriuretic peptide (NT-proBNP) in sepsis is disputable and unstable among different models.We attempt to evaluate the prognostic potential of NT-proBNP in combination with the sequential organ failure assessment (SOFA) score in sepsis.Methods In this retrospective study,100 consecutive sepsis patients were enrolled.Clinical data such as admission SOFA,the Acute Physiologic and Chronic Health Evaluation score,shock prevalence,use of lung protective ventilation,vasopressors,and glucocorticoids were recorded.Additionally,serum creatinine (Scr1 and Scr3) and NT-proBNP (NT-proBNP1 and NT-proBNP3) were assayed and evaluated at admission and on day 3 respectively.Results △NT-proBNP (NT-proBNP3 minus NT-proBNP1) (P <0.001,Hazard ratio (HR)=1.245,95% confidence interval (C/),1.137-1.362) and admission SOFA (P <0.001,HR=1.197,95% C/,1.106-1.295) were independently related to in-hospital mortality.Their combination was a more robust predictor for in-hospital mortality than either of them individually.Patients with high △NT-proBNP and SOFA had the poorest prognosis.Conclusions In our study,both △NT-proBNP and SOFA were independent predictors of septic patients' prognosis.Moreover,the combination of △NT-proBNP and admission SOFA provided a novel strategy that contained information regarding both the response to treatment and sepsis severity.

  17. Symptomatic ventricular tachyarrhythmia is associated with delayed gadolinium enhancement in cardiac magnetic resonance imaging and with elevated plasma brain natriuretic peptide level in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Oka, Katsumi; Tsujino, Takeshi; Nakao, Shinji; Lee-Kawabata, Masaaki; Ezumi, Akira; Masai, Miho; Ohyanagi, Mitsumasa; Masuyama, Tohru

    2008-10-01

    Delayed gadolinium enhancement (DGE) in cardiac magnetic resonance (CMR) imaging indicates the areas with myocardial fibrosis, which are suggested to be arrhythmogenic substrate in hypertrophic cardiomyopathy (HCM). Elevated brain natriuretic peptide (BNP) is associated with cardiovascular events in HCM. We investigated the grade of DGE in CMR and plasma BNP levels in HCM patients with or without symptomatic ventricular tachycardia (VT) or ventricular fibrillation (VF). We recruited 26 consecutive untreated HCM patients without any symptoms of heart failure. They were divided into 2 groups: (1) patients with symptomatic VT/VF [VT/VF(+) group, n=6]; (2) patients without symptomatic VT/VF [VT/VF(-) group, n=20]. CMR was performed to evaluate left ventricular geometry and the grade of DGE. Plasma BNP levels, left ventricular mass index, and the number of segments with positive DGE were greater in the VT/VF(+) group than in the VT/VF(-) group (698.1+/-387.6 vs. 226.9+/-256.8 pg/ml, p=0.006; 152.3+/-49.5 vs. 89.5+/-24.1 g/m(2), p=0.003; 9.7+/-5.7 vs. 3.5+/-3.3, p=0.013). On logistic regression, adjusted odds ratio for symptomatic VT/VF was 214 for logBNP (95% confidence interval [CI] 1.2-37,043, p=0.04) and 1.54 for DGE score (95% CI 1.01-2.34, p=0.04). High plasma BNP levels and the enlarged area of DGE in CMR were associated with symptomatic ventricular tachyarrhythmia. These factors may be useful markers for detecting high-risk patients of sudden cardiac death in HCM.

  18. Magnetic Resonance Imaging-Detected Myocardial Inflammation and Fibrosis in Rheumatoid Arthritis: Associations With Disease Characteristics and N-Terminal Pro-Brain Natriuretic Peptide Levels.

    Science.gov (United States)

    Kobayashi, Hitomi; Kobayashi, Yasuyuki; Yokoe, Isamu; Akashi, Yosikatsu; Takei, Masami; Giles, Jon T

    2017-09-01

    Myocardial dysfunction and heart failure (HF) are increased in rheumatoid arthritis (RA), yet there are few studies of the myocardium in RA. RA patients with no known heart disease or risk factors underwent gadolinium-enhanced cardiac magnetic resonance imaging (MRI). Images were assessed for left-ventricular (LV) structural and functional parameters and for myocardial late gadolinium enhancement (LGE; an indicator of myocardial fibrosis) and T2-weighted imaging (an indicator of active inflammation). We modeled the associations between RA characteristics and N-terminal pro-brain natriuretic protein (NT-proBNP) levels with LGE and T2-weighted imaging. We also assessed whether LGE and/or T2-weighted imaging were associated with abnormal LV structure or dysfunction. A total of 60 RA patients were studied. LGE was present in 19 (32%) and T2-weighted imaging in 7 (12%), 5 of whom also had LGE. After adjustment for relevant confounders, higher odds of LGE with each swollen joint (odds ratio [OR] 1.87, P = 0.008), each log unit higher C-reactive protein level (OR 3.36, P = 0.047), and each log unit higher NT-proBNP (OR 20.61, P = 0.009) were found. NT-proBNP was also significantly higher (135%) among those with T2-weighted imaging than in those without T2-weighted imaging or LGE. Higher LV mass index and LV mass:end diastolic volume ratio were observed in those with T2-weighted imaging than in those with no myocardial abnormalities and in those with LGE without T2-weighted imaging; however, ejection fraction was not reduced in those with either LGE or T2-weighted imaging. These data suggest that cardiac MRI findings indicating myocardial inflammation/fibrosis are correlated with RA disease activity and alterations in myocardial structure known to precede clinical HF. © 2016, American College of Rheumatology.

  19. Effect of angiotensin-converting enzyme inhibitor on left ventricular parameters and circulating brain natriuretic peptide in elderly hypertensives with left venticular hypertrophy.

    Science.gov (United States)

    Kohno, M; Minami, M; Kano, H; Yasunari, K; Maeda, K; Hanehira, T; Yoshikawa, J

    2000-10-01

    In the elderly, left ventricular hypertrophy (LVH) is a powerful risk factor for cardiovascular events and cardiovascular death. The purpose of the present study is to investigate the effect of long-term effective blood pressure control with the angiotensin-converting enzyme (ACE) inhibitor temocapril on left ventricular (LV) mass and function indices and the circulating concentration of the cardiac hormone brain natriuretic peptide (BNP) in elderly hypertensives with LVH. Temocapril treatment was administered for 1 year to 11 elderly hypertensives (mean age, 72 years) with LVH. Cardiac dimensions and circulating concentrations of BNP were monitored before initiation of treatment and after 1 year of treatment. At entry, BNP levels were positively correlated with the LV mass index, but were not correlated with the mean blood pressure, LV ejection fraction, or E/A ratio (the ratio of peak transmitral flow velocity in early diastole, peak E, to that in late diastole, peak A). After 1 year, temocapril treatment resulted in effective control of blood pressure. The treatment did not affect the LV ejection fraction, but modestly increased the E/A ratio. Temocapril significantly reduced septal and posterior wall thickness and the LV mass index. BNP significantly declined after 1 year. Changes in BNP were significantly related to changes in the LV mass index, but were not related to changes in the mean blood pressure, LV ejection fraction, or E/A ratio. The results suggest that long-term ACE inhibitor treatment with temocapril can induce the regression of LV mass and reduce elevated plasma BNP in elderly hypertensive patients with LVH. In this study, changes in BNP reflected the magnitude of regression of LVH.

  20. 重组人脑利钠肽在慢性肺源性心脏病失代偿期的疗效观察%Curative Effect Observation of Recombinant Human Brain Natriuretic Peptide in Decompensated Chronic Cor Pulmonale

    Institute of Scientific and Technical Information of China (English)

    李翊; 刘爱东; 陈小会

    2015-01-01

    目的 探讨重组人脑利钠肽在慢性肺源性心脏病失代偿期的治疗效果.方法 选择天津市第一医院内科病房的慢性肺源性心脏病失代偿期患者70例患者临床资料进行回顾性分析.结果 试验组总有效率优于对照组(P<0.05),14 d血清脑利钠肽、肺动脉压、左室射血分数均优于对照组(P<0.05).结论 重组人脑利钠肽能改善慢性肺源性心脏病失代偿期症状,临床治疗效果显著.%Objective Study therapeutic effect of recombinant human brain natriuretic peptide in decompensated chronic cor pulmonale. Methods Chronic pulmonary heart disease from in the Department of internal medicine of Tianjin First Hospital ward patients with decompensated 70 patients clinical data were retrospectively analyzed. Results The total effective rate of experimental group was significantly better than the control group,P < 0.05, 14 d of serum brain natriuretic peptide, pulmonary artery pressure, left ventricular ejection fraction was significantly better than the control group (P < 0.05). Conclusion Recombinant human brain natriuretic peptide can obviously improve the chronic cor pulmonale decompensation symptoms.

  1. Urine albumin/creatinine ratio, high sensitivity C-reactive protein and N-terminal pro brain natriuretic peptide--three new cardiovascular risk markers--do they improve risk prediction and influence treatment?

    DEFF Research Database (Denmark)

    Olsen, Michael H; Sehestedt, Thomas; Lyngbaek, Stig

    2010-01-01

    In order to prioritize limited health resources in a time of increasing demands optimal cardiovascular risk stratification is essential. We tested the additive prognostic value of 3 relatively new, but established cardiovascular risk markers: N-terminal pro brain natriuretic peptide (Nt-pro...... a larger subgroup of 16% with high cardiovascular risk in which primary prevention may be advised despite low-moderate cardiovascular risk based on HeartScore. Furthermore, combined use of high UACR or high Nt-proBNP in subjects with known cardiovascular disease or diabetes identified a large subgroup...

  2. Elevated N-terminal pro-brain natriuretic peptide is associated with mortality in tobacco smokers independent of airflow obstruction.

    Directory of Open Access Journals (Sweden)

    Jason A Stamm

    Full Text Available BACKGROUND: Tobacco use is associated with an increased prevalence of cardiovascular disease. N-terminal pro-brain natiuretic peptide (NT-proBNP, a widely available biomarker that is associated with cardiovascular outcomes in other conditions, has not been investigated as a predictor of mortality in tobacco smokers. We hypothesized that NT-proBNP would be an independent prognostic marker in a cohort of well-characterized tobacco smokers without known cardiovascular disease. METHODS: Clinical data from 796 subjects enrolled in two prospective tobacco exposed cohorts was assessed to determine factors associated with elevated NT-proBNP and the relationship of these factors and NT-proBNP with mortality. RESULTS: Subjects were followed for a median of 562 (IQR 252-826 days. Characteristics associated with a NT-proBNP above the median (≥49 pg/mL were increased age, female gender, and decreased body mass index. By time-to-event analysis, an NT-proBNP above the median (≥49 pg/mL was a significant predictor of mortality (log rank p = 0.02. By proportional hazard analysis controlling for age, gender, cohort, and severity of airflow obstruction, an elevated NT-proBNP level (≥49 pg/mL remained an independent predictor of mortality (HR = 2.19, 95% CI 1.07-4.46, p = 0.031. CONCLUSIONS: Elevated NT-proBNP is an independent predictor of mortality in tobacco smokers without known cardiovascular disease, conferring a 2.2 fold increased risk of death. Future studies should assess the ability of this biomarker to guide further diagnostic testing and to direct specific cardiovascular risk reduction inventions that may positively impact quality of life and survival.

  3. Does Serum N-Terminal pro-Brain Natriuretic Peptide Level Predict the Severity of Angiographic Lesions in Patients with Acute Coronary Syndrome?

    Directory of Open Access Journals (Sweden)

    Afsaneh Rajabiani

    2015-10-01

    Full Text Available Background: Serum N-terminal pro-brain natriuretic peptide (NT-proBNP, a polypeptide secreted by ventricular myocytes in response to stretch, was suggested as a predictor of adverse prognosis of the acute coronary syndrome (ACS. We examined the association between NT-proBNP level and angiographic findings in ACS patients to determine whether it could be used as a predictor of the severity of angiographic lesions.Methods: This cross-sectional study was performed on 126 patients with chest pain or other ischemic heart symptoms suggestive  of ACS.  Venous  blood  samples  were  drawn  to  measure  serum  levels  of  NT-proBNP. Afterward,  coronary angiography was performed and the patients were categorized into four groups according to the number of coronary vessels with significant stenosis. The severity of angiographic lesions was assessed with the Gensini scoring system.Results: According to angiographic diagnosis, 11 (8.7% patients had normal coronary arteries (no coronary artery disease [CAD] and 115 (91.3% had CAD, of whom 108 (85.7% had obstructive CAD and 7 (5.6% had minimal CAD. The serum NT-proBNP concentration was higher in the CAD group than in the non-CAD group (p value <0.01. A progressive significant increase in the NT-proBNP concentration according to the Gensini score and the number of involved vessels was reported after adjustment for sex and age. Furthermore, the Receiver Operating Characteristic Curve (ROC analysis indicated that an NT-proBNP cut-point of 400 pg/ml could predict obstructive CAD with a sensitivity of 65% and a specificity of 78%.Conclusion: Higher levels of NT-proBNP among our ACS patients were associated with the severity of angiographic lesions in terms of both the Gensini score and the number of involved vessels. This finding underscores the potential role of NT-proBNP in predicting the severity of CAD before performing angiography.

  4. Pro-Brain Natriuretic Peptide and Troponin T-Hypersensitivity Levels Correlate With the Severity of Liver Dysfunction in Liver Cirrhosis.

    Science.gov (United States)

    Zhao, Jiancheng; Li, Sai; Ren, Linan; Guo, Xiaozhong; Qi, Xingshun

    2017-08-01

    Increased pro-brain natriuretic peptide (pro-BNP) or troponin T-hypersensitivity (TnT-HSST) levels are common in liver cirrhosis. We conducted a retrospective observational study aimed to evaluate the correlation of pro-BNP and TnT-HSST levels with the clinical characteristics, laboratory data and in-hospital outcomes of patients with liver cirrhosis. We selected cirrhotic patients admitted to our hospital between January 2011 and June 2014. All eligible patients had pro-BNP or TnT-HSST data, or both. The pro-BNP and TnT-HSST data were further divided according to the presence of cardiac diseases. The prevalence of pro-BNP level >900pg/mL was 41.72% (63 of 151 patients). The prevalence of TnT-HSST level >0.05ng/mL was 11.22% (45 of 401 patients). In the overall analysis, pro-BNP level significantly correlated with red blood cell (RBC), platelet, ascites, blood urea nitrogen (BUN), creatinine (Cr), Child-Pugh score, model for end-stage liver disease (MELD) score and in-hospital death; TnT-HSST level significantly correlated with white blood cell, ascites, albumin (ALB), BUN, Cr, Child-Pugh score, MELD score and in-hospital death. In patients with cardiac diseases, pro-BNP level significantly correlated with RBC, ascites, BUN, Cr, Child-Pugh score and MELD score; TnT-HSST level significantly correlated with sex, ascites, white blood cell, ALB, BUN, Cr, Child-Pugh score, MELD score and in-hospital death. In patients without cardiac diseases, pro-BNP level significantly correlated with ascites, RBC, platelet, BUN, Cr, MELD score and in-hospital death; TnT-HSST level significantly correlated with age, ascites, RBC, ALB, BUN, Cr, Child-Pugh score, MELD score and in-hospital death. Pro-BNP and TnT-HSST levels significantly correlated with the severity of liver dysfunction and in-hospital mortality in cirrhosis. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  5. Effect of physical training on exercise capacity, gas exchange and N-terminal pro-brain natriuretic peptide levels in patients with chronic heart failure.

    Science.gov (United States)

    Maria Sarullo, Filippo; Gristina, Tommaso; Brusca, Ignazio; Milia, Salvatore; Raimondi, Raffaella; Sajeva, Massimo; Maria La Chiusa, Stella; Serio, Gesualdo; Paterna, Salvatore; Di Pasquale, Pietro; Castello, Antonio

    2006-10-01

    Decreased exercise capacity is the main factor restricting the daily life of patients with chronic heart failure. N-terminal pro-brain natriuretic peptide (NT pro-BNP) is strongly related to the severity of and is an independent predictor of outcome in chronic heart failure. The study aimed to evaluate the effect of exercise training on functional capacity and on changes in NT pro-BNP levels and to assess the effect of exercise training on quality of life. Sixty patients (45 men/15 women, mean age 52.7 years; +/-5.3 SD), with stable heart failure (45 ischaemic/hypertensive and 15 idiopathic patients), in New York Heart Association (NYHA) functional class II (n=35) to III (n=25), with an ejection fraction less than 40%, were randomly assigned to a training (n=30) and a control group (n=30). The training group (30 patients) performed 3 months of supervised physical training programme using a bicycle ergometer for 30 min three times a week at a load corresponding to 60-70% of their oxygen consumption (VO2) peak. The control group did not change their previous physical activity. A graded maximal exercise test with respiratory gas analysis and an endurance test with constant workload corresponding to 85% of the peak oxygen load at the baseline and after 3 months were performed, and at the same times NT pro-BNP levels were measured. The exercise capacity increased from 15.8 (+/-2.3 SD) to 29.9 (+/-2.1 SD) min (P<0.0001) and the peak VO2 tended to improve from 14.5 (+/-1.4 SD) to 17.7 (+/-2.6 SD) ml/kg per min (P<0.0001) during the supervised training period. VO2 at the anaerobic threshold increased from 12.9 (+/-1.0 SD) to 15.5 (+/-1.7 SD) ml/kg per min (P<0.0001). NT pro-BNP levels decreased from 3376 (+/-3133 SD) to 1434 (+/-1673 SD) pg/ml (P=0.043). The positive training effects were associated with an improvement in the NYHA functional class. Physical training of moderate intensity significantly improves the exercise capacity and neurohormonal modulation in patients

  6. Relationship between N-terminal pro-brain natriuretic peptide, obesity and the risk of heart failure in middle-aged German adults.

    Directory of Open Access Journals (Sweden)

    Janine Wirth

    Full Text Available Both high concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP and obesity are related to higher heart failure risk. However, inverse relationships between NT-proBNP and obesity have been reported. Therefore, it was investigated whether the association between NT-proBNP and the risk of heart failure differed according to obesity status.A case-cohort study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC-Potsdam, comprising a random sub-cohort (non-cases = 1,150, cases = 13, mean age: 50.5±9.0 years and heart failure cases outside the sub-cohort (n = 197. Weighted Cox proportional hazards regression was used to examine the association between NT-proBNP and heart failure risk during a mean follow-up time of 8 years. Stratified analyses were performed according to obesity status as defined by body mass index (<30 kg/m2 versus ≥30 kg/m2.Overall, NT-proBNP was associated with higher risk of heart failure after multivariable adjustment (hazard ratio (HR and 95% confidence interval (CI: 2.56 (1.49-4.41 for the top versus bottom tertile of NT-proBNP, ptrend:<0.01. In stratified analyses, the shape of association was linear in non-obese and U-shaped in obese participants: HRs (95%CI from the first to the third tertile of NT-proBNP for non-obese: reference, 1.72 (0.85-3.49, 2.72 (1.42-5.22, and for obese: 3.29 (1.04-10.40, reference, 3.74 (1.52-9.21.Although high circulating concentrations of NT-proBNP were positively associated with incident heart failure in the entire sample, the association differed according to obesity status. In obese, an increased risk of heart failure was also observed in those with low NT-proBNP concentrations. If confirmed, this observation warrants further investigation to understand underlying pathophysiological mechanisms.

  7. Usefulness of brain natriuretic peptide level at implant in predicting mortality in patients with advanced but stable heart failure receiving cardiac resynchronization therapy.

    Science.gov (United States)

    El-Saed, Aiman; Voigt, Andrew; Shalaby, Alaa

    2009-11-01

    Brain natriuretic peptide (BNP) level has emerged as a predictor of death and hospital readmission in patients with heart failure (HF). The value of baseline BNP assessment in advanced HF patients receiving cardiac resynchronization defibrillator therapy (CRT-D) has not been firmly established. We hypothesized that a baseline BNP level would predict all cause mortality and HF hospitalization in HF patients receiving cardiac resynchronization therapy. A retrospective chart review of all patients having BNP assessment prior to implantation of a CRT-D for standard indications during 2004 and 2005 was conducted at the Veterans Affairs Pittsburgh Healthcare System. The primary endpoint was all-cause mortality and the secondary endpoint was HF-related hospitalization. We used findings from the receiver operating characteristic (ROC) curve to define low ( or =492 pg/mL) BNP groups. Out of 173 CRT-D recipients, 115 patients (mean age 67.0 +/- 10.7 years, New York Heart Association [NYHA] class 2.9 +/- 0.3, left ventricular ejection fraction [LVEF] 22.5% +/- 9.6%, QRS 148.3 +/- 30.4 ms) had preimplantation BNP measured (mean 559 +/- 761 pg/mL and median 315 pg/mL). During a mean follow-up time of 17.5 +/- 6.5 mo, 27 deaths (23.5%) and 31 HF hospitalizations (27.0%) were recorded. Compared to those with low BNP (n = 74), those of high BNP (n = 41) were older, had lower LVEF, higher creatinine levels, suffered more deaths, and HF hospitalizations. In multivariate regression models, higher BNP remained a significant predictor of both the primary endpoint (hazard ratio [HR]: 2.89, 95% confidence interval [CI] 1.06-7.88, p = 0.038) and secondary endpoint (HR: 4.23, 95% CI: 1.68-10.60, p = 0.002). Baseline BNP independently predicted mortality and HF hospitalization in a predominantly older white male population of advanced HF patients receiving CRT-D. Elevated BNP levels may identify a vulnerable HF population with a particularly poor prognosis despite CRT-D.

  8. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    . An inefficient post-translational prohormone maturation will also affect the biology of the cardiac natriuretic peptide system. This review aims at summarizing the myocardial synthesis of natriuretic peptides focusing on B-type natriuretic peptide, where new data has disclosed cardiac myocytes as highly...

  9. REMODELING OF THE RIGHT HEART AND THE LEVEL OF BRAIN NATRIURETIC PEPTIDE IN PATIENTS WITH CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION: A COMPARATIVE CROSS-SECTIONAL OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    A. A. Klimenko

    2015-09-01

    Full Text Available Aim. To study the right heart remodeling and level of N-terminal brain natriuretic peptide (Nt-proBNP in patients with chronic thromboembolic pulmonary hypertension (CTEPH. Material and methods. Patients (n=79 after pulmonary embolism were included into the study. The main group consisted of patients (n=43 with an increase in systolic pulmonary artery pressure (SPAP >30 mm Hg: 30 (37.9%  patients had pulmonary hypertension (PH degree I, and 13 (16.5%  — PH degree II–III. Group of comparison con- sisted of 36 patients expired pulmonary embolism and having SPAP <30 mm Hg. The control group consisted of 20 people. 6-minute walk test (6-MWT and Doppler echocardiography were performed in all patients. Besides myocardial tissue Doppler echocardiography and assessment of Nt-proBNP level were performed in 38 and 71 patients, respectively. Results. Dyspnea occurred in 90.7% of patients with various degrees of PH and 80.5% of patients with normal SPAP. Patients without PH and with PH I complained of palpitations, weakness, fatigue, and dizziness with similar frequency. Patients with PH I were comparable with ones of comparison group in 6-MWT distance that dramatically decreased in patients with PH II–III. Enlargement of the right atrium (RA and/or right ventricular (RV was observed in 76.7% of patients with PH I and 100% of patients with PH II–III. RV diastolic function abnormalities (E/A<1 and E/A>2 were detected in 19.4%, 16.7% and 61.5% of patients of comparison group, PH I and PH II–III patients, respectively. According to myocardial tissue Doppler echocardiography Em/Am<1 was observed in 8 (72.7% patients of the comparison group and in 13 (76.4% patients with PH. Nt-proB-NP level was 17.3 [2.3, 33.9] fmol/ml in PH I patients and 142.1 [62.1, 171.8] fmol/ml in PH II–III patients. Nt-proBNP level was 6.5 [3.1, 18.3] fmol/mL in patients of the comparison group, and it was higher than this in patients of the control group (3.5 [1.8, 7

  10. Diagnostic value of troponin, myocardial enzymes, brain natriuretic peptide to acute myocardial infarction patients%肌钙蛋白、心肌酶谱联合脑钠肽与急性心梗相关性研究

    Institute of Scientific and Technical Information of China (English)

    陈杰民

    2012-01-01

      目的研究肌钙蛋白(cTnI,cTnT)、心肌酶谱联合脑钠肽对急性心肌梗死(acute myocardial infarction,AMI)的诊断价值.方法住院的 AMI 患者104例,正常对照组来自我院体检科60例.研究两组之间的肌钙蛋白、心肌酶谱联合脑钠肽指标的应用价值.结果 AMI 组治疗前和对照组之间的心肌酶指标包括谷草转氨酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、乳酸脱氢酶(LDH),心梗指标包括肌红蛋白 Mb、cTnI、cTnT,以及新指标脑钠肽(brain natriuretic peptide,BNP)在两组之间的差异明显(P〈0.05).BNP、BNP /AST、BNP /CKMB、BNP /cTnT 以及 BNP /cTnI 的曲线下面积均大于0.90,对治疗前急性心梗的诊断价值较高.指标的诊断价值排序为:BNP /cTnT > BNP /cTnI > BNP /CKMB > BNP /AST > BNP.结论 BNP、BNP /AST、BNP /CKMB、BNP /cTnT 以及 BNP /cTnI 的对急性心梗的诊断价值较高.%  Objective: To study diagnostic value of the study troponin (cTnI, cTnT), myocardial enzymes, brain natriuretic peptide to acute myocardial infarction. Methods: 104 cases of hospitalized patients with AMI and 60 cases of normal control group from the hospital physical examination department.Research the application value of troponin, myocardial enzymes, brain natriuretic peptide between the two groups. Results: AMI group before treatment and control group were significant differences in aspartate aminotransferase, creatine kinase, creatine kinase MB, lactate dehydrogenase, myocardial infarction indicators include myoglobin Mb , cTnI, cTnT, as wel as new indicators of brain natriuretic peptide (P ﹤0.05). BNP, BNP /AST, BNP / CKMB, BNP / cTnT and BNP / cTnI area under the curve were greater than 0.90, the diagnosis is high before the treatment of acute myocardial infarction. The diagnostic value of sort of targets: BNP / cTnT﹥ BNP / cTnI﹥ BNP / CKMB﹥ BNP / AST﹥ BNP. Conclusion: BNP, BNP / AST, BNP / CKMB, BNP / cTnT and BNP / cTnI have high

  11. Progress in the Predictive Value of Brain Natriuretic Peptide for Congestive Heart Failure%脑钠肽对充血性心力衰竭近期预后影响研究进展

    Institute of Scientific and Technical Information of China (English)

    洪斌; 葛均波

    2007-01-01

    脑钠肽(brain natriuretic peptide,BNP)是由心室分泌的一种调节心血管系统功能的多肽类激素,半衰期为23min,随充血性心力衰竭(congestive heart failure,CHF)的加重而分泌增加。BNP来源于心室,心肌缺血、损伤、坏死,心室壁张力和压力过重、苯福林、肾上腺素、异丙肾上腺素等均刺激BNP的合成与分泌。BNP通过受体起作用。

  12. Incremental value of a combination of cardiac troponin T, N-terminal pro-brain natriuretic peptide and C-reactive protein for prediction of mortality in end-stage renal disease

    DEFF Research Database (Denmark)

    Hallén, Jonas; Madsen, Lene Helleskov; Ladefoged, Søren

    2011-01-01

    Abstract Objective. To determine the relative prognostic merits of C-reactive protein (CRP), cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) for prediction of all-cause death in patients with end-stage renal disease (ESRD) receiving haemodialysis. Material...... were predictive of death in univariate analysis. In multivariable analysis, elevated cTnT (> 0.01 µg/l) and CRP (> 1.0 mg/dl) remained significantly associated with mortality [hazard ratio (95% confidence interval), 3.2 (1.2-8.5), p = 0.017 for cTnT; 2.0 (1.0-3.8), p = 0.032 for CRP], while NT...

  13. Ammonia inhibits the C-type natriuretic peptide-dependent cyclic GMP synthesis and calcium accumulation in a rat brain endothelial cell line.

    Science.gov (United States)

    Konopacka, Agnieszka; Zielińska, Magdalena; Albrecht, Jan

    2008-05-01

    Recently we reported a decrease of C-type natriuretic peptide (CNP)-dependent, natriuretic peptide receptor 2 (NPR2)-mediated cyclic GMP (cGMP) synthesis in a non-neuronal compartment of cerebral cortical slices of hyperammonemic rats [Zielińska, M., Fresko, I., Konopacka, A., Felipo, V., Albrecht, J., 2007. Hyperammonemia inhibits the natriuretic peptide receptor 2 (NPR2)-mediated cyclic GMP synthesis in the astrocytic compartment of rat cerebral cortex slices. Neurotoxicology 28, 1260-1263]. Here we accounted for the possible involvement of cerebral capillary endothelial cells in this response by measuring the effect of ammonia on the CNP-mediated cGMP formation and intracellular calcium ([Ca2+]i) accumulation in a rat cerebral endothelial cell line (RBE-4). We first established that stimulation of cGMP synthesis in RBE-4 cells was coupled to protein kinase G (PKG)-mediated Ca2+ influx from the medium which was inhibited by an L-type channel blocker nimodipine. Ammonia treatment (1h, 5mM NH4Cl) evoked a substantial decrease of CNP-stimulated cGMP synthesis which was related to a decreased binding of CNP to NPR2 receptors, and depressed the CNP-dependent [Ca2+]i accumulation in these cells. Ammonia also abolished the CNP-dependent Ca2+ accumulation in the absence of Na+. In cells incubated with ammonia in the absence of Ca2+ a slight CNP-dependent increase of [Ca2+]i was observed, most likely representing Ca2+ release from intracellular stores. Depression of CNP-dependent cGMP-mediated [Ca2+]i accumulation may contribute to cerebral vascular endothelial dysfunction associated with hyperammonemia or hepatic encephalopathy.

  14. Value of serum brain natriuretic peptide levels in the prognosis of brain damage after cardiopulmonary resuscitation%血清脑钠肽水平对心肺复苏后脑损伤的预测价值研究

    Institute of Scientific and Technical Information of China (English)

    李钦浩; 巩晓娜; 周娆娆; 刘朋; 张磊; 亓雪梅; 蒋芳杰

    2013-01-01

    OBJECTIVE To evaluate the effect of serum brain natriuretic peptide levels on brain damage at the early stage after cardiopulmonary resuscitation (CPR). METHODS There were 34 patients with restoration of spontaneous circulation after successful CPR.After 2 months of successful cardiopulmonary resuscitation (CPR) , patients with GCS score ≥ 12 were mild brain damage (I group, male 6 cases, female 8 cases); GCS score 9 ≤ GCS ≤ 11 were moderate brain damage (II group, male 4 cases, female 6 cases); GCS score 3 ≤ GCS ≤ 8 were severe brain damage (Ⅲ group, male 5 cases, and female 5 cases) . Control group was consisted of 15 healthy volunteers. All of the patients' venous blood were respectively collected and BNP was detected by enzyme linked immunosorbent assay at 2, 8, 12, 24 and 48 h after restoring of independent circulation. RESULTS Compared the age, sex, start time of cardiac arrest to recovery in cardiopulmonary resuscitation (CPR) group and control group, differences were not statistically significant (P> 0.05); at 2, 8, 12, 24 and 48 h, serum BNP levels in I , II and Ⅲ groups were significantly higher than the control group (P < 0.05); And in the trail group, I group was significantly lower than the II group (P< 0.05); II group and was significantly lower than the HI group (P< 0.05). CONCLUSION Serum BNP levels can reflect cardiopulmonary resuscitation (CPR) early after HPC ischemia brain damage, and for the assessment of the recovery cardiopulmonary resuscitation (CPR) has an important value.%目的 探讨血清脑钠肽(BNP)对心肺复苏后脑损伤的预测的价值.方法 34例经心肺复苏后自主循环恢复的患者,以心肺复苏成功后2个月格拉斯哥昏迷评分(GCS)≥12为轻度脑损伤(Ⅰ组),男6例,女8例;9≤GCS≤11为中度脑损伤(Ⅱ组),男4例,女6例;3≤GCS≤8为重度脑损伤(Ⅲ组),男5例,女5例.另外选取14例健康者(女8例,男6例)作为对照组.所有患者均在自主循环恢复后2、8

  15. A Novel Role for Brain Natriuretic Peptide: Inhibition of IL-1β Secretion via Downregulation of NF-kB/Erk 1/2 and NALP3/ASC/Caspase-1 Activation in Human THP-1 Monocyte

    Directory of Open Access Journals (Sweden)

    Letizia Mezzasoma

    2017-01-01

    Full Text Available Interleukin-1β (IL-1β is a pleiotropic cytokine and a crucial mediator of inflammatory and immune responses. IL-1β processing and release are tightly controlled by complex pathways such as NF-kB/ERK1/2, to produce pro-IL-1β, and NALP3/ASC/Caspase-1 inflammasome, to produce the active secreted protein. Dysregulation of both IL-1β and its related pathways is involved in inflammatory/autoimmune disorders and in a wide range of other diseases. Identifying molecules modulating their expression is a crucial need to develop new therapeutic agents. IL-1β is a strong regulator of Brain Natriuretic Peptide (BNP, a hormone involved in cardiovascular homeostasis by guanylyl cyclase Natriuretic Peptide Receptor (NPR-1. An emerging role of BNP in inflammation and immunity, although proposed, remains largely unexplored. Here, we newly demonstrated that, in human THP-1 monocytes, LPS/ATP-induced IL-1β secretion is strongly inhibited by BNP/NPR-1/cGMP axis at all the molecular mechanisms that tightly control its production and release, NF-kB, ERK 1/2, and all the elements of NALP3/ASC/Caspase-1 inflammasome cascade, and that NALP3 inflammasome inhibition is directly related to BNP deregulatory effect on NF-kB/ERK 1/2 activation. Our findings reveal a novel potent anti-inflammatory and immunomodulatory role for BNP and open new alleys of investigation for a possible employment of this endogenous agent in the treatment of inflammatory/immune-related and IL-1β/NF-kB/ERK1/2/NALP3/ASC/Caspase-1-associated diseases.

  16. Effects of recombinant human brain natriuretic peptide on the prognosis of patients with acute anterior myocardial infarction undergoing primary percutaneous coronary intervention: a prospective, multi-center, randomized clinical trial

    Science.gov (United States)

    Hou, Ai-Jie; Zang, Hong-Yun; Huang, Ru-Gang; Zheng, Xiao-Qun; Lin, Hai-Long; Wang, Wei; Hou, Ping; Xia, Fei; Li, Zhan-Quan

    2017-01-01

    Background This study aims to investigate the effects of recombinant human brain natriuretic peptide (rhBNP) on serum enzyme data, cardiac function parameters and cardiovascular events in patients with acute anterior myocardial infarction (MI). Methods A total of 421 patients with acute anterior or extensive anterior MI were collected from 20 hospitals. These patients were randomly divided into two groups: rhBNP and control groups. Both groups of patients received primary percutaneous coronary intervention (PCI) within the effective time window. In the rhBNP group, rhBNP administration (0.01 µg/kg/min, 48–72 successive hours) was performed as early as possible after hospital admission. Prior to and one or seven days after PCI, serum concentrations of cardiac troponin (cTnT), creatine kinase-MB (CK-MB) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured. At seven days and 6 months after PCI, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd) and stroke volume (SV) were measured using 2D Doppler echocardiography. MACEs that occurred during hospitalization and within 6 months after PCI were recorded. Results At postoperative days one and seven, serum concentrations of cTnT were significantly lower in the rhBNP group than in the control group. At postoperative day one, serum concentrations of CK-MB were significantly lower in the rhBNP group than in the control group. At postoperative day seven, serum concentrations of NT-proBNP were significantly lower in the rhBNP group than in the control group, and LVEF was significantly greater in the rhBNP group than in the control group. At postoperative 6 months, LVEDd was significantly lower in the rhBNP group compared with the control group. In addition, SV and LVEF were significantly greater in the rhBNP group than in the control group. By postoperative month 6, the incidence of composite cardiovascular events (16.0% vs. 26.0%, P=0.012), cardiac death (7.0% vs.13

  17. Changes in Serum Natriuretic Peptide Levels after Percutaneous Closure of Small to Moderate Ventricular Septal Defects

    Directory of Open Access Journals (Sweden)

    Yuksel Kaya

    2012-01-01

    Full Text Available Background. B-type natriuretic peptide has been shown to be a very sensitive and specific marker of heart failure. In this study, we aimed to investigate the effect of percutaneous closure of ventricular septal defects with Amplatzer septal occluders on brain natriuretic peptide levels. Methods. Between 2008 and 2011, 23 patients underwent successfully percutaneous ventricular septal defect closure in 4 cardiology centers. Brain natriuretic peptide levels were measured in nine patients (4 male, mean ages were 25.3±14.3 who underwent percutaneous closure with Amplatzer occluders for membranous or muscular ventricular septal defects were enrolled in the study. Brain natriuretic peptide levels were measured one day before and one month after the closure. Patients were evaluated clinically and by echocardiography one month after the procedure. Results. Percutaneous closures of ventricular septal defects were successfully performed in all patients. There was not any significant adverse event in patients group during followup. Decrease in brain natriuretic peptide levels after closure were statistically significant (97.3±78.6 versus 26.8±15.6, =0.013. Conclusion. Brain Natriuretic Peptide levels are elevated in patients with ventricular septal defects as compared to controls. Percutaneous closure of Ventricular Septal Defect with Amplatzer occluders decreases the BNP levels.

  18. Atrial Natriuretic Peptide (ANP) in early pregnancy is associated with development of preeclampsia in type 1 diabetes

    DEFF Research Database (Denmark)

    Nielsen, Lene Ringholm; Pedersen-Bjergaard, Ulrik; Thorsteinsson, Birger;

    2011-01-01

    The vasoactive markers of cardiac overload Atrial Natriuretic Peptide (ANP) and Brain Natriuretic Peptide (BNP) are elevated in preeclampsia. This study documents higher ANP concentrations as early as at 9 weeks in type 1 diabetic women subsequently developing preeclampsia suggesting...... that preeclampsia is associated with cardiovascular changes in early pregnancy....

  19. 生物标志物-血清脑钠素在充血性心力衰竭诊断中的价值%Measurement of Serum Brain Natriuretic Peptide Level as a Biomarker for Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    王频佳; 王娴

    2007-01-01

    Objective To explore the value of Brain Natriuretic pepfide (BNP) in estimating the degree of seriousness of congestive heart failure (HF) and study BNP level of CHF caused by various cardiovascular diseases.Methods 100 patients with CHF were divided into three classes (classⅠ,Ⅱ and Ⅳ)by New York Heart Association (NYHA) functional classification Standard. 100 healthy individuals were selected into control group.Serum BNP concentration Were measured by electrochemical luminescence assay (Elecsys 2010,Roche Diagnostics).Results Mean serum BNP concentration of patients with CHF was 4 745.49±3 698.70 ng/ml,which was higher significantly than that of normal control (66.18±44.30ng/ml).Moreover,the growth in BNP level was increased with NYHA functional classification:class Ⅳ (1 0251±9 326.8 ng/ml) >class Ⅲ(1 239±1 063.8 ng/ml) > class Ⅱ (167.4±143.4 ng/ml),which was statistically significant (P0.05),但NYHAⅡ级各病因组间BNP水平差异有显著性(P<0.05).结论 CHF患者血清BNP水平显著增高,且随着NYHA分级增加而增加,可作为评价CHF严重程度的客观指标.

  20. 脑钠肽在儿童心血管疾病诊治中的研究进展%Research advance of brain natriuretic peptide in the diagnosis and treatment of pediatric cardiovascular disease

    Institute of Scientific and Technical Information of China (English)

    吴利伟(综述); 王凤鸣(审校)

    2013-01-01

      脑钠肽(BNP)是一种主要来源于心室的心脏内分泌激素,具有很强的利钠、利尿、扩张血管、抑制肾素–血管紧张素–醛固酮系统(RAAS)和交感神经系统活性作用。研究表明,心血管疾病患儿的血浆BNP及氨基末端脑钠肽原(NT-proBNP)水平升高,可以反映心室功能变化。该文就BNP/NT-proBNP的生物学特性、检测方法、正常值范围及其在儿童心血管疾病诊治中的研究进展作一综述。%Brain natriuretic peptide(BNP) is a cardiac hormone mainly secreted by myocytes in the ventricular wall. It has strong action of natriuresis, diuresis, vasodilation, inhibition of renin-angiotensin-aldosterone system and sympathetic nervous system. The increased levels of BNP and NT-proBNP have been reported in children’s cardiovascular diseases in numerous stu-dies and can reflect cardiac function. This article simply reviews the BNP and NT-proBNP about its biology character, detection method, medical reference range and its progress in pediatric cardiovascular disease.

  1. Predictability of brain natriuretic peptide on the prognosis in elderly patients with septic shock%BNP水平对老年感染性休克患者预后评估的作用

    Institute of Scientific and Technical Information of China (English)

    崔志新; 卓裕丰; 陈伟杰; 李泽伦

    2014-01-01

    Objective:To investigate the predictability of brain natriuretic peptide ( BNP ) on the prognosis in elderly patients with septic shock. Methods:Seventy-eight elderly patients with septic shock recruited between June 2007 and October 2013 in the Intensive Care Unit, Panyu Hexian Memorial Hospital, were retrospectively analyzed. Patients were,according to their BNP levels at 6 and 24 h after admission,allocated to group A ( BNP0.05) . Compared with groups A and B,all indices were significantly heightened in group C ( all P0.05),与A组、B组比较,C组上述指标均显著升高( P<0.05)。结论:BNP水平对老年感染性休克患者预后的判断有一定意义,BNP水平≥500 pg/mL可能是患者病情加重及死亡率增高的一个重要判断指标。

  2. 血清脑钠肽水平与慢性阻塞性肺疾病的相关性研究%Correlation research between serum brain natriuretic peptide level and chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    钟晓华

    2015-01-01

    ObjectiveTo investigate and research correlation between serum brain natriuretic peptide (BNP) level and chronic obstructive pulmonary disease (COPD).MethodsThere were 80 COPD patients. BNP levels in acute exacerbation and clinical remission were observed and compared.ResultsThere were statistically significant differences of BNP levels in different COPD degree patients at the same period (P0.05). Grade Ⅲ and Ⅳ COPD in acute exacerbation had much higher BNP level than clinical remission, and the difference had statistical significance (P0.05),Ⅲ、Ⅳ级COPD患者急性加重期的BNP水平显著高于临床缓解期,差异具有统计学意义(P<0.05)。结论COPD患者疾病进展程度和BNP水平有着显著相关,病情越重则BNP水平变化越明显,可作为COPD的诊断和病情严重程度的判别依据。

  3. The clinical importance and change of brain natriuretic peptide in diagnosing chronic obstructive pulmonary disease%慢性阻塞性肺疾病中脑钠肽水平的变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    王煜

    2013-01-01

    Objective: To investigate the changes of the levels of plasma brain natriuretic peptide (BNP) in patients with chronic obstructive pulmonary disease (COPD) and chronic cor pulmonale (CCP). Methods: Plasma BNP levels were detected in 30 patients with CCP at acute stage, compared with simple COPD group, and the rela tionship between it and PO2 , pulmonary artery pressure (PAP) was analyzed. Measurements were repeated in the same 30 patients with CCP at remission tage after therapy in hospital. Results: The levels of BNP at acute stage (262. 84 ± 47. 59)pg/ml and remission stage (128. 52 ±24. 82) pg/ml for CCP group were both higher than that in the simple COPD group (64.76 ± 12.03) pg/ml (P0. 05). In the acute stage of CCP group, BNP levels in the plasma were positively correlated with the PAP(r=0. 763, P0.05).结论:在COPD伴CCP患者中,血浆BNP水平上升,可能与缺氧、肺动脉高压(PAH)等因素相关.

  4. Serum Soluble Urokinase-Type Plasminogen Activator Receptor Is Associated with Low Left Ventricular Ejection Fraction and Elevated Plasma Brain-Type Natriuretic Peptide Level

    Science.gov (United States)

    Fujita, Shu-ichi; Tanaka, Suguru; Maeda, Daichi; Morita, Hideaki; Fujisaka, Tomohiro; Takeda, Yoshihiro; Ito, Takahide; Ishizaka, Nobukazu

    2017-01-01

    Background Recent studies have suggested that soluble urokinase plasminogen activator receptor (suPAR), a biomarker of subclinical levels of inflammation, is significantly correlated with cardiovascular events. Purpose We investigated the association between suPAR and left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), and plasma B-type natriuretic peptide (BNP) among cardiac inpatients. Methods and Results In total, 242 patients (mean age 71.3 ± 9.8 years; 70 women) admitted to the cardiology department were enrolled in the study. suPAR was significantly correlated with LVEF (R = -0.24, P 3236 pg/mL) was associated with low LVEF ( 300 pg/mL) with an odds ratio of 3.84 (95% confidence interval [CI], 1.22–12.1) and 5.36 (95% CI, 1.32–21.8), respectively, after adjusting for age, sex, log-transformed estimated glomerular filtration rate (log(eGFR)), C-reactive protein, and diuretic use. The association between suPAR and LVMI was not statistically significant. In multivariate receiver operating characteristic analysis, addition of log(suPAR) to the combination of age, sex, log(eGFR) and CRP incrementally improved the prediction of low LVEF (area under the curve [AUC], 0.827 to 0.852, P = 0.046) and BNP ≥ 300 pg/mL (AUC, 0.869 to 0.906; P = 0.029). Conclusions suPAR was associated with low LVEF and elevated BNP, but not with left ventricular hypertrophy, independent of CRP, renal function, and diuretic use among cardiac inpatients who were not undergoing chronic hemodialysis. PMID:28135310

  5. Relationship of brain natriuretic peptide concentrations to left ventricular function and adverse outcomes in children with end-stage renal disease undergoing hemodialysis.

    Science.gov (United States)

    Ouali, Sana; Bougmiza, Iheb; Abroug, Saoussen; Omezzine, Asma; Ben Salem, Helmi; Neffeti, Elyes; Remedi, Fahmi; Bouslema, Ali; Harabi, Abdelaziz; Boughzela, Essia

    2011-06-01

    B-type natriuretic peptide (BNP) is a biomarker of cardiovascular disease that is common in adults with chronic kidney disease (CKD). However, in children with CKD, the range and predictive power of BNP concentrations are not known. We aimed to determine the effect of HD on BNP, as well as the prognostic impact of BNP, in end-stage renal disease (ESRD) children undergoing hemodialysis (HD). Thirty-five children with chronic renal failure (16 boys age 12.1 ± 3.7 years) on maintenance HD were included. BNP level was measured, and Doppler echocardiography was performed 30 min before (pre-HD BNP) and 30 min after (post-HD BNP) HD in each patient. An adverse event was defined as all-cause death and heart failure hospitalization. The median pre-HD BNP, the post-HD BNP, and the change in BNP were, respectively, 240 pg/ml (72 to 3346), 318 pg/ml (79 to 3788), and 9 pg/ml (-442 to 1889). Pre-HD BNP concentration was negatively correlated with left ventricular (LV) ejection fraction (r = -0.41, P = 0.018). During a mean follow-up of 39 ± 14 months, 6 patients died, and 3 were hospitalized for heart failure. Using univariate analysis, BNP before and after HD as well as Doppler tissue imaging velocities had a strong graded relationship with adverse events. Cox proportional hazards model demonstrated that pre-HD body weight (P = 0.008), pre-HD BNP (P = 0.011), and post-HD BNP (P = 0.038) remained independent predictors of adverse outcome. Even in case of ESRD, BNP still strongly correlated with LV systolic and diastolic dysfunction and was associated with mortality in HD children.

  6. Elevated plasma levels of N-terminal pro-brain natriuretic peptide in patients with chronic hepatitis C during interferon-based antiviral therapy

    Institute of Scientific and Technical Information of China (English)

    J(o)rg Bojunga; Christoph Sarrazin; Georg Hess; Stefan Zeuzem

    2006-01-01

    AIM: To investigate plasma levels of N-terminal probrain natriuretic peptide (NT-proBNP), an established marker of cardiac function, in patients with chronic hepatitis C during interferon-based antiviral therapy.METHODS: Using a sandwich immunoassay, plasma levels of NT-proBNP were determined in 48 patients with chronic hepatitis C at baseline, wk 24 and 48 during antiviral therapy and at wk 72 during follow-up.RESULTS: Plasma NT-proBNP concentrations were significantly increased (P < 0.05) at wk 24, 48 and 72 compared to the baseline values. NT-proBNP concentrations at baseline and wk 24 were closely correlated (r = 0.8; P < 0.001). At wk 24, 7 (14.6%)patients had NT-proBNP concentrations above 200 ng/L compared to 1 (2%) patient at baseline (P = 0.059).Six of these 7 patients had been treated with high-dose IFN-α induction therapy. In multiple regression analysis,NT-proBNP was not related to other clinical parameters,biochemical parameters of liver disease or virus load and response to therapy.CONCLUSION: Elevated levels of NT-proBNP during and after interferon-based antiviral therapy of chronic hepatitis C may indicate the presence of cardiac dysfunction, which may contribute to the clinical symptoms observed in patients during therapy. Plasma levels of NT-proBNP may be used as a diagnostic tool and for guiding therapy in patients during interferonbased antiviral therapy.

  7. 肌钙蛋白I与N端脑钠肽原在慢性心衰危险预测中的应用价值分析%Value of troponin I and N-terminal pro-brain natriuretic peptide in predicting the risk of chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    朱湘慧; 钱银芬

    2016-01-01

    Objective To investigate the va1ue of troponin I and N- termina1 pro-brain natriuretic peptide in predicting the risk of chronic heart fai1ure. Methods A tota1 of 37 patients with chronic heart fai1ure who were treated in our hospita1 from September 2013 to September 2105 were enro11ed as observation group. Another 37 patients with norma1 cardiac function who were admitted to our hospita1 were enro11ed as contro1 group. Troponin I and N- termina1 pro-brain natriuretic peptide 1eve1s were determined for both groups after admission and compared between the two groups. Results Compared with the contro1 group, the observation group had significant1y higher mean 1eve1s of troponin I (4.5±3.0ng/m1) and N- termina1 pro-brain natriuretic peptide (769.5±322.5pg/m1) (P<0.05). The patients with cardiac function c1ass II had the 1owest 1eve1s of troponin I and N-termina1 pro- brain natriuretic peptide, and those with cardiac function c1ass IV had the highest 1eve1s of troponin I and N-termina1 pro- brain natriuretic peptide. The 1eve1s of troponin I and N-termina1 pro-brain natriuretic peptide showed significant differences across the three groups (P<0.05). Conclusion Troponin I and N- termina1 pro- brain natriuretic peptide can be measured to predict the condition of patients with chronic heart fai1ure and suggest the severity of their condition.%目的:对肌钙蛋白I与N端脑钠肽原在慢性心衰患者危险预测中的应用价值进行分析讨论。方法选择我院2013年9月-2015年9月间37例慢性心衰患者,将其作为观察组,同时随机选取心功能正常入院患者37例,将其作为对照组,所有患者入院后都进行肌钙蛋白I与N端脑钠肽原检测,比较两组患者肌钙蛋白I与N端脑钠肽原水平。结果观察组患者肌钙蛋白I水平平均为(4.5±3.0)ng/m1,明显高于对照组,患者N端脑钠肽原水平平均为(769.5±322.5)pg/m1,同样高于对照组,两组比较存在明显差异,P<0.05

  8. Bibliometric Analysis of Literatures on Research Focuses on Brain Natriuretic Peptide in Recent 4 Years%脑钠肽近4年研究热点文献计量学分析

    Institute of Scientific and Technical Information of China (English)

    王占胜; 胡健; 宋占春; 孟庐松

    2012-01-01

    Objective To present the hot topics on brain natriuretic peptide( BNP )research by analyzing the related literatures. Methods The research papers published from 2007 to June 2011 on this topic were analyzed by the method of citation analysis and the highly-cited references were clustered by SPSS software. Based on the contents of the papers in each cluster,the research focuses were concluded. Results The important research literatures about BNP were mainly published in well-known journal of cardiovascular disease and the comprehensive journals were in the second place. There were 5014 related papers covered in science citation index( SCI), of which 43 were cited more than 100 times. 7 clusters were formed according to their co-cited frequencies. Conclusion The research focuses are classified as: BNP and heart failure; BNP and coronary artery disease; BNP in comparison with atrial natriuretic peptide( ANP)in heart failure; BNP and creatinine clearance rate; BNP structure and basic function; BNP and right heart dysfunction caused by pulmonary hypertension; natriuretic peptide and the echocardiographic assessment of ventricular remodeling after myocardial infarction.%目的 调查有关脑钠肽(BNP)研究的文献,分析当前该主题的研究热点.方法 采用引文分析方法对2007 ~2011年6月有关该主题的重要文献进行调查分析,并用SPSS软件对高频被引文献进行聚类分析,根据各个类中的文献内容分析当前研究的热点.结果 有关BNP研究的重要文献多数发表于著名的心血管病专业刊物上,发表于著名综合刊物的次之.检得科学引文索引数据库(SCI)相关文献5014篇,其参考文献出现频次高于100次论文43篇.高被引论文聚类分析树图分7类.结论 BNP与心力衰竭、BNP与冠状动脉性疾病、BNP与心房利钠肽在心力衰竭中作用比较、BNP与肌酐清除率关系、BNP结构功能基础研究、BNP与肺动脉高压右心功能障碍及钠肽类与心肌

  9. Predictive value of natriuretic peptides in dogs with mitral valve disease

    DEFF Research Database (Denmark)

    Tarnow, Inge; Olsen, Lisbeth Høier; Kvart, Clarence;

    2009-01-01

    Natriuretic peptides are useful in diagnosing heart failure in dogs. However, their usefulness in detecting early stages of myxomatous mitral valve disease (MMVD) has been debated. This study evaluated N-terminal (NT) fragment pro-atrial natriuretic peptide (NT-proANP) and NT-pro-brain natriuretic...... peptide (NT-proBNP) in 39 Cavalier King Charles Spaniels (CKCS) with pre-clinical mitral valve regurgitation (MR), sixteen dogs with clinical signs of heart failure (HF) and thirteen healthy control dogs. Twenty seven CKCS and ten control dogs were re-examined 4 years after the initial examination...

  10. Natriuretic peptides: a new lipolytic pathway in human adipocytes.

    Science.gov (United States)

    Sengenès, C; Berlan, M; De Glisezinski, I; Lafontan, M; Galitzky, J

    2000-07-01

    Atrial natriuretic peptide (ANP) receptors have been described on rodent adipocytes and expression of their mRNA is found in human adipose tissue. However, no biological effects associated with the stimulation of these receptors have been reported in this tissue. A putative lipolytic effect of natriuretic peptides was investigated in human adipose tissue. On isolated fat cells, ANP and brain natriuretic peptide (BNP) stimulated lipolysis as much as isoproterenol, a nonselective beta-adrenergic receptor agonist, whereas C-type natriuretic peptide (CNP) had the lowest lipolytic effect. In situ microdialysis experiments confirmed the potent lipolytic effect of ANP in abdominal s.c. adipose tissue of healthy subjects. A high level of ANP binding sites was identified in human adipocytes. The potency order defined in lipolysis (ANP > BNP > CNP) and the ANP-induced cGMP production sustained the presence of type A natriuretic peptide receptor in human fat cells. Activation or inhibition of cGMP-inhibited phosphodiesterase (PDE-3B) (using insulin and OPC 3911, respectively) did not modify ANP-induced lipolysis whereas the isoproterenol effect was decreased or increased. Moreover, inhibition of adenylyl cyclase activity (using a mixture of alpha(2)-adrenergic and adenosine A1 agonists receptors) did not change ANP- but suppressed isoproterenol-induced lipolysis. The noninvolvement of the PDE-3B was finally confirmed by measuring its activity under ANP stimulation. Thus, we demonstrate that natriuretic peptides are a new pathway controlling human adipose tissue lipolysis operating via a cGMP-dependent pathway that does not involve PDE-3B inhibition and cAMP production.

  11. Association between high-sensitivity cardiac troponin T and N-terminal pro-brain natriuretic peptide in a community based population

    Institute of Scientific and Technical Information of China (English)

    Xu Ruyi; Ye Ping; Luo Leiming; Sheng Li; Wu Hongmei; Xiao Wenkai; Zheng Jin

    2014-01-01

    Background N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) are excellent biomarkers for detecting heart failure and subclinical myocardial injury.However,it remains unclear whether subclinical myocardial injury is associated with NT-proBNP elevation in a community based population.Methods In a community based study,levels of hs-cTnT and of NT-proBNP were determined in 1 497 participants older than 45 years.The lower detection limit of the hs-cTnT assay used in the present study was 0.003 ng/ml.The association of hs-cTnT levels and NT-proBNP levels was analyzed.Results When the subjects with undetectable (<0.003 ng/ml),intermediate (0.003-0.014 ng/ml),and elevated (≥0.014 ng/ml) levels of hs-cTnT were compared (r=0.175,P <0.001),a strong association between the hs-cTnT levels and NT-proBNP levels was observed (β=-0.206,P <0.001; β=-0.118,P <0.001,respectively).In multivariable analyses,older age and hs-cTnT were positively and independently associated with NT-proBNP levels (β=0.341,P <0.001; β=0.143,P <0.001,respectively),and male gender and the levels of eGFR were inversely and independently associated with NT-proBNP levels.When the subjects with normal or elevated NT-proBNP were analyzed separately,the hs-cTnT level was not an independent predictor for the NT-proBNP level in the normal NT-proBNP group,whereas the hs-cTnT level was the only independent predictor for NT-proBNP level in the elevated NT-proBNP group (β=0.399,P <0.01).Conclusions In this community based population,NT-proBNP elevation was common.In addition to female gender and older age,subclinical myocardial injury indicated by the hs-cTnT level was another important factor in NT-proBNP elevation.

  12. Next generation natriuretic peptide measurement

    DEFF Research Database (Denmark)

    Hunter, Ingrid; Goetze, Jens P

    2012-01-01

    Plasma measurement of natriuretic peptides is a "must" for clinical laboratories. For the next generation measurement, the unraveling of the molecular complexity of the peptides points toward a more qualitative assessment, as the posttranslational processing also changes with disease. Changes...... in the molecular heterogeneity could in itself contain valuable information of clinical status, and the time seems right for industry and dedicated researchers in the field to get together and discuss the next generation natriuretic peptide measurement. In such an environment, new strategies can be developed...

  13. Atrial natriuretic peptides in plasma

    DEFF Research Database (Denmark)

    Goetze, Jens P; Holst Hansen, Lasse; Terzic, Dijana

    2015-01-01

    Measurement of cardiac natriuretic peptides in plasma has gained a diagnostic role in the assessment of heart failure. Plasma measurement is though hampered by the marked instability of the hormones, which has led to the development of analyses that target N-terminal fragments from the prohormone....... These fragments are stable in plasma and represent surrogate markers of the actual natriuretic hormone. Post-translational processing of the precursors, however, is revealing itself to be a complex event with new information still being reported on proteolysis, covalent modifications, and amino acid...

  14. Natriuretic peptide family as a novel antimigration factor of vascular smooth muscle cells.

    Science.gov (United States)

    Ikeda, M; Kohno, M; Yasunari, K; Yokokawa, K; Horio, T; Ueda, M; Morisaki, N; Yoshikawa, J

    1997-04-01

    Vascular smooth muscle cell (SMC) migration is proposed to be an important process in the initiation and/or progression of atherosclerosis. The present study examined the effects of the natriuretic peptide family (atrial, brain, and C-type natriuretic peptides; ANP, BNP, and CNP) on the migration of cultured rat SMCs, using Boyden's chamber methods. Fetal calf serum (FCS) and platelet-derived growth factor (PDGF)-BB potently stimulated SMC migration. Rat ANP(1-28), rat BNP-45, and rat CNP-22 clearly inhibited SMC migration stimulated with FCS or PDGF-BB in a concentration-dependent manner. CNP-22 had the most potent inhibitory effect compared with other natriuretic peptides. When PDGF-BB-induced migration was separated into chemotactic and chemokinetic activities, the chemotactic component was strongly inhibited by these natriuretic peptides. Such inhibition by these natriuretic peptides was paralleled by an increase in the cellular level of cyclic GMP. The addition of a cyclic GMP analogue, 8-bromo cyclic GMP, and an activator of the cytosolic guanylate cyclase, sodium nitroprusside, significantly inhibited FCS- and PDGF-BB-stimulated migration in a concentration-dependent manner. These results suggest that natriuretic peptides, especially CNP-22, inhibit FCS- or PDGF-BB-stimulated SMC migration at least in part through a cyclic GMP-dependent process. Thus, the natriuretic peptide family may play a role as an antimigration factor of SMCs under certain circumstances.

  15. Clinical Application of Plasma Brain Natriuretic Peptide in Acute Coronary Syndromes%血浆脑钠肽在急性冠状动脉综合征中的临床应用进展

    Institute of Scientific and Technical Information of China (English)

    陈作强

    2011-01-01

    脑钠肽是主要由心室肌细胞分泌的一种心脏神经激素,是心功能不全时机体的代偿机制之一.近年来研究表明,心肌缺血同样能够引起脑钠肽水平的升高,血浆脑钠肽与急性冠脉综合征的关系已经引起人们的关注.脑钠肽与NYHA分级和左室射血分数间存在较好的相关性,可作为预测急性冠脉综合征心室重塑、冠脉病变程度的有效指标,是急性冠脉综合征的独立预后因子,并作为高敏C反应蛋白、肌酸激酶同工酶和肌钙蛋白I等生化指标的有益补充,为急性冠脉综合征提供有价值的辅助诊断.%Brain natriuretic peptide ( BNP) is a cardiac neural hormone, secreted by cardiac myocytes, and one of the body's compensatory mechanisms during heart failure. Recent studies have shown that myocardial ischemia can cause elevated BNP levels. BNP may be an effective indicator to predict ventricular remodeling and the extent of coronary artery disease in acute coronary syndrome patients. It is also an independent predictors of acute coronary syndromes, and a useful addition to biochemical index such as hs-CRP, CK-MB and cTnl. This article reviews BNP's role in ACS and how it may be used as a diagnostic tool.

  16. Progress in use of brain natriuretic peptide in congenital heart disease and perioperative pediatric cardiac operation%脑钠肽在小儿先天性心脏病及围手术期的应用进展

    Institute of Scientific and Technical Information of China (English)

    肖书娜

    2013-01-01

    脑钠肽是一种神经内分泌激素,它与先天性心脏病患儿心功能不全和肺动脉高压程度呈正相关,已成为评估先天性心脏病患儿心功能不全程度、反映先天性心脏病患儿术前术后心功能状态的简便、准确的生物化学指标.它对先天性心脏病心脏手术预后有预测作用,对围手术期治疗有指导意义,能减少术后并发症和病死率,成为迅速、即时床边检查的辅助手段.该文就其与先天性心脏病的相关性和在先天性心脏病围手术期应用进展作一概述.%Brain natriuretic peptide (BNP) is a neuroendocrine hormone,which has a positive correlation with degree of cardiac dysfunction and pulmonary arterial hypertension of children with congenital heart disease (CHD).BNP has been shown to be a simple,accurate and useful biochemical indicator in assessing cardiac dysfunction degree and reflecting perioperative cardiac function state of children with CHD.It has prognostic value in congenital heart surgery and can guide the perioperative treatment and reduce the postoperative complications and mortality.It is a quick,instant bedside inspection supplementary means.This article describes the relevance between BNP and CHD and the application progress of BNP in pefioperative of CHD.

  17. Correlation between arterial wall stiffness, N-terminal prohormone of brain natriuretic peptide, functional and structural myocardial abnormalities in patients with type 2 diabetes mellitus and cardiac autonomic neuropathy

    Directory of Open Access Journals (Sweden)

    Viktoriya Aleksandrovna Serhiyenko

    2013-12-01

    Full Text Available Aim. To assess arterial wall stiffness, plasma levels of of N-terminal prohormone of brain natriuretic peptide (NT-proBNP, as well as functional state and structure of the myocardium in patients with type 2 diabetes mellitus (T2DM and cardiac autonomic neuropathy (CAN.Materials and Methods. The study involved a total of 65 patients with T2DM. 12 had no evidence of cardiovascular disease (CVD or CAN, 14 were diagnosed with subclinical stage of CAN, 18 – with functional stage, and 21 – with organic stage. We measured aortic pulse wave velocity (PWV, aortic augmentation index (AIx, brachial artery AIx, ambulatory arterial stiffness index (AASI and plasma levels of NT-proBNP. Clinical examination included ECG, Holter monitoring, ambulatory BP measurement and echocardiography.Results. Patients with isolated T2DM showed a trend for increased vascular wall stiffness. PWV was increased in patients with subclinical stage of CAN. Aortic and brachial AIx, PWV and AASI were elevated in patients with functional stage of CAN, PWV being significantly higher vs. subclinical CAN subgroup. Organic stage was characterized by pathologically increased values of all primary parameters; PWV and AASI were significantly higher compared with other groups. Development and progression of CAN was accompanied by an increase in NT-proBNP plasma levels. Concentration of NT-proBNP was in direct correlation with left ventricular mass (LVM and PWV. PWV and LVM values also directly correlated between themselves.Conclusion. Development and progression of CAN in patients with T2DM is accompanied by an increase in vascular wall stiffness. The elevation of plasma NT-proBNP in patients with T2DM correlates with the development of CAN and is significantly and independently associated with an increase in LVM and PWV. Our data suggests the pathophysiological interconnection between metabolic, functional and structural myocardial abnormalities in patients with T2DM and CAN.

  18. Loss of inhibition by brain natriuretic peptide over P2X3 receptors contributes to enhanced spike firing of trigeminal ganglion neurons in a mouse model of familial hemiplegic migraine type-1.

    Science.gov (United States)

    Marchenkova, Anna; van den Maagdenberg, Arn M J M; Nistri, Andrea

    2016-09-07

    Purinergic P2X3 receptors (P2X3Rs) play an important role in pain pathologies, including migraine. In trigeminal neurons, P2X3Rs are constitutively downregulated by endogenous brain natriuretic peptide (BNP). In a mouse knock-in (KI) model of familial hemiplegic migraine type-1 with upregulated calcium CaV2.1 channel function, trigeminal neurons exhibit hyperexcitability with gain-of-function of P2X3Rs and their deficient BNP-mediated inhibition. We studied whether the absent BNP-induced control over P2X3Rs activity in KI cultures may be functionally expressed in altered firing activity of KI trigeminal neurons. Patch-clamp experiments investigated the excitability of wild-type and KI trigeminal neurons induced by either current or agonists for P2X3Rs or transient receptor potential vanilloid-1 (TRPV1) receptors. Consistent with the constitutive inhibition of P2X3Rs by BNP, sustained pharmacological block of BNP receptors selectively enhanced P2X3R-mediated excitability of wild-type neurons without affecting firing evoked by the other protocols. This effect included increased number of action potentials, lower spike threshold and shift of the firing pattern distribution toward higher spiking activity. Thus, inactivation of BNP signaling transformed the wild-type excitability phenotype into the one typical for KI. BNP receptor block did not influence excitability of KI neurons in accordance with the lack of BNP-induced P2X3R modulation. Our study suggests that, in wild-type trigeminal neurons, negative control over P2X3Rs by the BNP pathway is translated into tonic suppression of P2X3Rs-mediated excitability. Lack of this inhibition in KI cultures results in a hyperexcitability phenotype and might contribute to facilitated trigeminal pain transduction relevant for migraine. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  19. Increased ventricular ectopic activity in relation to C-reactive protein, and NT-pro-brain natriuretic peptide in subjects with no apparent heart disease

    DEFF Research Database (Denmark)

    Sajadieh, A; Nielsen, OW; Rasmussen, Verner

    2006-01-01

    BACKGROUND: Subjects with frequent ventricular premature complexes (VPC) and no apparent heart disease make a heterogenic group with regard to prognosis. Some biomarkers have recently proved useful in risk stratification in different heart diseases. We examined prognostic impact of NT-Pro-brain...... with a significantly higher risk of death and acute myocardial infarction. These subjects deserve primary prevention measures and further work up for structural heart disease....

  20. Changes of plasma brain natriuretic peptide and amino-terminal pro-brain natriuretic peptide in children of congenital heart disease complicated with different degrees of pulmonary hypertension%先天性心脏病伴不同程度肺动脉高压患儿血浆脑钠肽及氨基末端脑钠肽前体的变化

    Institute of Scientific and Technical Information of China (English)

    郭俊晓; 张玉龙; 刘志平; 赵龙

    2015-01-01

    Objective To explore the changes of plasma brain natriuretic peptide (BNP) and aminoterminal pro-brain natriuretic peptide (NT-proBNP) in children with congenital heart disease (CHD) complicated with different degrees of pulmonary arterial hypertension (PAH).Methods Totally 60 children of left-right shunt congenital heart disease from December 2012 to December 2013 were enrolled.The pulnonary arterial systolic pressure was measured by echocardiography;the BNP and NT-proBNP level were measured and compared among patients with different degree of PAH.Results The plasma BNP and NT-proBNP were increased in non PAH, mild PAH, moderate PAH and severe PAH patients [(30 ± 26), (134 ± 22), (307 ± 86), (661 ± 67) ng/L;(94 ±35), (153 ± 25), (487 ± 213), (2 430 ± 1 278) ng/L].There were significant differences regarding plasma BNP among non PAH, mild PAH, moderate PAH and severe PAH patients (all P < 0.05);NT-proBNP showed statistical differences in severe PAH patients compared with that in non-PAH patients (P < 0.05) and no differences were observed among other patients (all P > 0.05).Conclusion In left to right shunt congenital heart disease children complicated with PAH, the plasma BNP and NT-proBNP levels increased with increasing of PAH degree, and can be used as an index to evaluate the degrees of PAH.%目的 分析先天性心脏病伴不同程度肺动脉高压(PAH)患儿血浆脑钠肽(BNP)及氨基末端脑钠肽前体(NT-proBNP)水平的变化情况.方法 纳入2012年12月至2013年12月内蒙古医科大学附属医院经超声心动图确诊的左向右分流先天性心脏病患儿60例.采用超声心动图评估肺动脉收缩压,比较不同程度PAH患儿血浆BNP及NT-proBNP水平差异.结果 无PAH患儿16例、轻度PAH患儿16例、中度PAH患儿14例、重度PAH患儿14例.血浆BNP及NT-proBNP水平在无PAH、轻度PAH、中度PAH和重度PAH患儿中依次升高[BNP: (30 ±26)、(134 ±22)、(307±86)、(661±67) ng/L;NT-proBNP:(94

  1. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    Cardiac-derived peptide hormones were identified more than 25 years ago. An astonishing amount of clinical studies have established cardiac natriuretic peptides and their molecular precursors as useful markers of heart disease. In contrast to the clinical applications, the biogenesis of cardiac...

  2. Effect of Recombinant Human Brain Natriuretic Peptide on Prognosis of Patients with Acute Severe Heart Failure%重组人脑利钠肽对急性重症心力衰竭患者预后影响

    Institute of Scientific and Technical Information of China (English)

    李晚泉; 方长庚; 曾小茹; 涂军荣; 郑晓东; 梁建光

    2015-01-01

    目的:探讨重组人脑利钠肽(rhBNP)对急性重症心力衰竭患者预后的影响。方法:将2010年8月至2013年8月收治的急性重症心力衰竭患者237例随机分为观察组(n=120)和对照组(n=117),对照组给予异舒吉治疗,观察组给予 rhBNP 治疗,比较两组气促缓解时间、住院时间及治疗前后尿量、液体入量、左室射血分数(LVEF)、每搏输出量(SV)、心脏指数(CI)、左心室舒张末期内径(LVDd)、N 末端 B 型利钠肽原(NT-proBNP)的变化。结果:治疗后,观察组24 h 尿量、LVEF明显高于对照组(P<0.05);观察组呼吸困难缓解时间、住院时间、NT-proBNP 水平、不良心血管事件发生率均明显低于对照组(P<0.05)。结论:rhBNP能有效改善急性重症心力衰竭患者左心室功能,缩短气促缓解时间、住院时间,降低不良心血管事件发生率。%Objective:To explore the effect of recombinant human brain natriuretic peptide (rhBNP)on the prognosis of patients with acute severe heart failure. Methods:237 patients with acute severe heart failure were randomly divided into observation group (n=120) and control group (n=117) treated by rhBNP and isosorbide dinitrate respectively from Aug 2010 to Aug 2013.The dyspnea remission time , hospitalization time and amount of urine before and after the treatment, the intake of liquid, left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac index (CI), left ventricular end diastolic diameter (LVDd), N terminal B type natriuretic peptide (NT-proBNP) changes were compared between the two groups. Results: Compared with the control group after the treatment, 24h urine volume and LVEF were significantly higher in the observation group (both P < 0.05), and the dyspnea remission time , hospitalization time , NT-proBNP levels , adverse cardiovascular event rates were significantly lower in the observation group (all P < 0

  3. 川崎病患儿心型脂肪酸结合蛋白和脑利钠肽的变化及与心功能的关系%Changes of serum heart type fatty acid binding protein and brain natriuretic peptide and their clinical significance in children with Kawasaki disease

    Institute of Scientific and Technical Information of China (English)

    王金菊; 陈宗波; 王文棣

    2015-01-01

    Objective To explore the serum levels changes of heart-type fatty acid-binding protein and brain natriuretic peptide in children with Kawasaki disease,as well as their links with the heart function. Methods A total of 53 children with Kawasaki disease admitted to our hospital from February 2008 to March 2012 were selected and at the same time 50 healthy controls were randomly selected. The serum levels for the children in acute phase,recovery period of Kawasaki disease and control group children were determined by en-zyme-linked immnoabsorbent assay. The internal diameter of coronary artery,LVEF,LVSF,CI and E/A of chil-dren were measured by two-dimensional echocardiography. Results The heart-type fatty acid-binding protein and brain natriuretic peptide concentrations of children with Kawasaki disease in acute stage[(18. 23 ± 13. 81) ng/ml,(517. 2 ±213. 2) pg/ml] were higher than those in recovery stage[(6. 29 ± 1. 26) ng/ml,(92. 1 ± 46. 0) pg/ml](P<0. 05). They were also higher for children in acute stage than those of control group[(6. 26 ± 1. 60) ng/ml,(37. 6 ± 7. 6) pg/ml]. The LVEF,LVSF,CI of Kawasaki disease for children in acute stage were lower than those in recovery phase[(60. 3 ± 3. 6)% vs. (64. 8 ± 4. 3)%,(30. 6 ± 2. 5)% vs. (34. 9 ± 1. 9)%,(3. 1 ± 0. 3)% vs. (3. 5 ± 0. 3)%]. Linear correlation analysis showed the heart-type fatty acid-binding protein and brain natriuretic peptide′concentrations in Kawasaki disease were negatively correlated with LVEF (P<0. 05). The heart-type fatty acid-binding protein′positive rates were also higher than brain natriuretic peptide for the children in acute and recovery phase. Conclusion The heart-type fatty acid-binding protein and brain na-triuretic peptide could be used as the biochemical markers for myocardial damage of children with Kawasaki dis-ease. The heart-type fatty acid-binding protein was more significant than brain natriuretic peptide. The heart-type fatty acid-binding protein and brain

  4. 重组人脑利钠肽在应激性心肌病并急性泵衰竭中的应用%Application of recombinant human brain natriuretic peptide in stress cardiomyopathy complicated acute left heart failure

    Institute of Scientific and Technical Information of China (English)

    余浩; 胡晓军; 李姣; 孙玉真

    2016-01-01

    Objective:To observe therapeutic effect of lyophilized recombinant human brain natriuretic peptide (Lrh-BNP)on stress cardiomyopathy (SCM)complicated acute bump failure.Methods:A total of 23 patients with SCM complicated acute bump failure were randomly divided into routine treatment group (n=10,received routine treatment)and Lrh-BNP group (n=13,received Lrh-BNP based on routine treatment).Clinical symptoms and signs,cardiac function :left ventricular ejection fraction (LVEF),stroke volume (SV),cardiac index (CI),peak early diastolic velocity/peak late diastolic velocity (E/A)assessed by echocardiography before and after treatment, and total effective rate were compared between two group.Results:Total effective rate of Lrh-BNP group was sig- nificantly higher than that of routine treatment group (92.3% vs.80.0% ,P0.05 all);after treatment,com- pared with routine treatment group,there were significant rise in LVEF [(50.2±16.3)% vs.(59.4±14.1)%],SV [(39.5±10.4)ml vs.(48.3±12.5)ml],CI [(3.7±1.1)L min-1 m-2 vs.(4.6±1.4)L min-1 m-2 ]and E/A [(1.0±0.5)vs.(1.3±0.7)]in Lrh-BNP group,P0.05);治疗后,与常规治疗组比较,Lrh-BNP组LVEF[(50.2±16.3)%比(59.4±14.1)%]、SV[(39.5±10.4)ml比(48.3±12.5)ml]、CI[(3.7±1.1)L·min-1·m-2比(4.6±1.4)L·min-1·m-2]、E/A[(1.0±0.5)比(1.3±0.7)]显著升高(P均<0.05).结论:Lrh-BNP治疗应激性心肌病合并急性泵衰竭有明显疗效.

  5. Correlation between heart rate variability and brain natriuretic peptide in patients with persistent atrial fibrillation%持续性心房颤动患者心率变异性与脑钠尿肽的关系

    Institute of Scientific and Technical Information of China (English)

    李宏松; 石来新; 卢英民; 韦彩雯; 宋蕾; 李志华; 蔡振东

    2012-01-01

    目的:探讨持续性心房颤动患者心率变异性与脑钠尿肽(BNP)的相关性.方法:入选45例持续性心房颤动患者,20例正常对照组.行24小时动态心电图检查,检测心率变异性时域指标,并行BNP测定,再分析以上两者的相关性.结果:持续性房颤患者与对照组比较,心率增快,心率变异性时域指标SDNN、RMSSD、PNN50显著增加(P<0.01);平均RR间期(RINNT)实测值与BNP呈负相关;以平均心率矫正后的有关心率变异时域指标RMSS-DDdiff和PNN50Ddiff与BNP呈正相关.结论:持续性心房颤动患者心率变异性时域参数增加,BNP受心率和心率变异性改变的影响.%AIM: To investigate the correlation between heart rate variability and brain natriuretic peptide (BNP) in patients with persistent atrial fibrillation (AF). METHODS: Forty-five patients with persistent AF were placed into one group and 20 patients without persistent AF were placed in the normal control group. Twenty-four hour ECG was monitored for the time domain indexes of heart rate variability, and plasma BNP concentration was tested. Correlation between the time domain indexes and plasma BNP concentration was analyzed. RESULTS: In patients with persistent AF, the heart rate increased and heart rate variability time domain indexes (SDNN, RMSSD and PNN50) increased significantly (P < 0. 01). The actual RINNT was negatively correlated with plasma BNP concentration. After correction with the average heart rate, heart rate variability time domain indexes (RMSSDDdiff and PNN50Ddiff) were positively correlated with BNP concentration. CONCLUSION: In patients with persistent AF, the time domain parameters of heart rate variability increase and plasma BNP concentration is affected by the heart rate and the changes in heart rate variability.

  6. Natriuretic peptides in cardiometabolic regulation and disease

    DEFF Research Database (Denmark)

    Zois, Nora E; Bartels, Emil D; Hunter, Ingrid

    2014-01-01

    In the 30 years since the identification of the natriuretic peptides, their involvement in regulating fluid and blood pressure has become firmly established. Data indicating a role for these hormones in lifestyle-related metabolic and cardiovascular disorders have also accumulated over the past...... these conditions can coexist and potentially lead to heart failure, a syndrome associated with a functional natriuretic peptide deficiency despite high circulating concentrations of immunoreactive peptides. Therefore, dysregulation of the natriuretic peptide system, a 'natriuretic handicap', might be an important...

  7. 重组人脑钠肽治疗急性左心衰竭的疗效和安全性研究%Efficacy and safety of recombinant human brain natriuretic peptite in treatment of acute left heart failure

    Institute of Scientific and Technical Information of China (English)

    曹东来; 韩冷; 倪杰

    2014-01-01

    Objective To investigate the efficacy and safety of recombinant human brain natriuretic peptite(rhBNP) on acute left heart failure.Methods Sixty-five patients with acute left heart failure selected from January 2010 to June 2012 were divided into control group (40 cases) and treatment group (25 cases).According to the random number,the two groups were given basic standard treatment and treatment group was added with rhBNP.The clinical symptoms of two groups of patients with remission,endogenous plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP) level,hemodynamic changes and adverse event were observed.Results After 4 d and 1 week of treatment,the NT-proBNP levels in treatment group were significantly lower than those in the control group; the difference was statistically significant[(5 472 ± 422)μg/L,(3 892 ± 225)μg/L vs (7 627 ± 276) μg/L,(5 983 ± 399)μg/L,P < 0.05].After 1 week of treatment,the effective rate of control group[60% (24/40)] was lower than that in the treatment group[84% (21/25)],the difference was statistically significant (x2 =13.29,P =0.024).After 4 d and 1 week of treatment,the left ventricular ejection fraction of treatment group was higher than that in the control group [(45.9 ± 5.9) %,(52.2 ± 6.2) % vs (35.9 ± 3.8) %,(40.1 ± 3.2) %] ; the central venous pressure of treatment group was lower than that in the control group; the difference was statistically significant[(8.8 ± 1.9),(6.6 ± 1.2) cmH2O vs (11.4 ± 2.0),(9.3 ± 2.1) cmH2O,P <0.05].After 1 year of follow-up,the incidence rate of adverse reaction in control group[37.5% (11/40)] was higher than that in the treatment group[20% (4/25)] ; the difference was statistically significant(x2 =11.20,P=0.029).Conclusion rhBNP can effectively improve the cardiac function in patients with heart failure and reduce the incidence of adverse events.%目的 探讨重组人脑钠肽(rhBNP)对急性左心衰竭的疗效及安全性.方法 选取2010年1月至2012

  8. [Natriuretic peptides: a new lipolytic pathway in human fat cells].

    Science.gov (United States)

    Sengenes, Coralie; Moro, Cédric; Galitzky, Jean; Berlan, Michel; Lafontan, Max

    2005-12-01

    Human fat cell lipolysis was considered until recently to be an exclusive cAMP/protein-kinase A (PKA)-regulated metabolic pathway under the control of catecholamines and insulin. Moreover, exercise-induced lipid mobilization in humans was considered to mainly depend on catecholamine action and interplay between fat cell beta- and alpha2-adrenergic receptors controlling adenylyl cyclase activity and cAMP production. We have recently demonstrated that natriuretic peptides stimulate lipolysis and contribute to the regulation of lipid mobilization in humans. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) stimulate lipolysis in human isolated fat cells. Activation of the adipocyte plasma membrane type A guanylyl cyclase receptor (NPR-A), increase in intracellular guanosine 3',5'-cyclic monophosphate (cyclic GMP) levels and activation of hormone-sensitive lipase mediate the action of ANP. ANP does not modulate cAMP production and PKA activity. Increment of cGMP induces the phosphorylation of hormone-sensitive lipase and perilipin A via the activation of a cGMP dependent protein kinase-I (cGK-I). Plasma concentrations of glycerol and nonesterified fatty acids are increased by i.v. infusion of ANP in humans. Physiological relevance of the ANP-dependent pathway was demonstrated in young subjects performing physical exercise. ANP plays a role in conjunction with catecholamines in the control of exercise-induced lipid mobilization. This pathway becomes of major importance when subjects are submitted to chronic treatment with a beta-blocker. Oral beta-adrenoceptor blockade suppresses the beta-adrenergic component of catecholamine action in fat cells and potentiates exercise-induced ANP release by the heart. These findings may have several implications whenever natriuretic peptide secretion is altered such as in subjects with left ventricular dysfunction, congestive heart failure and obesity.

  9. Clinical Observation on Application of Tiroifban and Recombinant Human Brain Natriuretic Peptide in the Treatment of Acute Myocardial Infarction Complicated With Heart Failure%探讨急性心肌梗死合并心力衰竭应用替罗非班及重组人脑利钠肽的临床观察

    Institute of Scientific and Technical Information of China (English)

    李艳萍

    2016-01-01

    Objective To investigate the clinical effect of tirofiban and recombinant human brain natriuretic peptide for the treatment of patients with acute myocardial infarction complicated with heart failure.Methods In our hospital from September 2013 to August 2015, 168 cases of patients with AMI-HF were divided into two groups. The control group and the research group had 84 cases. AMI-HF baseline treatment was used in the two groups. The control group increased urokinase thrombolytic therapy, the study group used tirofiban and treatment with recombinant human brain natriuretic peptide. The adverse reactions and treatment of the two groups were compared and analyzed.ResultsThe effective rate of clinical treatment in the study group was 96.43%, and the effective rate of the control group was 83.33%. Conclusion Acute myocardial infarction complicated with heart failure patients accept for the effect of tirofiban and recombinant human brain natriuretic peptide in patients with relatively good, with high security.%目的:探讨替罗非班和重组人脑利钠肽治疗急性心肌梗死合并心衰患者的临床效果。方法选取2013年9月~2015年8月我院收治的168例AMI-HF患者进行了分组研究,对照组和研究组,每组各84例。两组患者均采用AMI-HF基线治疗。对照组增加尿激素酶溶栓治疗,研究组采用替罗非班及重组人脑利钠肽治疗。比较分析两组患者的不良反应和治疗情况。结果研究组患者的临床治疗有效率为96.43%,对照组的临床治疗有效率为83.33%。结论采用替罗非班及重组人脑利钠肽治疗急性心肌梗死合并心衰患者效果显著,具有较高的安全性。

  10. Prognostic Value of Brain Natriuretic Peptide in Puerperant be Complicated by Acute Congestive Heart Failure%脑钠肽对判定围生期急性充血性心力衰竭预后的临床意义

    Institute of Scientific and Technical Information of China (English)

    金善律; 赵薇; 张京晓

    2011-01-01

    目的 观察血浆脑钠肽与围生期充血性心力衰竭患者预后的关系.方法 我院ICU科2009年1月-2010年6月收治的41例剖宫产终止妊娠后并发急性充血性心力衰竭患者,终止妊娠后第1天均行肝肾功能、脑钠肽、心电图及超声心动图检查;30 例剖宫产终止妊娠后无充血性心力衰竭患者作为对照组.结果 与结论 剖宫产终止妊娠合并急性充血性心力衰竭患者血浆脑钠肽浓度较对照组高(P<0.001 ),血浆脑钠肽浓度越高,患者入住ICU的时间则越长,其病死率也越高.%Objective Through the detection of concentration of brain natriuretic peptide(BNP)in blood plasma in the women who terminate pregnancy by utedrine-incision delivery and complicated by congestive heart failure,we observate the association between the prognosis and BNP.Methods 41 patients enrolled in the study who terminated pregnancy by uterine-incision delivery and complicated by congestive heart failure we have treated in the ICU department during2009.01-2010.06. We detectded alanine aminotransferase(Alt),aspartate aminotransferase(Ast),creatinine,urea,electrocardiogram,ultrasonic cardiogram on the first day after the delivery.Other30 pregnancy women with mormal heart funtion were get by control group.Results and Conclusion The concentration of brain natriuretic peptide in the patients who complicated by congestive heart failure was obviously raise up than the control group,and the concentration of brain natriuretic peptide prognosticate the length of stay and case fatality rate.

  11. 冻干重组人脑利钠肽治疗充血性心力衰竭疗效观察%Clinical efficacy of lyophilized recombinant human brain natriuretic peptide in the treatment of patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    苏素缺; 郑朝霞; 代东艳; 王鹏

    2014-01-01

    目的 探讨冻干重组人脑利钠肽治疗充血性心力衰竭的临床疗效和安全性.方法 选择120例充血性心力衰竭患者,按照随机数字分组法分为两组,观察组58例患者采用冻干重组人脑利钠肽进行治疗,对照组62例患者采用硝普钠进行治疗,比较两组患者的临床疗效、超声心动图指标、血流动力学指标的变化情况以及不良反应的发生情况.结果 治疗后,观察组总有效率为91.37%,明显高于对照组(x2=4.23,P<0.05),观察组治疗后的LVEF、氨基末端脑钠肽前体水平分别为(59.0±8.2)%和(535.4±123.8) ng/L,其改善程度较对照组更为明显(P<0.05),两组不良反应的发生率基本相当(P>0.05).结论 冻干重组人脑利钠肽在治疗充血性心力衰竭具有十分显著的疗效,其安全可靠.%Objective To investigate the clinical efficacy and safety of lyophilized recombinant human brain natriuretic peptide(rhBNP) in the treatment of patients with congestive heart failure (CHF).Methods 120 CHF patients were randomly divided into two groups.58 cases in the observation group were given lyophilized rhBNP,and 62 patients in the control group were given sodium nitroprusside.The clinical effect,changes of echocardiographic indicators and hemodynamic parameters,adverse reactions were observed.Results After treatment,the total effective rate of the observation group was 91.37%,which was significantly higher than that of the control group(x2 =4.23,P < 0.05).The LVEF and NT-proBNP levels in observation group were (59.0 ± 8.2)% and (535.4 ± 123.8)ng/L,which had higher improvement than control group (P < 0.05).The incidence rate of adverse reactions between the two groups had no significant difference (P> 0.05).Conclusion Lyophilized rhBNP in the treatment of CHF has significant effect,and it is worthy of clinical application and promotion.

  12. Clinical application of plasma brain natriuretic peptid to assess the dry weight of hemodialysis patient%血浆脑钠肽在评估血液透析患者干体重中的应用价值

    Institute of Scientific and Technical Information of China (English)

    王世进; 笪义生

    2012-01-01

    目的:观察血液透析(HD)患者调整干体重前后血浆脑钠肽(BNP)水平的变化,探讨BNP评估HD患者干体重的应用价值.方法:根据透析患者胸部X线片心胸比(CRT)、血压、下腔静脉内径(IVCD)、评估50例血液透析患者干体重,将患者分为干体重未达标组(A组)与达标组(B组)各25例,且将A组经过4周逐渐增加透析脱水量下调干体重达到临床干体重(D组).同时选取25名健康体检合格成人作为对照组(C组),测定血压、CRT、IVCD/体表面积(VCD)、BNP等数值.结果:A组BNP、CRT和VCD水平均显著高于B、C和D组(P<0.01),B、C和D组BNP、CRT和VCD水平差异均无统计学意义(P>0.05),且A组患者干体重调节前后BNP水平变化和VCD值、CRT之间均呈正相关关系(P<0.01).结论:BNP作为HD患者超水平负荷的指标,评估干体重有一定价值.%Objective: To observe the plasma brain natriuretic peptid ( BNP) levels of hemodialysis ( HD ) patient before and after adjustment of dry weight and explore its value in evaluating dry weight. Methods: Fifty HD patients were divided into group A ( no-reaching the dry weight standard, 25 cases) and group B ( reaching the dry weight standard, 25 cases) according to the dry weight evaulated by cardiac thoracic rate (CRT) , blood pressure, body weight and the inferior vena cava width(IVCD). The dry weight of partial patients from group A were adjusted to reach the clinical dry weight by increasing the dialysis dehydrated level for 4 weeks, which was divided into group D. Twenty-five healthy persons were divided into group C(control group) ,which blood pressure, CRT, VCD and BNP were measured. Results: The levels of BNP, CRT and VCD of group A were significantly higher than that of group B, C and D( P 0. 05 ) . BNP level changes of group A before and after adjustment of dry weight were positively related to its value of VCD and CRT( P < 0. 01) . Conclusions: BNP can be used as the water load index of HD patients

  13. 脑钠肽与不稳定型心绞痛患者左心功能相关性研究%Relationship between brain natriuretic peptide and left heart function in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    杨波; 夏勇

    2012-01-01

    Objective To observe the changing rule of plasma level of brain natriuretic peptide (BNP) and left ventricular end-diastolic pressure (LVEDP)in patients with unstable angina pectoris ( UAP) ,and explore the correlation between the changes of left heart function and BNP. Methods Fifty-seven cases who underwent coronary angiography( CAC) examination were included. Twelve cases with normal CAG examination results as control group, forty -five patients with UAP were divided into grade Ⅰ group(n = 16) ,grade Ⅱ group(n = 14) and grade Ⅲ group(n = 15) according to the class of Braunwald. The left atrial dianieter(LAD) ,left ventricular end-diastolic diameter( LVEDd), left ventricular posterior wall thickness( LVP-WT) ,intervenlricular septal thickness( IVST) ,left ventricular ejection fraction( LVEF)and E/A were detected in all cases by Doppler echocardiography. The value of LVEDP was detected by record left ventricular pressure curves in all cases. The plasma concentration of BNP was measured by radioimmunoassay. Results There were significant differences in the plasma levels of BNP and LVEDP in control group,grade Ⅰ, Ⅱ, Ⅲ groups(P 0.05). The plasma level of BNP was obviously correlated with LVEDP in all cases ( r = 0.756, P < 0.01). Conclusion The level of BNP could reflect the severity of cardiac ischemia in patients with UAP.it could reflect the severities of congestive heart failure to some extend.%目的 研究血浆脑钠肽(BNP)水平与左心室舒张末期压力(LVEDP)在不稳定型心绞痛(UAP)患者中的变化规律,探讨左心功能的变化与BNP变化的相关性.方法 选择57例冠状动脉造影(CAG)检查者为研究对象,CAG检查正常者12例作为对照组,45例UAP患者按Braunwald分级分为Ⅰ级组(16例)、Ⅱ级组(14例)和Ⅲ级组(15例).所有患者采用多普勒超声心动图检测左心房前后径(LAD)、左心室舒张末期内径(LVEDd)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室射血分

  14. Serum sodium levels of heart failure and its influence on plasma renin-angiotensin-aldosterone system and brain natriuretic peptide levels%心力衰竭血钠水平对 RAAS 及 BNP 水平的影响

    Institute of Scientific and Technical Information of China (English)

    王玉东; 任松涛; 蔡青云

    2014-01-01

    Objective To study the correlation between serum sodium levels of heart failure and plasma renin-angiotensin-aldosterone system( PAAS) and brain natriuretic peptide(BNP) levels . Methods 122 122 patients with heart failure were divided into control ( serum sodium concentration<135 mmol/L ,57 cases) and observation group ( serum sodium concentration≥135 mmol/L , 65 cases) according to serum sodium levels . PRA , Ang Ⅱ , ALD and BNP levels of two groups were compared and analyzed , the correlation between serum sodium levels and levels of PRA ,AngⅡ ,ALD and BNP were analyzed by Pearson correlation analysis . Results Levels of PRA , Ang Ⅱ ,ALD and BNP of observation group were higher than that in control group significantly( P < 0 .05 ) .Pearson correlation analysis showed , serum sodium levels was positively correlated with levels of PRA , Ang Ⅱ , ALD and BNP( P <0 .05 ) .Conclusion Low level serum sodium of heart failure promotes the release of PRA , Ang , ALD and BNP , serum sodium levels is positively correlated with levels of PRA , Ang Ⅱ , ALD and BNP .%目的:研究心力衰竭患者血钠水平与血浆肾素-血管紧张素-醛固酮系统(RAAS)及脑钠肽之间(BNP)的相关性。方法选择我院收治的122例心力衰竭患者,根据血钠水平分为对照组(血清钠离子浓度<135 mmol/L ,57例)和观察组(血清钠离子浓度≥135 mmol/L ,65例),对2组患者的肾素(PRA)、血管紧张素(AngⅡ)、醛固酮(ALD)及BNP水平进行比较分析,并对血钠水平与AngⅡ、ALD及BNP水平的相关性采用 Pearson相关分析。结果观察组的PRA、AngⅡ、ALD及BNP水平显著高于对照组,差异具有统计学意义(P <00.5),通过 Pearson相关分析可见,患者的血钠水平与PRA、AngⅡ、ALD及BNP水平均呈负相关( P <00.5)。结论心力衰竭患者血钠水平低时能促进PRA、AngⅡ、ALD及BNP的释放,且血钠水平

  15. 脓毒症休克与血清氨基末端B型利钠肽前体研究进展%Research Progress on N-terminal Pro-brain Natriuretic Peptide in Septic Shock

    Institute of Scientific and Technical Information of China (English)

    商娜; 张源波; 周荣斌; 杨萌

    2013-01-01

    脓毒症休克是极为常见的危重病,病情凶险,病死率高达30%~70%.近年来,随着早期目标指导性治疗(EGDT)在重症领域的应用,其病死率有了很大改善.目前,临床医师多数根据血流动力学指标的异常指导治疗和判断预后,但血流动力学指标的获得操作复杂、技术要求高,且具有一定的滞后性.国内外学者一直致力于探索敏感性和特异性较高的生物标记物--血清氨基末端B型利钠肽前体(NT-proBNP),希望为脓毒症休克的早期积极干预提供参考依据.研究发现,脓毒症休克时NT-proBNP升高有多种机制参与,NT-proBNP水平的变化可指导脓毒症休克患者的治疗和判断预后.NT-proBNP检测简便迅速,具有广阔的临床应用前景.本文主要结合国内外文献探讨脓毒症休克时NT-proBNP变化机制及其临床应用.%Septic shock is a very common disease and its mortality rate is as high as 30% to 70% . In recent years, with the widely application of early goal - directed therapy ( EGDT ) in intensive illnesses, the mortality rate was greatly reduced. Currently, hemodynamic parameters are used to guide treatment and predict prognosis, but these parameters can only be obtained by skilled operators and are time - consuming. Domestic and foreign scholars have been dedicated to exploring a biological marker with high sensitivity and specificity, that is, serum amino - terminal pro - brain natriuretic peptide ( NT - proBNP ), which can provide reference for the early intervention and prediction of patients with septic shock. Studies have found that multiple mechanisms can cause the changes of NT - proBNP level in septic shock, and these changes can guide treatment and prognosis of patients with septic shock. Besides, the detection of NT - proBNP is simple and fast, so its clinical application is promising. This paper is aimed to introduce mechanisms of NT - proBNP change in septic shock and its clinical application.

  16. Associativity of subclinical thyroid dysfunction with serum NT-pro-brain natriuretic peptide%亚临床甲状腺功能异常与血清NT-pro-BNP水平相关性的研究

    Institute of Scientific and Technical Information of China (English)

    金丹玲; 许艳玲; 刘兆军

    2012-01-01

    目的:研究亚临床甲状腺功能异常患者血浆中NT-pro-BNP浓度的差异.方法:选取2002年至2010年亚临床甲状腺功能异常住院患者122例,年龄23~ 82岁.其中男性54例,女性68例.根据血清TSH水平分为:A组,亚临床甲减1组(TSH4.5~9.9 mU·L-1,n=26);B组,亚临床甲减2组(TSH≥10 mU·L-1,n =30);C组,亚临床甲亢1组(TSH 0.1 ~0.44 mU·L-1,n=24);D组,亚临床甲亢2组(TSH<0.1 mU·L-1,n =21);E组,甲状腺功能正常组(TSH 0.45 ~4.5 mU·L-1,n=21).测定每组患者血清NT-pro-BNP浓度.结果:D组血清NT-pro-BNP浓度较E组增高(95% CI:57.8477~ 168.5159,P<0.05),较C组显著增高(95% CI:11.5080~ 138.5656,P<0.05).A组和B组血清NT-pro-BNP浓度较E组无明显差异(P>0.05).受试者体质量指数、空腹血糖水平、左室质量指数与血浆NT-pro-BNP浓度没有相关性.结论:亚临床甲亢患者TSH <0.1 mU·L-1时,心力衰竭的发生风险明显增加.%Objective: To evaluate the serum NT- pro- brain natriuretic peptide ( NT- pro- BNP) in different subgroup of the subclinical thyroid dysfunction. Methods: 122 patients to be in hospital in the department of endocrinology and cardiology from the year 2002 to 2010, who, on the basis of plasma levels of TSH, were divided into subclinical hypothyroidism 1 group (TSH 4. 5-9. 9 mU·L-1 ,n =26) , subclinical hypothyroidism 2 group (TSH ≥ 10 mU · L-1, n = 30 ) , subclinical hyperthyroidism 1 group ( TSH 2s 0. 1 , < 0. 45 mU · L -1 , n = 24 ) , subclinical hyperthyroidism 2 group ( TSH < 0. 1 mU·L-1,n =21) , control subjects with normal thyroid profile TSH (0.45-4.5 mU·L-1 ,n =21) , to evaluate the serum NT-pro-BNP. Results: Compared to control subjects, subclinical hyperthyroidism were characterized by higher serum NT- pro- BNP, this increase was particularly pronounced in subclinical hyperthyroidism 2 ( TSH < 0. 1 mU · L -1 ) compared to subelinical hyperthyroidism 1 ( TSH ≥ 0. 1 , <0. 45 mU·L-1), serum NT-pro-BNP did not

  17. 重组人脑利钠肽对动脉硬化大鼠血管内皮功能的影响%The effects of Brain Natriuretic Peptide on the function of rats arteriosclerosis model vascular endothelial

    Institute of Scientific and Technical Information of China (English)

    周琳; 张静; 袁天阳; 李扬雪; 徐艳玲; 戴琎

    2013-01-01

    目的 探讨rhBNP对动脉粥样硬化(AS)大鼠模型血管内皮功能的影响.方法 40只健康wistar大鼠,随机分为对照组、模型组、处理组各8只.处理组分别给予硝酸酯类、阿魏酸钠、重组人脑利钠肽皮下注射.采用酶联免疫吸附(ELISA)方法测定各组大鼠处理前后血清中血栓素B2(TXB2)和6-酮前列腺素F1a(6-Keto-PGF1a)的含量,并且光镜下观察各组处理前后大鼠的主动脉内膜细胞的变化.结果 1)处理组药物治疗后,血清中TXB2均下降、6-Keto-PGF1a均升高,与治疗前比较有统计学差异(P0.05);3)光镜的观察结果提示:模型组血管管腔内有附壁斑块;平滑肌细胞排列紊乱;处理组内膜较光滑,局部有MC粘附,偶可见EC缺失,但好于模型组,各处理组之间未见明显差别.结论 rhBNP通过保护血管内皮功能具有抗动脉粥样硬化的作用.%Objective The effects of Brain Natriuretic Pcptidc on the function of rats arteriosclerosis model vascular endothelial. Methods 40 healthy wistar rats, divided into five groups at random, eight rats in contorl group, eight in model group,each of the treatment group of nitratcs(Hua rcn xin shu),Sodium Fcrulatc(Haisi) ., rhBNP (xinhuosu) model group were eight rats. Adopt enzyme-linked immunosorbent adsorption (ELISA) methods to determine each rat treatment and scrum blood TXB2 and 6-Kcto-PGFla content,and light-microscopy each rat before and after processing the aortic lining cells changes. Results a. The treatment group scrum TXB2 and 6-Kcto-PGFla levels obviously different than bcforc(P 0. 05). c. Optical microscope observations, the control group vascular lumen, no calcium sediment, big plaques can be seen. Smooth muscle cells is boom and ectoblast is conjunction tissue, arranging disorganized. The treatment group is smoother,local macrophagc adhesion,visible EC missing,but better than model group,and the treatment group showed no significant difference between. Conclusion rhBNP can not

  18. Determinação do peptídeo natriurético cerebral humano em portadores da doença de Chagas Measurement of human brain natriuretic peptide in patients with Chagas' disease

    Directory of Open Access Journals (Sweden)

    Railton Bezerra de Melo

    2005-02-01

    Full Text Available OBJETIVO: Determinar os níveis séricos do peptídeo natriurético cerebral (PNB em pacientes com cardiopatia chagásica crônica e em indivíduos com sorologia positiva para doença de Chagas sem comprometimento cardíaco, e correlacionar os níveis de PNB com o grau de comprometimento cardíaco, dimensões cardíacas, presença de marcapasso e fração de ejeção. MÉTODOS: Concentrações séricas de PNB foram determinadas através do Triage® - BNP Test, produzido pela BIOSITE®. Foi avaliado o PNB sérico de 25 indivíduos do ambulatório de doença de Chagas do Hospital Universitário Oswaldo Cruz, distribuídos em 2 grupos, um, G1; composto por 13 portadores de sorologia positiva para doença de Chagas, assintomáticos e sem cardiopatia detectável pelo eletrocardiograma, radiografia do tórax e ecocardiograma, o outro, G2; por 12 portadores da doença de Chagas com comprometimento cardíaco. RESULTADOS: Níveis significativamente mais elevados de PNB foram detectados nos pacientes chagásicos com comprometimento cardíaco: (G1=4,4±4,4 pg/ml, G2=293,0±460,2 pg/ml pOBJECTIVE: To measure the serum levels of brain natriuretic peptide (BNP in patients with chronic chagasic heart disease and in individuals with positive serology for Chagas' disease and no heart impairment, and to correlate the serum BNP levels with the degree of cardiac impairment, cardiac dimensions, presence of a pacemaker, and ejection fraction. METHODS: Serum BNP concentrations were determined by use of the Triage - BNP Test produced by BIOSITE. Serum BNP was assessed in 25 patients from the Chagas' disease outpatient clinic of the Hospital Universitário Oswaldo Cruz, who were divided into 2 groups as follows: 1 G1 - comprising 13 assymptomatic patients with positive serology for Chagas' disease and no heart disease detectable on electrocardiography, chest X-ray, and echocardiography; and 2 G2 - comprising 12 patients with Chagas' disease and heart impairment. RESULTS

  19. Protective effect of recombinant human brain natriuretic peptide on acute renal injury induced by endotoxin in canines%rhB NP对内毒素介导的犬急性肾损伤的保护作用

    Institute of Scientific and Technical Information of China (English)

    李牧; 刘岩; 李辉

    2014-01-01

    目的:观察重组人脑利钠肽(recombinant human brain natriuretic peptide,rhBNP)对犬急性肾损伤的保护作用,探讨rhBNP对内毒素介导的犬急性肾损伤血清HMGB1水平的影响。方法20只健康成年犬随机均分为4组(n=5):空白对照组,脓毒症组、低剂量干预组和高剂量干预组。除空白组外的15只健康成年犬静脉注射脂多糖建立脓毒症休克模型。脓毒症组和空白组不给予rhBNP处理,低剂量干预组和高剂量干预组分别给予5μg/kg、10μg/kg rhBNP处理。观察各组犬于0、2、4、8、12 h时的外周血管阻力(systemic vascular resistance index,SVRI),并在以上各时间点留取适量外周静脉血用于检测血清高迁移率族蛋白-1(high mobility group box-1,HMGB-1)的水平和肌酐值(creatinine values,CR),于12 h后处死动物并留取肾脏标本用于组织病理学观察。结果①光镜下观察脓毒症组肾小管上皮细胞肿胀、出现管型,间质细胞肿胀,肾脏组织病理评分为3分;低剂量干预组与高剂量干预组上述改变明显减轻,但2者镜下观察差异不显著,肾脏组织病理评分均为1~2分。②与同时间点脓毒症组相比,低剂量干预组在8、12 h时血清CR水平显著降低(P<0.01),高剂量干预组血清CR水平在4 h、8 h、12 h时显著降低(P<0.01);高剂量干预组与低剂量干预组相比,血清CR水平在4 h、8 h、12 h时均有显著性差异(P<0.05)。③与同时间点脓毒症组比较,低剂量干预组在2 h时SVRI显著降低(P<0.01),高剂量干预组在2 h、4 h时SVRI显著降低(P<0.01);高剂量干预组与低剂量干预组相比,SVRI于4 h时差异有统计学意义(P<0.05)。④与同时间点脓毒症组相比,低剂量干预组与高剂量干预组犬血清HMGB-1水平均显著降低(P<0.01);高剂量干预组与同时间点低剂

  20. Observation of the Effect of Lyophilized Recombinant Human Brain Natriuretic Peptide Jointing Low-dose Dobutamine Used to Refractory Heart Failure%人冻干重组脑利钠肽联合小剂量多巴酚丁胺对顽固性心力衰竭的疗效观察

    Institute of Scientific and Technical Information of China (English)

    黄瑞娜; 吴铿; 冼倩; 陈铭林; 李上海; 李腾; 叶少强; 游琼

    2013-01-01

    Objective To evaluate the effect of the patients with Refractory heart failure using Lyophilized recombinant human brain natriuretic peptide jointing low-dose Dobutamine. Methods 120 patients with Refractory heart failure were randomly divided into A group(n=40), B group(n=40) and C group(n=40), A group was treated with conventional-dose Dobutamine, B group was treated with Lyophilized recombinant human brain natriuretic peptide. C group was treated with Lyophilized recombinant human brain natriuretic peptide jointing low-dose Dobutamine. Three groups were compared the effect of heart failure treatment, LAD,LVEDD,LVEF and plasma BNP level.Results Compared with A group and B group, C group’s treatment of arrhythmia get best results. Compared with before treatment,three group’s LAD ,LVEDD and plasma BNP level decreased,E/A improved, the effect of group C is especially obvious. Conclusion It is effective and safe for the patients with Refractory heart failure to use Lyophilized recombinant human brain natriuretic peptide jointing low-dose Dobutamine.%目的:对顽固性心力衰竭患者使用人冻干重组脑利钠肽联合小剂量多巴酚丁胺的疗效进行评估。方法选取顽固性心力衰竭患者120例,随机分为A组、B组和C组各40例,常规基础治疗上,A组给予常规剂量多巴酚丁胺,B组给予人冻干重组脑利钠肽,C组给予人冻干重组脑利钠肽联合小剂量多巴酚丁胺。比较三者临床疗效、左房内径、左心室舒张期末径、左心室射血分数、血浆脑利钠肽等指标。结果 C组对顽固性心力衰竭的疗效明显高于A组、B组;与治疗前比较,三组在治疗后72h左室内径减小,左室射血分数提高,血浆BNP水平下降,但以C组效果尤佳。结论人冻干重组脑利钠肽联合小剂量多巴酚丁胺治疗顽固性心力衰竭效果显著,副作用小。

  1. Natriuretic peptides in the monitoring of anthracycline induced reduction in left ventricular ejection fraction

    DEFF Research Database (Denmark)

    Daugaard, Gedske; Lassen, Ulrik; Bie, Peter;

    2005-01-01

    BACKGROUND: The use of anthracyclines in treatment of cancer is limited by cardiotoxicity of these compounds and may lead to heart failure. Therefore monitoring of cardiac function is necessary during therapy. AIM: We evaluated the value of natriuretic peptides (N-terminal pro-atrial natriuretic...... measurements, 19% showed a significant EF decrease (>0.10) and ended with a final EF value below 0.50. Baseline EF was no predictor of a change in EF during treatment. Neither baseline levels of N-ANP or BNP nor a change in the same variables during therapy were predictive of a change in EF. CONCLUSIONS...... peptide (N-ANP) and brain natriuretic peptide (BNP)) for monitoring and predicting anthracycline induced cardiotoxicity using radionuclide left ventricular ejection fraction (EF) measurements as reference. METHODS AND RESULTS: A total of 107 consecutive patients receiving anthracycline as part...

  2. Clinical analysis of treating acute decompensated heart failure by recombinant human brain natriuretic peptide and nitroglycerin%重组人脑利钠肽和硝酸甘油治疗急性失代偿性心力衰竭的临床分析

    Institute of Scientific and Technical Information of China (English)

    孙晶

    2015-01-01

    Objective: research clinical effects of treating acute decompensated heart failure by recombinant human brain natriuretic peptide and nitroglycerin. Method: choose 86 cases patients with acute or chronic heart failure received in our hospital, and randomly divided them into control and treatment group, 43 cases in each. Apply nitroglycerin for control group patients and recombinant human brain natriuretic peptide and nitroglycerin for treatment group. Compare patients of two groups before and after treatment with index of improvement magnitude of respiration and heart rate level, treatment effect of acute decompensated heart failure, number of adverse reactions during treatment, heart failure symptoms remission time, ECG recovery time to normal level, total time of heart disease medication therapy treatment. Result:improvement magnitude of respiration and heart rate level of treatment group patients is signiifcantly bettern than that of control group, difference is signiifcant between groups (P0.05);and heart failure symptoms remission time, ECG recovery time to normal level, total time of heart disease medication therapy treatment is obviously shorter than that of control group, difference between groups is signiifcant (P0.05);心衰症状缓解时间、心电图表现恢复正常时间、心衰疾病用药治疗总时间明显短于对照组,组间差异显著(P<0.05)。结论应用硝酸甘油与重组人脑利钠肽联合对患有急性失代偿性心力衰竭疾病的患者实施治疗的临床效果非常明显。

  3. Plasma natriuretic peptides in children and adolescents with obstructive sleep apnoea and their changes following intervention

    Directory of Open Access Journals (Sweden)

    Albert Martin Li

    2014-03-01

    Full Text Available Objective: This study aimed to evaluate circulating natriuretic peptides (NP concentration in obese and non-obese children and adolescents with and without OSA, and their levels following OSA treatment.Methods: Subjects with habitual snoring and symptoms suggestive of OSA were recruited. They underwent physical examination and overnight polysomnography (PSG. OSA was diagnosed if obstructive apnea hypopnea index (OAHI ≥1/h. Fasting serum atrial natriuretic peptide (ANP and brain natriuretic peptide (BNP were taken after overnight PSG. The subjects were divided into obese, non-obese, with and without OSA groups for comparisons.Results: 114 children (77 were boys with a median (IQR age of 10.8 (8.3-12.7 years (range: 2.4-11.8 years were recruited. Sixty-eight subjects were found to have OSA. Natriuretic peptide levels did not differ between subjects with and without OSA in both obese and non-obese groups. . Stepwise multiple linear regressions revealed that body mass index (BMI z-score was the only independent factor associated with NP concentrations. Fifteen children with moderate-to-severe OSA (OAHI >5/h underwent treatment and there were no significant changes in both ANP and BNP levels after intervention.Conclusion: BMI rather than OSA was the main determinant of natriuretic peptide levels in school-aged children and adolescents.

  4. Natriuretic peptides, obesity and cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Yaniel Castro-Torres

    2015-02-01

    Full Text Available Obesity, hypertension and heart failure are conditions commonly associated with each other. Recent investigations have demonstrated that low plasmatic levels of natriuretic peptides are linked with obesity. Thus, knowing the actions of these hormones in water and salt homeostasis, it is possible to establish that low levels of natriuretic peptides may be the common denominator among obesity, hypertension and heart failure. Knowledge on this topic is crucial to develop further investigation for definitive conclusions.

  5. Hyponatremia and brain injury: absence of alterations of serum brain natriuretic peptide and vasopressin Hiponatremia e traumatismo cranioencefálico: ausência de alteração sanguínea do peptídeo natriurético cerebral e hormônio antidiurético

    Directory of Open Access Journals (Sweden)

    Karina Nascimento Costa

    2009-12-01

    Full Text Available OBJECTIVE: To study any possible relation between hyponatremia following brain injury and the presence of cerebral salt-wasting syndrome (CSWS or the syndrome of inappropriate secretion of antidiuretic hormone (SIADH, and if vasopressin, brain natriuretic peptide (BNP and aldosterone have a role in its mechanism. METHOD: Patients with brain injury admitted to the intensive care unit were included and had their BNP, aldosterone and vasopressin levels dosed on day 7. RESULTS: Twenty six adult patients were included in the study. Nine (34.6% had hyponatremia and presented with a negative water balance and higher values of urinary sodium, serum potassium and diuresis than patients with normonatremia. The serum levels of BNP, aldosterone, and vasopressin were normal and no relation was observed between plasma sodium and BNP, aldosterone or vasopressin. CONCLUSION: The most likely cause of hyponatremia was CSWS and there was no correlation between BNP, aldosterone and vasopressin with serum sodium level.OBJETIVO: Estudar a possível relação entre a hiponatremia seguindo traumatismo cranioencefálico e a presença da síndrome cerebral perdedora de sal (SCPS ou a síndrome da secreção inapropriada do hormônio antidiurético (SSIHAD, e se a vasopressina, peptídeo natriurético cerebral (BNP e aldosterona têm um papel nesse mecanismo. MÉTODO: Foram incluídos pacientes com traumatismo cranioencefálico admitidos na unidade de terapia intensiva e foram dosados no sétimo dia seguindo o trauma, BNP, aldosterona e vasopressina. RESULTADOS: Vinte e seis pacientes foram incluídos no estudo. Nove (34,6% tiveram hiponatremia e apresentaram um balanço hídrico mais negativo e altos valores de sódio urinário, potássio sérico e diurese quando comparados com o grupo que apresentou normonatremia. Os níveis séricos de BNP, aldosterona e vasopressina foram normais e não foi observada relação entre o sódio sérico e BNP, aldosterona e vasopressina

  6. 血浆B型脑钠肽水平在慢性肺源性心脏病诊断中的作用%Role of plasma B-type brain natriuretic peptide level in diagnosis of chronic cor pulmonale

    Institute of Scientific and Technical Information of China (English)

    吴颖; 高蔚; 施斌

    2016-01-01

    Objective To investigate the diagnostic value of plasma B-type brain natriuretic peptide(BNP) level in chronic cor pulmonale by detecting plasma BNP level in the patients with chronic dyspnea. Methods Two hundreds and sixty-four inpa-tients with chronic dyspnea in the respiration department and cardiology department of our hospital from March 2014 to April 2015 were selected and divided into the simple pulmonary disease group (100 cases),chronic cor pulmonale group (89 cases) and left cardiac failure group(75 cases) based on the clinical data,clinical manifestations and related detection results. The levels of plasma BNP in each group were measured by immunofluorometric assay. Chest X-ray and electrocardiogram(EKG) examinations were also performed in all the cases. Results (1)The plasma BNP levels in the simple pulmonary disease group,cor pulmonale group and left cardiac failure group were (83.26±14.84),(330.24±38.10),(1 180.73±100.51)pg/mL respectively,the differences in inter-group pairwise comparison showed statistical significance(P<0.05).(2)In plasma BNP level for diagnosing chronic cor pulmonale,the area under the receiver operating characteristic(ROC) curve was 0.871,the optimal diagnostic cut-off was 95 . 00 pg/mL and the accuracy was 83.5%;the area under ROC curve for diagnosing left cardiac failure was 0.896 ,the optimal di-agnostic cut-off was 310.50 pg/mL and the accuracy was 84.2%. (3) In the optimal cut-off values of chest X-ray,EKG and BNP, their accuracies for the single diagnosis of chronic cor pulmonale were 66.7%,72.7%and 83.5%respectively,which for single di-agnosis of left cardiac failure were 64.3%,70.1%and 84.2%respectively. Conclusion (1)BNP is involved in the pathophysio-logic process of right cardiac insufficiency and left cardiac failure in cor pulmonale and may serve as an indicator of early diagno-sis of cardiac dysfunction.(2)The diagnostic value of clinical suspected diagnosis combined plasma BNP level detection in chronic cor

  7. 血清脑利钠肽检测在肺心病患者中的应用价值%The value of serum brain natriuretic peptide in chronic pulmonary heart disease

    Institute of Scientific and Technical Information of China (English)

    肖靖华; 刘升明; 田东波; 陈芸; 陈卫萍; 付志萍; 王海娥

    2016-01-01

    目的:探讨血清脑利钠肽(BNP)在慢性肺心病不同时期的诊断价值。方法选择符合入组标准的肺心病患者168例,按病情不同分为四组,分别为肺心病心功能代偿期组(B 组,n =43例)、肺心病右心衰竭组(C 组,n =45例)、单纯左心衰竭组(D 组,n =40例)、全心衰竭组(E 组,n =40例),另选择健康体检者为健康对照组(A 组,n =48例),检测各组血清 BNP 值、肺功能,进行心脏彩色多普勒超声检查,比较各组BNP 水平与各项指标的差异,并进行相关性分析;绘制各组 ROC 曲线,取最佳截点,分析 BNP 在慢性肺心病不同时期的诊断价值。结果A、B、C、D、E 组血清 BNP 值分别为(11.00±3.39)ng/L、(182.44±69.71)ng/L、(495.44±219.90)ng/L、(882.57±288.56)ng/L、(891.78±256.45)ng/L,五组差异有统计学意义(F =178.900,P =0.000);C 组血清 BNP 值高于 B 组(P <0.001);D 组、E 组血清 BNP 值均高于 C 组(P <0.001)。肺心病患者 BNP 与右心室舒张期内径(RV)、右心室流出道宽度(RVOT)、肺动脉压(PASP)呈正相关,与第1秒用力呼气量占预计值(FEV1%)呈负相关,与左心射血分数(LVEF%)无相关性;左心衰竭及全心衰竭患者,BNP 与 LVEF%呈负相关。肺心病心功能代偿期与肺心病右心衰竭患者的 BNP 最佳截点为285.3 ng/L,肺心病右心衰竭与全心衰竭患者的 BNP 最佳截点为764.2 ng/L。结论在慢性肺心病患者诊断中,血清BNP 水平与其病情进展有一定相关性,其动态监测对肺心病患者的判断有一定参考意义。%Objective To investigate the diagnostic value of serum brain natriuretic peptide(BNP)in chron-ic cor pulmonale of different period.Methods According to the inclusion criteria,we recruited 216 cases from heart and respiratory medicine

  8. Significance of Changes of Brain Natriuretic Peptide in Children with Rheumatic Heart Disease%风湿性心脏病患儿血浆脑利钠肽水平变化的意义

    Institute of Scientific and Technical Information of China (English)

    孙裕平; 王文棣; 马少春; 郑兴厂; 王金菊; 魏超平

    2012-01-01

    目的 观察风湿性心脏病患儿血浆脑利钠肽(BNP)水平的变化,探讨其在风湿热(RF)并心脏病变患儿中的诊断价值.方法 选择RF患儿20例(RF组),包括风湿性心脏病患儿11例(心脏病变组),无心脏病变患儿9例(无心脏病变组).同时选择20例健康儿童作为健康对照组.采用ELISA测定各组血浆BNP、肌钙蛋白I(cTnI)水平,并行心脏彩色多普勒超声及ECG检查.健康对照组随机采血1次,测定血浆BNP和cTnI水平.应用SPSS 11.5软件进行统计学分析.结果 RF组患儿血浆BNP、cTnI水平均明显高于健康对照组(Pa<0.01);心脏病变组血浆BNP水平较无心脏病变组明显升高(P<0.01),cTnI水平二组比较差异亦有统计学意义(P<0.05);BNP异常升高率显著高于cTnI(x2=14.19,P<0.01)及ECG(x2=10.23,P<0.01),cTnI异常率与ECG异常率比较差异无统计学意义(x2=1.37,P>0.05).心脏病变组患儿BNP与cTnI水平呈显著正相关(r=0.32,P<0.05).结论 BNP在风湿性心脏病患儿中异常增高,与cTnI呈正相关,且较cTnI、ECG灵敏度高.BNP、cTnI二者结合对RF并心脏病变的诊断具有重要意义.%Objective To observe the changes of brain natriuretic peptide(BNP) in children with rheumatic fever(RF) disease,and explore its diagnostic value in rheumatic heart disease. Methods Twenty RF children( RF group) were collected,including 11 patients combined with heart disease ( heart disease group) and 9 patients without heart disease (non - heart disease group) ;Twenty healthy children were obtained as healthy control group. The plasma level of BNP and cardiac troponin I(cTnl) were measured by using enzyme - linked immu-nosorbent assay; Two - dimensional echocardiography and ECG were used for all the patients. The plasma levels of BNP and cTnl were randomly measured once in healthy control group. SPSS 11.5 software was used to analyze the data. Results BNP and cTnl were significantly higher in RF group than those in healthy

  9. 利钠肽家族及其与心力衰竭的关系%Natriuretic peptide family and its relationship with heart failure

    Institute of Scientific and Technical Information of China (English)

    韩曼; 于远望

    2015-01-01

    The natriuretic peptide family as endocrine hormones, including atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), C type natriuretic peptide (CNP) and D type natriuretic peptide (DNP), play a signifi-cant role in regulating blood volume, blood pressure, blood vessel elasticity through natriuresis, diuresis, vasodilata-tion and antagonism of the rennin-angiotensin-aldosterone system. Researches showed that the natriuretic peptide (es-pecially the BNP) in plasma was elevated in patients with heart failure (HF) or heart disease, and the elevated natriuret-ic peptide suggested high risk for cardiovascular events. The monitoring of natriuretic peptide is helpful for the diagno-sis, guidance of treatment and prognosis in HF. Here is to make a commentary of the relationship between natriuretic peptide family and HF.%利钠肽家族作为内分泌激素,主要包括心房钠尿肽、脑钠肽、C型利钠肽及D型利钠肽,通过利钠、利尿、舒张血管及对抗肾素-血管紧张素-醛固酮系统等途径在调节血容量、血管弹性、血压等方面发挥重要的作用。对利钠肽(尤其是脑钠肽)的研究表明,心力衰竭等心脏病患者血浆利钠肽水平升高,升高的利钠肽提示心血管事件的高危险性,监测血浆利钠肽有助于心力衰竭的诊断、治疗指导和预后评估。本文就利钠肽家族及其与心力衰竭的关系做一综述。

  10. The predictive value of plasma B-type natriuretic peptide levels on outcome in children with pulmonary hypertension undergoing congenital heart surgery

    Directory of Open Access Journals (Sweden)

    Ayse Baysal

    2014-09-01

    Full Text Available Background and objectives: In children undergoing congenital heart surgery, plasma brain natriuretic peptide levels may have a role in development of low cardiac output syndrome that is defined as a combination of clinical findings and interventions to augment cardiac output in children with pulmonary hypertension. Methods: In a prospective observational study, fifty-one children undergoing congenital heart surgery with preoperative echocardiographic study showing pulmonary hypertension were enrolled. The plasma brain natriuretic peptide levels were collected before operation, 12, 24 and 48 h after operation. The patients enrolled into the study were divided into two groups depending on: (1 Development of LCOS which is defined as a combination of clinical findings or interventions to augment cardiac output postoperatively; (2 Determination of preoperative brain natriuretic peptide cut-off value by receiver operating curve analysis for low cardiac output syndrome. The secondary end points were: (1 duration of mechanical ventilation ≥72 h, (2 intensive care unit stay >7days, and (3 mortality. Results: The differences in preoperative and postoperative brain natriuretic peptide levels of patients with or without low cardiac output syndrome (n = 35, n = 16, respectively showed significant differences in repeated measurement time points (p = 0.0001. The preoperative brain natriuretic peptide cut-off value of 125.5 pg mL−1 was found to have the highest sensitivity of 88.9% and specificity of 96.9% in predicting low cardiac output syndrome in patients with pulmonary hypertension. A good correlation was found between preoperative plasma brain natriuretic peptide level and duration of mechanical ventilation (r = 0.67, p = 0.0001. Conclusions: In patients with pulmonary hypertension undergoing congenital heart surgery, 91% of patients with preoperative plasma brain natriuretic peptide levels above 125.5 pg mL−1 are at risk of developing low cardiac

  11. Long-term infusion of brain natriuretic peptide suppresses post myocardial infarction ventricular remodeling in rats%脑钠肽静脉滴注抑制大鼠心肌梗死后的心室重构

    Institute of Scientific and Technical Information of China (English)

    潘晔生; 魏盟; 朱伟; 马健; 辛平; 徐振兴; 韩蓓蓓; 何亚萍

    2011-01-01

    Objective To compare protective effects of chronic brain natriuretic peptide (BNP) infusion and enalapril administration on post myocardial infarction (MI) ventricular remodeling, and to investigate their effects on the matrix metalloproteinase(MMPs) expression in myocardium. Methods Rats were randomly assigned to sham-operated group, MI group in which MI models were prepared by coronary ligation, BNP group in which MI rats received chronic BNP infusion [0.06|ig/(kgmin)] and enalapril group in which MI rats received enalapril administration [10mg/(kgd)]. Ventricular remodeling and heart function were estimated by echocardiography (ECG), immunohistochemistry, ELISA and Western blot. Results Exogenous BNP infusion maintained a higher BNP level in heart tissue. BNP treatment achieved similar protective effects as enalapril therapy on postinfarction myocardial remodeling. Both BNP and enalapril inhibited the increase of left ventricular weight index by 13.2% and 16.9% respectively, (P <0.05). ECG results demonstrated that left ventricular end-diastolic diameter(LVEDD) and fractional shortening(FS) were more satisfactory in BNP and enalapril groups than in MI group [LVEDD: (8.8 ± 0.6)mm in MI group, (7.5 ± 0.7)mm in enalapril group, and (7.5 ± 1.0) mm in BNP group, P < 0.05; FS: (19.2 ± 2.6)% in MI group, (27.7 ± 5.6)% in enalapril group, and (27.5 ± 3.9) % in BNP group, P < 0.05]. Both enalapril and BNP inhibited collagen deposition in non-infarcted area obviously, especially type I collegen, by (6.8±1.4)% in MI group, (4.0±0.9)% in enalapril group, and (3.7±1.1)% in BNP group respectively(P < 0.05). BNP infusion increased cyclic guanosine monophosphate (cGMP) concentration in cardiac tissue more significantly than enalapril, while inhibited angiotensin Ⅱ less significantly than enalapril. BNP infusion did not lead to obvious change of MMP-2 and MMP-9 content in non-infarcted area. Conclusion Continuous BNP infusion may play cardiac protection roles through

  12. Natriuretic peptides for the detection of paroxysmal atrial fibrillation

    Science.gov (United States)

    Seegers, Joachim; Zabel, Markus; Grüter, Timo; Ammermann, Antje; Weber-Krüger, Mark; Edelmann, Frank; Gelbrich, Götz; Binder, Lutz; Herrmann-Lingen, Christoph; Gröschel, Klaus; Hasenfuß, Gerd; Feltgen, Nicolas; Pieske, Burkert; Wachter, Rolf

    2015-01-01

    Background and purpose Silent atrial fibrillation (AF) and tachycardia (AT) are considered precursors of ischaemic stroke. Therefore, detection of paroxysmal atrial rhythm disorders is highly relevant, but is clinically challenging. We aimed to evaluate the diagnostic value of natriuretic peptide levels in the detection of paroxysmal AT/AF in a pilot study. Methods Natriuretic peptide levels were analysed in two independent patient cohorts (162 patients with arterial hypertension or other cardiovascular risk factors and 82 patients with retinal vessel disease). N-terminal-pro-brain natriuretic peptide (NT-proBNP) and BNP were measured before the start of a 7-day Holter monitoring period carefully screened for AT/AF. Results 244 patients were included; 16 had paroxysmal AT/AF. After excluding patients with a history of AT/AF (n=5), 14 patients had newly diagnosed AT/AF (5.8%) NT-proBNP and BNP levels were higher in patients with paroxysmal AT/AF in both cohorts: (1) 154.4 (IQR 41.7; 303.6) versus 52.8 (30.4; 178.0) pg/mL and 70.0 (31.9; 142.4) versus 43.9 (16.3; 95.2) and (2) 216.9 (201.4; 277.1) versus 90.8 (42.3–141.7) and 96.0 (54.7; 108.2) versus 29.1 (12.0; 58.1). For the detection of AT/AF episodes, NT-proBNP and BNP had an area under the curve in receiver operating characteristic analysis of 0.76 (95% CI, 0.64 to 0.88; p=0.002) and 0.75 (0.61 to 0.89; p=0.004), respectively. Conclusions NT-proBNP and BNP levels are elevated in patients with silent AT/AF as compared with sinus rhythm. Thus, screening for undiagnosed paroxysmal AF using natriuretic peptide level initiated Holter monitoring may be a useful strategy in prevention of stroke or systemic embolism. PMID:26288739

  13. Natriuretic peptides modify Pseudomonas fluorescens cytotoxicity by regulating cyclic nucleotides and modifying LPS structure

    Directory of Open Access Journals (Sweden)

    Feuilloley Marc GJ

    2008-07-01

    Full Text Available Abstract Background Nervous tissues express various communication molecules including natriuretic peptides, i.e. Brain Natriuretic Peptide (BNP and C-type Natriuretic Peptide (CNP. These molecules share structural similarities with cyclic antibacterial peptides. CNP and to a lesser extent BNP can modify the cytotoxicity of the opportunistic pathogen Pseudomonas aeruginosa. The psychrotrophic environmental species Pseudomonas fluorescens also binds to and kills neurons and glial cells, cell types that both produce natriuretic peptides. In the present study, we investigated the sensitivity of Pseudomonas fluorescens to natriuretic peptides and evaluated the distribution and variability of putative natriuretic peptide-dependent sensor systems in the Pseudomonas genus. Results Neither BNP nor CNP modified P. fluorescens MF37 growth or cultivability. However, pre-treatment of P. fluorescens MF37 with BNP or CNP provoked a decrease of the apoptotic effect of the bacterium on glial cells and an increase of its necrotic activity. By homology with eukaryotes, where natriuretic peptides act through receptors coupled to cyclases, we observed that cell-permeable stable analogues of cyclic AMP (dbcAMP and cyclic GMP (8BcGMP mimicked the effect of BNP and CNP on bacteria. Intra-bacterial concentrations of cAMP and cGMP were measured to study the involvement of bacterial cyclases in the regulation of P. fluorescens cytotoxicity by BNP or CNP. BNP provoked an increase (+49% of the cAMP concentration in P. fluorescens, and CNP increased the intra-bacterial concentrations of cGMP (+136%. The effect of BNP and CNP on the virulence of P. fluorescens was independent of the potential of the bacteria to bind to glial cells. Conversely, LPS extracted from MF37 pre-treated with dbcAMP showed a higher necrotic activity than the LPS from untreated or 8BcGMP-pre-treated bacteria. Capillary electrophoresis analysis suggests that these different effects of the LPS may be due

  14. Genetic Variation in the Natriuretic Peptide System, Circulating Natriuretic Peptide Levels, and Blood Pressure

    DEFF Research Database (Denmark)

    Jeppesen, Jørgen L; Nielsen, Søren J; Torp-Pedersen, Christian;

    2012-01-01

    BackgroundIn a large collaborative study (n > 50,000), common variants in the natriuretic peptide (NP) genes were found to be associated with circulating NP levels and also with blood pressure (BP) levels based on office BP measurements (OBPMs). It is unknown if determining an individual's BP by ...... evidence that the NP system plays an important role in BP regulation.American Journal of Hypertension 2012; doi:10.1038/ajh.2012.96.......-h ambulatory BP measurements (ABPMs) will influence the effect of NP gene variations on BP levels.MethodsWe used rs632793 at the NPPB (NP precursor B) locus to investigate the relationship between genetically determined serum N-terminal pro-brain NP (NT-proBNP) concentrations and BP levels......). Office BP decreased across the genotypes from A:A to G:G, but the differences did not reach statistical significance (P = 0.12).ConclusionsThis study suggests that 24-h ABPMs is a better method than OBPMs to detect significant differences in BP levels related to genetic variance and provides further...

  15. Clinical observation of lyophilized recombinant human brain natriuretic peptide for the treatment of acute decompensated heart failure%冻干重组人脑利钠肽治疗急性失代偿性心力衰竭临床观察

    Institute of Scientific and Technical Information of China (English)

    王沐; 魏盟

    2014-01-01

    目的:研究冻干重组人脑利钠肽治疗急性代偿性心力衰竭的临床效果。方法选择急性失代偿性心力衰竭患者90例,随机分成观察组(45例)和对照组(45例)。对2组患者均进行常规治疗,观察组同时静脉注射冻干重组人脑利钠肽;对照组则静脉注射硝酸甘油。结果治疗前观察组和对照组左心室舒张末期内径(LVEDD)及左心室射血分数(LVEF)差异无统计学意义(P>0.05)。治疗后观察组LVEDD显著小于对照组(P<0.01),LVEF显著高于对照组(P<0.01)。治疗前2组患者动脉血二氧化碳分压(PaCO2)、时间肺活量、收缩压及动脉血氧饱和度比较差异均无统计学意义(P>0.05)。治疗后观察组PaCO2、收缩压显著低于对照组(P<0.01),时间肺活量和动脉血氧饱和度显著高于对照组(P<0.01)。结论冻干重组人脑利钠肽可以有效改善急性失代偿性心力衰竭患者的心脏功能以及呼吸功能。%Objective To study the clinical effect of lyophilized recombinant human brain natriuretic peptide for the treatment of acute decompensated heart failure .Methods 90 patients with acute decompensated heart failure were ran-domly divided into observation group (n=45) and control group (n=45).The patients in both groups received routine treatment .The patients in the observation group received lyophilized recombinant human brain natriuretic peptide intrave -nous injection .The patients in the control group received intravenous injection of nitroglycerin .Results Before treat-ment, the left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) between the two groups showed no statistical difference (P>0.05).After treatment, the LVEDD in the observation group were signifi-cantly less than that in the control group (P0.05).After treatment, the PaCO2 and systolic blood pressure were significantly lower in the

  16. 重组人脑钠肽对心肌梗死所致急性心力衰竭的疗效和肾功能的影响%Effect of recombinant human brain natriuretic peptide on the efficacy and renal function of acute heart failure caused by myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    杨光

    2015-01-01

    目的:分析和探讨重组人脑钠肽对心肌梗死所致急性心力衰竭的疗效和肾功能的影响。方法选择在漯河市中心医院进行治疗的心肌梗死所致急性心力衰竭患者60例,随机将其分为观察组和对照组,每组30例,对照组给予常规、纠正心力衰竭以及硝酸甘油治疗,观察组则在常规治疗和纠正心力衰竭治疗的基础上给予重组人脑利钠肽(rhBNP)注射治疗,治疗结束后对两组患者的心功能指标、心力衰竭症状缓解情况进行比较,并检测血浆脑钠肽、尿素氮、血肌酐浓度和24 h 尿量。结果观察组和对照组治疗总有效率分别为96.7%和73.3%,观察组显著高于对照组,差异有统计学意义(P 0.05)。结论心肌梗死所致急性心力衰竭采用重组人脑钠肽进行治疗能够有效提高疗效,并且不会影响患者的肾功能,建议在临床上推广应用。%Objective To analyze and investigate the effect of recombinant human brain natriuretic peptide on the efficacy and renal function of acute heart failure caused by myocardial infarction. Methods Sixty patients with acute heart failure caused by myocardial infarction in the central hospital of Luohe were selected and divided into the observation group and the control group,with 30 cases in each group. The patients in the control group were given routine treatment, correcting heart failure treatment and nitroglycerin treatment; and the patients in the observation group were given rhBNP injection in addition. Heart function indexes and remission of the symptoms of heart failure of two groups were compared after treat-ment, plasma brain natriuretic peptide,urea nitrogen, concentration of serum creatinine,24 h urinary volume were checked. Results In the observation group and the control group, the total effective rate was 96. 7% and 73. 3% , that in the observation group was significantly higher than that in the control group(P 0. 05

  17. Biologic and physical characteristics of the non-peptidic, non-digitalis-like natriuretic hormone.

    Science.gov (United States)

    Bricker, N S; Zea, L; Shapiro, M; Sanclemente, E; Shankel, S

    1993-11-01

    At least three independent groups of natriuretic hormones have been isolated over the past ten years. Two, atrial natriuretic factor (ANF) and brain natriuretic peptide (BNP), are proteins and the third is made up of digitalis-like substances (DLS). The present report concerns the isolation, substantial purification and biologic actions of an entirely different natriuretic hormone (NH) which appears to be steroidal in nature and an isomer of cortisone. The source of NH was uremic urine. Purification involved successive chromatographic steps including gel filtration and multiple HPLC runs through C-18 resins. A translucent crystal ultimately was obtained. The product was examined using mass spectroscopy with trimethylsilyl derivatization. Only one compound was identifiable. The characteristics of the molecule include: a molecular weight, 360.4; a molecular formula, C21H28O5; a steroidal nucleus; UV absorption at 220 and 290 nm; and intrinsic fluorescence. The onset of action occurs within minutes both in the rat and, as previously shown, in several in vitro systems including the frog skin, toad bladder, fibroblasts and renal tubular epithelial cells grown in culture and isolated perfused cortical collecting tubules. In contrast to DLS, NH has been previously shown not to cross react with digoxin antibodies. Moreover, when given to intact rats, it produces a profound natriuresis but little or no kaliuresis. In contrast to ANF and BNP the compound is active orally as well as intravenously. It is clearly different from cortisone, based both on its biologic and mass spectroscopic characteristics.

  18. INTERACTING DISCIPLINES: Cardiac natriuretic peptides and obesity: perspectives from an endocrinologist and a cardiologist

    Science.gov (United States)

    Ramos, Hugo R; Birkenfeld, Andreas L; de Bold, Adolfo J

    2015-01-01

    Since their discovery in 1981, the cardiac natriuretic peptides (cNP) atrial natriuretic peptide (also referred to as atrial natriuretic factor) and brain natriuretic peptide have been well characterised in terms of their renal and cardiovascular actions. In addition, it has been shown that cNP plasma levels are strong predictors of cardiovascular events and mortality in populations with no apparent heart disease as well as in patients with established cardiac pathology. cNP secretion from the heart is increased by humoral and mechanical stimuli. The clinical significance of cNP plasma levels has been shown to differ in obese and non-obese subjects. Recent lines of evidence suggest important metabolic effects of the cNP system, which has been shown to activate lipolysis, enhance lipid oxidation and mitochondrial respiration. Clinically, these properties lead to browning of white adipose tissue and to increased muscular oxidative capacity. In human association studies in patients without heart disease higher cNP concentrations were observed in lean, insulin-sensitive subjects. Highly elevated cNP levels are generally observed in patients with systolic heart failure or high blood pressure, while obese and type-2 diabetics display reduced cNP levels. Together, these observations suggest that the cNP system plays a role in the pathophysiology of metabolic vascular disease. Understanding this role should help define novel principles in the treatment of cardiometabolic disease. PMID:26115665

  19. B-type natriuretic peptide and acute heart failure: Fluid homeostasis, biomarker and therapeutics.

    Science.gov (United States)

    Torres-Courchoud, I; Chen, H H

    2016-10-01

    Natriuretic peptides are a family of peptides with similar structures, but are genetically distinct with diverse actions in cardiovascular, renal and fluid homeostasis. The family consists of an atrial natriuretic peptide (ANP) and a brain natriuretic peptide (BNP) of myocardial cell origin, a C-type natriuretic peptide (CNP) of endothelial origin, and a urodilatin (Uro) which is processed from a prohormone ANP in the kidney. Nesiritide, a human recombinant BNP, was approved by the Federal Drug Administration (FDA) for the management of acute heart failure (AHF) in 2001. Human recombinant ANP (Carperitide) was approved for the same clinical indication in Japan in 1995, and human recombinant Urodilatin (Ularitide) is currently undergoing phase III clinical trial (TRUE AHF). This review will provide an update on important issues regarding the role of BNP in fluid hemostasis as a biomarker and therapeutics in AHF. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  20. 严重延迟复苏烧伤休克患者血浆脑钠肽的变化%Change in plasma brain natriuretic peptide and its clinical significance in burn patients after delayed fluid resuscitation of shock

    Institute of Scientific and Technical Information of China (English)

    黄永新; 詹新华; 郑静伟; 吴祖煌; 陈建崇; 朱剑仙; 谢包根; 刘世康

    2010-01-01

    Objective To observe the early change in plasma brain natriuretic peptide (BNP) level in burn patients with long delayed fluid resuscitation of burn shock and its clinical significance.Methods Thirty-six burn patients with second and third degree of burn covering 32%- 92% total body surface area were enrolled for the study, among them 10 patients were complicated with serious heart failure (heart failure group), and 26 patients rallied from shock after delayed fluid resuscitation without heart failure (stable group).The level of plasma BNP, lactate dehydrogenase (LDH), MB isoenzyme of creatine kinase (CK-MB), and left ventricle ejection fraction (LVEF) were determined at admission and 3 hours after hospitalization, and 24, 48, 72, 168 hours after the injury in both groups with electrochemiluminescence (ECL).Results Compared with stable group, the plasma BNP level (ng/L) of heart failure group at 3 hours after hospitalization, and 24, 48, 72 hours after the burn injury increased significantly (3 hours after hospitalization: 1 521.38±121.11 vs.391.36±63.27, 24 hours after burn: 2 516.86±193.25 vs.360.79±146.56, 48 hours after burn: 1 587.76±169.23 vs.398.92±77.46, 72 hours after burn: 974.45±166.33vs.283.43 ± 68.15, all P< 0.01), the level of LVEF lowered significantly (3 hours after hospitalization;0.33±0.03 vs.0.58±0.09, 24 hours after burn: 0.36±0.09 vs.0.60±0.10, 48 hours after burn: 0.35±0.08 vs.0.62±0.11, 72 hours after burn: 0.39±0.10 vs.0.64±0.10, all P<0.05).The levels of LDH (μmol·s-1·L-1)in stable group were 2.87±0.50 at admission,3.02±0.43 3hours after hospitalization,4.02±0.87 24 hours after burn, 6.90±0.87 48 hours after burn, 3.64±0.75 72 hours after burn, 2.670.45 168 hours after burn while in heart failure group, they were 2.97±1.40, 3.84±0.37, 4.29±0.45,8.50±0.38, 3.84±0.62, 2.30±0.38, respectively;and CK-MB (U/L) in stable group were 59.12±13.75at admission, 70.39 ±10.72 3 hours after hospitalization, 79.29 ±17

  1. Reference range of plasma N-terminal pro-brain natriuretic peptide levels in early preterm infants%早期早产儿血浆N末端脑钠肽参考值范围

    Institute of Scientific and Technical Information of China (English)

    张茜; 罗成汉; 时赞扬; 卢洁; 程欣茹; 徐千雅; 郭宏湘; 王丽; 程秀永

    2013-01-01

    .358,t1d与7 d=14.743,t3d与7d =11.105,P均=0.000).出生后1d、3d、7d早产儿血浆NT-proBNP水平分别为(1875 ±686) ng/L、(1615±574) ng/L、(1118 ±380) ng/L;均数95%置信区间分别为530~3220 ng/L、490~2740 ng/L、373~ 1863 ng/L.结论 早产儿血浆NT-proBNP水平出生第1天达高峰,之后随日龄增加而下降,二者呈负相关;血浆NT-proBNP水平不受胎龄、性别、出生体质量、分娩方式及营养方式的影响.%Objective To establish the reference range of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in early preterm infants.Methods 1.Inclusion criteria of the subjects:(1) preterm infants admitted to Neonatal Ward of First Affiliated Hospital of Zhengzhou University between Oct.2009 and Aug.2012 within 24 hours after birth;(2) maternal health during pregnancy; (3) written informed consent obtained from parents;(4) normal laboratory examination results such as blood gas analysis,electrolyte,hepatorenal function,myocardial enzyme,routine blood count and infectious disease screening (hepatitis B,hepatitis C,syphilis and acquired immune deficiency syndrome) within 24 hours after birth.Plasma NT-proBNP levels were measured on day 1,day 3 and day 7 of life.Variable data was analyzed using the Shapiro-Wilk test for normality test.Difference in plasma NT-proBNP levels on different days of life was analyzed using repeated measure analysis of variance.A multiple regression analysis was performed to determine the influencing factors for plasma NT-proBNP level,reference value interval:reference range containing 95 % of the reference population,namely(x-1.96 s)-(x-+ 1.96 s),with inspection level α =0.05.Results 1.A total of 204 preterm infants (104 cases were male and 100 cases were female) were included in the present study,with gestational age ranging from 27 + 1 to 36 +6 weeks(median 33 weeks) and birth weight ranging from 700 to 3050 g (median 1590 g).Of these preterm infants,vaginal delivery were 78

  2. [The role of B type natriuretic peptide in the assessment of post myocardial infarction prognosis].

    Science.gov (United States)

    Ben Halima, A; Ibn el Hadj, Z; Chrigui, R; Kammoun, I; Lefi, A; Chine, S; Gargouri, S; Keskes, H; Kachboura, S

    2006-10-01

    Recently cardiac peptides have received close attention as cardiovascular markers. Brain (B type) natriuretic peptide is a neurohormone synthesized predominantly in ventricular myocardium. Previous studies have shown that this hormone can provide prognostic information in patients with myocardial infarction. The aim of this review is to evaluate the impact of plasma levels of BNP on prediction of left ventricular ejection fraction and remodelling and major cardiac events after myocardial infarction.

  3. Increased natriuretic peptide receptor A and C gene expression in rats with pressure-overload cardiac hypertrophy

    DEFF Research Database (Denmark)

    Christoffersen, Tue E.H.; Aplin, Mark; Strom, Claes C.

    2006-01-01

    Both atrial (ANP) and brain (BNP) natriuretic peptide affect development of cardiac hypertrophy and fibrosis via binding to natriuretic peptide receptor (NPR)-A in the heart. A putative clearance receptor, NPR-C, is believed to regulate cardiac levels of ANP and BNP. The renin-angiotensin system...... also affects cardiac hypertrophy and fibrosis. In this study we examined the expression of genes for the NPRs in rats with pressure-overload cardiac hypertrophy. The ANG II type 1 receptor was blocked with losartan (10 mg.kg(-1).day(-1)) to investigate a possible role of the renin-angiotensin system...

  4. Increased natriuretic peptide receptor A and C gene expression in rats with pressure-overload cardiac hypertrophy

    DEFF Research Database (Denmark)

    Christoffersen, Tue E.H.; Aplin, Mark; Strom, Claes C.

    2006-01-01

    Both atrial (ANP) and brain (BNP) natriuretic peptide affect development of cardiac hypertrophy and fibrosis via binding to natriuretic peptide receptor (NPR)-A in the heart. A putative clearance receptor, NPR-C, is believed to regulate cardiac levels of ANP and BNP. The renin-angiotensin system...... also affects cardiac hypertrophy and fibrosis. In this study we examined the expression of genes for the NPRs in rats with pressure-overload cardiac hypertrophy. The ANG II type 1 receptor was blocked with losartan (10 mg.kg(-1).day(-1)) to investigate a possible role of the renin-angiotensin system...

  5. The Plasma Levels of Brain Natriuretic Peptide (BNP) in Patients With Acute Myocardial Infarction (AMI) Study of the Change%血浆中脑钠素(BNP)在急性心肌梗死(AMI)后的水平变化研究

    Institute of Scientific and Technical Information of China (English)

    祝红娟

    2015-01-01

    ObjectiveTo study the plasma levels of brain natriuretic peptide (BNP) in patients with acute myocardial infarction (AMI) after the change level.Methods the changes of BNP between the two groups comparison between AMI patients and healthy people.Results The observation group patients with 24 h within the plasma levels of BNP was significantly increased compared to the same period, with statistically significant difference between groups (P<0.05). ConclusionThe level of serum BNP in patients with acute myocardial infarction value to make early diagnosis of myocardial infarction with positive value.%目的:研究血浆中脑钠素(BNP)在急性心肌梗死(AMI)后的水平变化情况。方法对比 AMI患者和健康人两组间BNP变化。结果观察组患者24 h之内的BNP血浆水平明显增高,组间差异具有统计学意义(P<0.05)。结论急性心肌梗死患者的血浆BNP值对心肌梗死作出早期诊断具有积极的价值。

  6. Natriuretic peptides buffer renin-dependent hypertension.

    Science.gov (United States)

    Demerath, Theo; Staffel, Janina; Schreiber, Andrea; Valletta, Daniela; Schweda, Frank

    2014-06-15

    The renin-angiotensin-aldosterone system and cardiac natriuretic peptides [atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP)] are opposing control mechanisms for arterial blood pressure. Accordingly, an inverse relationship between plasma renin concentration (PRC) and ANP exists in most circumstances. However, PRC and ANP levels are both elevated in renovascular hypertension. Because ANP can directly suppress renin release, we used ANP knockout (ANP(-/-)) mice to investigate whether high ANP levels attenuate the increase in PRC in response to renal hypoperfusion, thus buffering renovascular hypertension. ANP(-/-) mice were hypertensive and had reduced PRC compared with that in wild-type ANP(+/+) mice under control conditions. Unilateral renal artery stenosis (2-kidney, 1-clip) for 1 wk induced similar increases in blood pressure and PRC in both genotypes. Unexpectedly, plasma BNP concentrations in ANP(-/-) mice significantly increased in response to two-kidney, one-clip treatment, potentially compensating for the lack of ANP. In fact, in mice lacking guanylyl cyclase A (GC-A(-/-) mice), which is the common receptor for both ANP and BNP, renovascular hypertension was markedly augmented compared with that in wild-type GC-A(+/+) mice. However, the higher blood pressure in GC-A(-/-) mice was not caused by disinhibition of the renin system because PRC and renal renin synthesis were significantly lower in GC-A(-/-) mice than in GC-A(+/+) mice. Thus, natriuretic peptides buffer renal vascular hypertension via renin-independent effects, such as vasorelaxation. The latter possibility is supported by experiments in isolated perfused mouse kidneys, in which physiological concentrations of ANP and BNP elicited renal vasodilatation and attenuated renal vasoconstriction in response to angiotensin II.

  7. C-type natriuretic-derived peptides as biomarkers in human disease

    DEFF Research Database (Denmark)

    Lippert, Solvej Kølvraa; Goetze, Jens Peter

    2010-01-01

    The natriuretic peptide system comprises three structurally related peptides: atrial natriuretic peptide, B-type natriuretic peptide and C-type natriuretic peptide. In circulation, they play an important endocrine role in the regulation of cardiovascular homeostasis by maintaining blood pressure...... and extracellular fluid volume. Atrial natriuretic peptide and B-type natriuretic peptide have gained considerable diagnostic interest as biomarkers in cardiovascular disease. By contrast, C-type natriuretic peptide has not yet been ascribed a role in human diagnostics. This perspective aims at recapitulating...... the present biochemical and clinical issues concerning C-type natriuretic peptide measurement in plasma as a potential biomarker....

  8. Detection and Significance of Brain Natriuretic Peptide Level in Normal Late Pregnant Women with Twin Pregnancy%正常双胎晚期妊娠孕妇氨基末端脑钠肽前体水平的检测及意义∗

    Institute of Scientific and Technical Information of China (English)

    游一平; 李晨辉; 唐雅兵; 王诗章

    2014-01-01

    目的探讨正常双胎晚期妊娠孕妇氨基末端脑钠肽前体(NT-proBNP)水平的正常值范围,为临床应用提供指导。方法用免疫电化学发光法测定本院758例正常双胎晚期妊娠孕妇血清 NT-proBNP水平,并根据孕周不同进一步将758例正常双胎晚期妊娠孕妇分为3个亚组,即 A组(孕28~31+6周)、B组(32~35+6周)、C组(≥孕36周),并比较三组NT-proBNP水平。结果正常双胎晚期妊娠孕妇NT-proBNP水平为(60.44±42.02)pg/mL,A、B、C三组血清NT-proBNP值分别为(29.55±25.49)pg/mL、(86.28±54.25)pg/mL、(66.69±31.44)pg/mL,A组与B、C组比较,A组血清NT-proBNP水平明显低于B组与C组,且差异有显著性(P0.05)。结论本组测得正常双胎晚期妊娠孕妇 NT-proBNP水平,样本量较大,其结果可以初步确立正常双胎晚期妊娠孕妇NT-proBNP参考值的范围。%Obj ective]To explore normal value range of brain natriuretic peptide(amino terminal pro-brain natriuretic peptide,NT-proBNP)level in normal late pregnant women with twin pregnancy so as to provide the guidance for clinical application.[Methods]Serum NT-proBNP level in 758 normal twin pregnant women of our hospital was determined by immune electrochemical luminescence method.According to gestational weeks,758 normal late pregnant women with twin pregnancy were further divided into 3 subgroups including group A(28~31+6 gestational weeks),group B(32~35+6 gestational weeks)and group C(≥36 gestational weeks).The levels of NT-proBNP among 3 groups were compared.[Results]The levels of NT-proBNP in normal late preg-nant women with twin pregnancy were (60.44±42.02)pg/mL,and those in group A,B and C were (29.55± 25.49)pg/mL,(86.28±54.25)pg/mL and (66.69±31.44)p/mL,respectively.The levels of NT-proBNP in group A were obviously lower than those in group B and C,and there was significant difference(P 0.05).[Conclusion]In this group, NT-proBNP level in normal late pregnant women with twin pregnancy is determined

  9. Curative Effect of Recombinant Human Brain Natriuretic Peptide Compared with Milrinone on Refractory Elderly Congestive Heart Failure%重组人脑钠肽和米力农治疗老年充血性心力衰竭的比较

    Institute of Scientific and Technical Information of China (English)

    黄馨

    2012-01-01

    目的:本文应用重组人脑钠肽(rhBNP) 和米力农对顽固性的老年充血性心力衰竭进行治疗,并观察临床治疗的疗效比较.方法:将30 例老年充血性心力衰竭患者随机分为两组,一组在常规治疗的基础上加用米力农,另一组在常规治疗的基础上加用重组人脑钠肽,观察治疗前后两组患者的临床症状、体征、心功能等的改善情况.结果:两组治疗前后,重组人脑钠肽疗效明显优于米力农组,两者比较,差异有统计学意义.结论:重组人脑钠肽治疗老年充血性心力衰竭疗效确切,较米力农改善更加明显.%Objective:To compare the clinical curative effect of treatment recombinant human brain natriuretic peptide (rhBNP) and milrinone in treatment of refractory elderly congestive heart failure patients.Methods:30 elderly patients with congestive heart failure on the basis of the conventional treatment were randomly divided into two groups (rhBNP group and milrinone group).Observe the patient's clinical symptoms,signs,cardiac function before and after treatment.Results:Clinical symptoms, signs, cardiac function,rhBNP group were significantly better than those in the milrinone group(all P<0.05).Conclusion:The clinical curative effect of rhBNP in treatment of refractory elderly congestive heart failure patients is superior to milrinone.

  10. Efficacy of recombinant human brain natriuretic peptide on acute heart failure with renal function insufficiency%重组人脑钠肽治疗急性心力衰竭合并肾功能不全的近期疗效观察

    Institute of Scientific and Technical Information of China (English)

    卢鑫; 胡桃红; 谢晓春; 刘胜林; 李慧君; 张玮; 王晶

    2014-01-01

    Objective To analyze the efficacy of recombinant human brain natriuretic peptide (rhBNP) treating congestive heart failure complicated with renal failure.Methods A retrospective analysis of 105 cases of heart failure and renal failure patients were randomly divided into two groups:group rhBNP (55 cases,on the basis of conventional therapy plus rhBNP) and routine treatment group (50 cases,treated with routine therapy).The effect of recombinant human brain natriuretic peptide [0.007 5 μg/(kg · min) micro pump intravenous infusion,once a day,each lasting approximately 10 hours,7 days for a course of treatment] was recorded before treatment,7 days and 3 months after treatment,including left ventricular ejection fraction,left ventricular end diastolic volume,left ventricular systolic end diastolic volume,24 hour urine volume,blood urea nitrogen,serum creatinine,serum cystatin C,NT-proBNP and creatinine clearance rate.Results Compared with routine therapy group after 7 days,NT-proBNP[(1 516 ±432)ng/L vs (4 951 ± 1 314)ng/L],the left ventricular ejection fraction[(46.9 ±6.8)% vs (30.6 ± 2.5) %],left ventricular end diastolic diameter [(50 ± 3) mm vs (57 ± 5) mm],left ventricular end systolic diameter [(35 ±6)mm vs (43 ±3)mm],24 hours urine volume [(975 ± 172) ml vs (786 ± 143)ml],urea nitrogen [(7.3 ± 2.3)mmol/L vs (12.9 ± 3.2)mmol/L],serum creatinine [(93 ± 8)μmol/L vs (234 ± 69) μmol/L],glomerular filtration rate [(46 ±6)ml/min vs (34 ±3)ml/min],serum cystatin C[(1.4 ± 0.1)mg/L vs (3.2 ± 1.9)mg/L] had significant differences between the two groups (P < 0.05).Conclusion The recombinant human brain natriuretic peptide is safe and can improve the renal function in chronic heart failure.%目的 观察重组人脑钠肽(rhBNP)治疗心力衰竭合并肾功能不全的近期疗效.方法 回顾性分析心力衰竭合并肾功能不全的患者105例,根据不同治疗分为2组,常规治疗组50例,给予常规治疗;rhBNP组55例,常规治疗

  11. Clinical Study of Brain Natriuretic Peptide and Blood Lactate Clearance Rate in Type A Aortic Dissection of Postoperative Respiratory Insufficiency%脑钠肽与血乳酸清除率在A型主动脉夹层术后呼吸功能不全的临床研究

    Institute of Scientific and Technical Information of China (English)

    欧阳晓仙; 刘易林; 李莉; 吴金平; 廖成全

    2016-01-01

    Objective:To observe dynamic changes of brain natriuretic peptide(BNP) levels and blood lactate clearance rate for postoperative respiratory insufficiency of type A aortic dissection surgery,in order to assess the extent of lung injury,guide the role of weaning.Method:A total of 42 patients with postoperative respiratory insufficiency of type A aortic dissection surgery in our hospital were selected from October 2010 to October 2015.According to patients with oxygen index to the acute lung injury group (ALI) (oxygenation index: 200 mm Hg≤PaO2/FiO2≤300 mm Hg) and ARDS group (PaO2/FiO2≤200 mm Hg),according to ventilator weaning results for the weaning success group (successful weaning and extubation and 48 h without complex in ventilation or support) the weaning failure group (48 h after weaning need to be ventilated again).Blood lactic acid,blood gas analysis and brain natriuretic peptide were observed at transferred,6,24,48 h,3 d until turn out.Result:All patients with postoperative respiratory insufficiency of type A aortic dissection surgery had higher blood lactic acid in the patients with respiratory insufficiency after operation,into the obvious,then gradually decreased,BNP levels increased gradually,the ALI group reached the peak at 3 d and 5 d dropped significantly, oxygenation index improved significantly in the ARDS group reached the peak at the 5 d,7 d dropped significantly, oxygenation index improved significantly.The weaning successful group was compared with the weaning failure group,BNP level was significantly lower,blood lactate clearance rate was higher and the differences between the two groups had statistical significance(P<0.05).Conclusion:Respiratory function of patients with the more severe,in patients with brain natriuretic peptide content is higher and the blood lactic acid clearance rate is low, postoperative weaning more difficult,BNP levels and blood lactic acid clearance rate is postoperative respiratory insufficiency of type A

  12. Natriuretic peptide-guided management in heart failure.

    Science.gov (United States)

    Chioncel, Ovidiu; Collins, Sean P; Greene, Stephen J; Ambrosy, Andrew P; Vaduganathan, Muthiah; Macarie, Cezar; Butler, Javed; Gheorghiade, Mihai

    2016-08-01

    Heart failure is a clinical syndrome that manifests from various cardiac and noncardiac abnormalities. Accordingly, rapid and readily accessible methods for diagnosis and risk stratification are invaluable for providing clinical care, deciding allocation of scare resources, and designing selection criteria for clinical trials. Natriuretic peptides represent one of the most important diagnostic and prognostic tools available for the care of heart failure patients. Natriuretic peptide testing has the distinct advantage of objectivity, reproducibility, and widespread availability.The concept of tailoring heart failure management to achieve a target value of natriuretic peptides has been tested in various clinical trials and may be considered as an effective method for longitudinal biomonitoring and guiding escalation of heart failure therapies with overall favorable results.Although heart failure trials support efficacy and safety of natriuretic peptide-guided therapy as compared with usual care, the relationship between natriuretic peptide trajectory and clinical benefit has not been uniform across the trials, and certain subgroups have not shown robust benefit. Furthermore, the precise natriuretic peptide value ranges and time intervals of testing are still under investigation. If natriuretic peptides fail to decrease following intensification of therapy, further work is needed to clarify the optimal pharmacologic approach. Despite decreasing natriuretic peptide levels, some patients may present with other high-risk features (e.g. elevated troponin). A multimarker panel investigating multiple pathological processes will likely be an optimal alternative, but this will require prospective validation.Future research will be needed to clarify the type and magnitude of the target natriuretic peptide therapeutic response, as well as the duration of natriuretic peptide-guided therapy in heart failure patients.

  13. C-type natriuretic-derived peptides as biomarkers in human disease

    DEFF Research Database (Denmark)

    Lippert, Solvej Kølvraa; Goetze, Jens Peter

    2010-01-01

    and extracellular fluid volume. Atrial natriuretic peptide and B-type natriuretic peptide have gained considerable diagnostic interest as biomarkers in cardiovascular disease. By contrast, C-type natriuretic peptide has not yet been ascribed a role in human diagnostics. This perspective aims at recapitulating...... the present biochemical and clinical issues concerning C-type natriuretic peptide measurement in plasma as a potential biomarker....

  14. Intracerebroventricular Administration of C-Type Natriuretic Peptide Suppresses Food Intake via Activation of the Melanocortin System in Mice

    OpenAIRE

    Yamada-Goto, Nobuko; Katsuura, Goro; Ebihara, Ken; Inuzuka, Megumi; Ochi, Yukari; Yamashita, Yui; Kusakabe, Toru; Yasoda, Akihiro; Satoh-Asahara, Noriko; Ariyasu, Hiroyuki; Hosoda, Kiminori; Nakao, Kazuwa

    2013-01-01

    C-type natriuretic peptide (CNP) and its receptor are abundantly distributed in the brain, especially in the arcuate nucleus (ARC) of the hypothalamus associated with regulating energy homeostasis. To elucidate the possible involvement of CNP in energy regulation, we examined the effects of intracerebroventricular administration of CNP on food intake in mice. The intracerebroventricular administration of CNP-22 and CNP-53 significantly suppressed food intake on 4-h refeeding after 48-h fastin...

  15. Atrial natriuretic peptide and feeding activity patterns in rats

    Directory of Open Access Journals (Sweden)

    Oliveira M.H.A.

    1997-01-01

    Full Text Available This review presents historical data about atrial natriuretic peptide (ANP from its discovery as an atrial natriuretic factor (ANF to its role as an atrial natriuretic hormone (ANH. As a hormone, ANP can interact with the hypothalamic-pituitary-adrenal axis (HPA-A and is related to feeding activity patterns in the rat. Food restriction proved to be an interesting model to investigate this relationship. The role of ANP must be understood within a context of peripheral and central interactions involving different peptides and pathways

  16. Chamber-dependent circadian expression of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Gøtze, Jens Peter; Georg, Birgitte; Jørgensen, Henrik L

    2010-01-01

    OFF. Eight animals (4 males and 4 females) were included at each time point. Another 48 animals were killed during the second cycle of dark/dark (designated Circadian Time or CT: CT 4, CT 8, CT 12, CT 16, CT 20, and CT 24). The cellular contents of the clock genes Per1 and Bmal1 as well as ANP, BNP......Atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) have important local functions within the myocardium, where they protect against accelerated fibrosis. As circadian expression of cardiac natriuretic peptides could be of importance in local cardiac protection against disease, we...

  17. A Clinical Study of Recombinant Human Brain Natriuretic Peptide on Patients with Acute Decompensated Heart Failure%重组人脑利钠肽治疗急性心力衰竭的疗效观察

    Institute of Scientific and Technical Information of China (English)

    周秀金; 卢竟前

    2013-01-01

    Objective:To observe the clinic efficacy and safety of used recombinant human brain natriuretie peptide (rh-BNP)on patients with acute decompensated heart failure.Methods:48 patients who suffered from acute decompensated heart failure patients were divided into rh-BNP group(n=22)and control group(n=26).The rh-BNP group received rh-BNP made by China and traditional heart failure treatment; the control group was treated with traditional heart failure treatment.The changes of the clinical efficacy, left ventricular ejection fraction (LVEF)and brain natriuretie peptide test parameters were observed. Results:After 7 days treatment, clinical efficacy improvements were more significant in rh-BNP group compared control group (81.7% vs 61.6,P<0.05).LVEF were improved in rh-BNP group compared with control group((51±6)%vs(46±5)%,P<0.01).and BNP level were decreased obviously in rh-BNP group than control group((498±209)pg/ml vs(642±318)pg/ml,P<0.01),and there had positive relation in BNP decrease and LVEF increased(P<0.05).Conclusion:The use of rh-BNP is efficient and safe for acute decompensated heart failure patient.And BNP test can provide a dog marker for diagnosis and prognostic.%目的:探讨在监测血清脑钠肽水平下,短期使用注射用重组人脑利钠肽治疗急性心力衰竭或慢性心力衰竭急性发作的临床效果。方法:48例急性心力衰竭患者根据是否使用注射用重组人脑利钠肽分为常规组和注射用重组人脑利钠肽组,对比两组治疗的临床效果和超声心动图情况,并监测BNP水平。结果:治疗7 d后,注射用重组人脑利钠肽组临床有效率明显好于常规组(81.7%vs61.6%,P<0.05),左室射血分数明显高于常规组(51±6)%vs(46±5)%,(P<0.01),且血清脑钠肽水平明显降低(498±209)pg/mL vs(642±318)pg/mL,(P<0.01),血清脑钠肽下降水平和左室射血分数提高水平差异有统计学意义(P<0.05),有

  18. The Value of Plasma Brain Natriuretic Peptide in Differentiating Acute Dyspnea from Aged Patients with Heart Failure%血液脑钠肽对鉴别老年心衰所致急性呼吸困难的价值

    Institute of Scientific and Technical Information of China (English)

    杨慧; 陈进军

    2009-01-01

    目的 探讨脑钠肽(BNP)对鉴别老年心衰所致急性呼吸困难的价值.方法 荧光免疫法测定145例以呼吸困难为主诉急诊人院或门诊老年患者血浆脑钠肽浓度.结果 心源性呼吸困难患者血液BNP浓度明显高于肺源性患者;BNP对于诊断左心衰有很强的预测价值,而早期诊断肺心病右心衰的价值尚待探讨;BNP值>100ng/L诊断心衰的灵敏度为94.1%,准确度93.1%,特异性79.5%,阳性预测值为91.3%,阴性预测值为85.4%.结论 快速检测血液BNP,用来诊断心力衰竭特别是左心衰,敏感、简便、快捷,可作为老年患者急性呼吸困难病因鉴别的一个重要检查方法 .%Objective To investigate the value of brain natriuretic peptide (BNP) in differentiating acute dyspnea from aged pa-tients with heart failure. Methods The concentration of plasma BNP was measured with immunofluorescence assay in 145 aged patients with dyspnea who admitted to hospital by emergency or were out - patients. Results The BNP level in patients with dyspnea caused by heart failure was significantly higher than that of lung disease patients. BNP for the diagnosis of left heart failure had a very strong predic-tive value, while the early diagnosis of pulmonary heart disease and right heart failure has yet to be explored. BNP values > 100ng / L for differentiating of heart failure was the following: the sensitivity of diagnosis was 94.1%, accuracy 93. I%, specificity 79.5%, positive predictive value was 91.3%, and negative predictive value was 85.4%. Conclusion BNP assay was a convenient, rapid and sensitive method for differentiating diagnosis in aged patients with heart failure, especially with left heart failure. It can be used as an important dif-ferential method in elderly patients with acute dyspnea.

  19. Significance of plasma brain natriuretic peptide in differentiating chronic cor pnlmonale from hypertensive heart failure%血浆脑钠素在肺源性心脏病和高血压性心脏病心力衰竭患者中的比较

    Institute of Scientific and Technical Information of China (English)

    黄蓓洁; 罗艳蓉; 徐晓雯; 李海玲

    2008-01-01

    Objective To study the significance of plasma brain natriuretic peptide(BNP)in differentiating patients with chronic cor pulmonale from those with hypertensive heart failure.Methods Thirty cases of cor pulmonale and 30 of hypertensive heart disease were recruited for the study.Heart rate and arterial partial oxygen pressure(PaO2)were measured for them,as well as plasma level of BNP Was measured by rapid immunofluorescence quantitative analysis.with 30 normal healthy persons as controls.Results As compared with the control group.plasma level of BNP increased significantly in patients with chronic cor pulmonale and hypertensive heart failure(P<0.05),and that in those with hypertensive heart failure[(597±68)ng/L]Was significantly higher than that in those with cot pulmonale[(179±34)ng/L,P<0.05]. Conclusion Plasma level of BNP can be used as an indicator to differentiate cor pulmonale from hypertensive heart failure both with dyspnea.%目的 探讨测定血浆脑钠素水平对鉴别肺源性心脏病和高血压性心脏病所致心力衰竭的意义.方法 肺源性心脏病、高血压性心脏病患者各30例,测定平均心率和PaO2,通过快速免疫荧光定量分析法测定血浆脑钠素水平,与30名正常健康人进行比较和分析.结果 肺源性心脏病和高血压性心脏病两组患者在心力衰竭时血浆脑钠素水平均高于对照组(P<0.05),其中高血压性心脏病组脑钠素[(597±68)ng/L]明显高于肺源性心脏病组[(179±34)ng/ml,P<0.01].结论 肺源性心脏病和高血压性心脏病患者心力衰竭时均表现出呼吸困难,血浆脑钠素可以作为鉴别两者的指标之一.

  20. Relationship of GRACE risk score with Plasma Brain Natriuretic Peptide and Myeloperoxidase in Patients with Non- ST Segment el-evation Acute Coronary Syndrome%非ST段抬高急性冠状动脉综合征患者GRACE危险积分与血浆 BNP、MPO的相关性

    Institute of Scientific and Technical Information of China (English)

    阚国庆; 高永; 王德启; 蔡忠贵; 王继征

    2016-01-01

    目的:探讨非 ST段抬高急性冠状动脉综合征(NSTE-ACS)患者全球急性冠状动脉事件注册(GRACE)评分与血浆脑钠肽( BNP)、髓过氧化酶(myeloperoxidase,MPO)水平的相关性。方法入选120例在我院住院的 NSTE-ACS患者,临床预测变量对其进行GRACE危险评分积分,并进行危险层次分层,入院后测定血浆 BNP、MPO水平。分析其与 GRACE危险积分不同层次之间的关系。结果①血浆 BNP、 MPO水平与GRACE危险积分呈正相关( r=0.71,P<0.05);随着 GRACE危险积分评分值增加,患者血浆 BNP、MPO水平亦逐渐升高;②随访期主要心血管事件发生率也增多(P <0.05)。结论 GRACE积分与BNP、MPO水平呈正相关,并与 NSTACS预后有关,能够对NSTEACS患者进行危险分层。%ObjectiveTo investigate the correlation of GRACE risk score and plasma brain natriuretic pep-tide ( BNP), myeloperoxidase in patients with non- ST segment elevation acute coronary syndrome.MethodsSelected 120 cases in NSTE-ACS patients in our hospital, clinical predictors its GRACE risk score points and dangerous level stratification, determination of plasma BNP, MPO levels after admission. Analyze the relationship between the different levels between the GRACE risk score.Results① The GRACE risk score is positively correlated with the plasma BNP and MPO levels ( r=0.71, P<0.05) ;② The incidence of MACE increased significantly with the rise of GRACE risk score and BNP, MPO levels.Conclusion: The higher GRACE risk score and BNP, MPO levels, the worse the prognosis, it could be use to predict the prognosis.

  1. Effect of Recombinant Human Brain Natriuretic Peptide on ST segment Elevation Acute Myocardial Infarction with Heart Failure%重组人脑利钠肽治疗急性ST段抬高型心肌梗死合并心力衰竭的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王如珠; 朱莉; 殷屹岗; 林杰

    2014-01-01

    目的:评价重组人脑利钠肽(rhBNP)治疗急性 ST段抬高型心肌梗死(STEMI)合并心力衰竭的疗效及其不良反应。方法46例 STEMI合并心力衰竭患者随机分成两组。治疗组23例,在常规药物治疗的基础上加用 rhBNP 治疗;对照组23例,仅采用常规治疗。观察两组患者用药前后生命体征、呼吸困难程度、相关血流动力学指标以及脑钠肽(BNP)的变化。结果治疗后两组血压、心率、心功能分级、左室射血分数、尿量及BNP差异有统计学意义(P<0.05)。结论常规治疗基础上联用rhBNP治疗STEMI合并心力衰竭的疗效显著,安全可行。%Objective To assess the effect and adverse reactions of recombinant human brain natriuretic peptide(rhBNP)on ST segment elevation acute myocardial infarction (STEMI)patients with heart failure.Methods Forty six STEMI patients with heart failure were randomly divided into two groups:Control group (n=23)treated with traditional therapy,and treatment group (n=23)treated with traditional therapy and rhBNP.Hemodynamics data were observed before and after the treatment.Results After the treatment, there were significant differences in clinical performance (including symptoms and signs),functional class,left ventricular ejection fraction,and urine volume (average urine volume per hour )between control group and treatment group (P<0.05).Conclusion rhB-NP was a valuable adj uvant to traditional therapy in treatment of STEMI with heart failure and low incidence of adverse reactions.

  2. Role of Troponins I and T and N-Terminal Prohormone of Brain Natriuretic Peptide in Monitoring Cardiac Safety of Patients With Early-Stage Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer Receiving Trastuzumab: A Herceptin Adjuvant Study Cardiac Marker Substudy.

    Science.gov (United States)

    Zardavas, Dimitrios; Suter, Thomas M; Van Veldhuisen, Dirk J; Steinseifer, Jutta; Noe, Johannes; Lauer, Sabine; Al-Sakaff, Nedal; Piccart-Gebhart, Martine J; de Azambuja, Evandro

    2017-03-10

    Purpose Women receiving trastuzumab with chemotherapy are at risk for trastuzumab-related cardiac dysfunction (TRCD). We explored the prognostic value of cardiac markers (troponins I and T, N-terminal prohormone of brain natriuretic peptide [NT-proBNP]) to predict baseline susceptibility to develop TRCD. We examined whether development of cardiac end points or significant left ventricular ejection fraction (LVEF) drop was associated with markers' increases. Patients and Methods Cardiac marker assessments were coupled with LVEF measurements at different time points for 533 patients from the Herceptin Adjuvant (HERA) study who agreed to participate in this study. Patients with missing marker assessments were excluded, resulting in 452 evaluable patients. A primary cardiac end point was defined as symptomatic congestive heart failure of New York Heart Association class III or IV, confirmed by a cardiologist, and a significant LVEF drop, or death of definite or probable cardiac causes. A secondary cardiac end point was defined as a confirmed significant asymptomatic or mildly symptomatic LVEF drop. Results Elevated baseline troponin I (> 40 ng/L) and T (> 14 ng/L), occurring in 56 of 412 (13.6%) and 101 of 407 (24.8%) patients, respectively, were associated with an increased significant LVEF drop risk (univariate analysis: hazard ratio, 4.52; P < .001 and hazard ratio, 3.57; P < .001, respectively). Few patients had their first elevated troponin value recorded during the study (six patients for troponin I and 25 patients for troponin T). Two patients developed a primary and 31 patients a secondary cardiac end point (recovery rate of 74%, 23 of 31). For NT-proBNP, higher increases from baseline were seen in patients with significant LVEF drop. Conclusion Elevated troponin I or T before trastuzumab is associated with increased risk for TRCD. A similar conclusion for NT-proBNP could not be drawn because of the lack of a well-established elevation threshold; however

  3. Relationship of plasma N-terminal pro-brain natriuretic peptide and cardiac function in patients with chronic kidney disease%慢性肾脏病患者血浆氨基末端前体脑钠肽与心功能的关系

    Institute of Scientific and Technical Information of China (English)

    向莉; 杨敏; 潘家荣

    2011-01-01

    Objective To study the relationship of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) and cardiac function in patients with chronic kidney disease(CKD). Methods Plasma NT-proBNP was examined in 152 CKD patients and 20 healthy subjects. The relationship of plasma NT-proBNP and echocardiographic and biochemistry parameter was analyzed. Results Plasma NT-proBNP level of CKD patients with heart failure was much higher than that of CKD cases in same stage but without heart failure. Plasma NT-proBNP level of CKD patients without heart failure increased with the decrease of the level of estimated glomerular filtration rate( eGFR),which was not in CKD patients with heart failure. NT-proBNP level was positively correlated with left atrial diameter (LAD), left ventricular end-diastolic diameter(LVEDD) and left ventricular end-systolic diameter (LVESD),but negatively correlated with left ventricular ejection frection(LVEF). Conclusion Plasma NT-proBNP is a sensitive marker for diagnosing early symptomless heart failure in CKD patients.%目的 研究血浆氨基末端前体脑钠肽(NT-proBNP)与心功能的关系.方法 采用固相免疫层析法检测152例不同分期慢性肾脏病(CKD)组患者与20例对照组血浆NT-proBNP水平,分析其与心脏彩超各指标、生化指标的关系.结果 伴有心衰的各期CKD患者NT-proBNP水平远高于同一分期无心衰患者;非心衰组CKD患者的NT-proBNP水平随着肾小球滤过率的下降逐渐升高;NT-proBNP水平与左房内径以及左室舒张末内径、左室收缩末内径均呈正相关,与心脏射血分数呈负相关.结论 NT-proBNP是早期诊断CKD患者无症状性心功能不全的敏感指标.

  4. Study on correlation between brain natriuretic peptide and heart rate variability in patients with type 2 diabetes and left ventricular diastolic dysfunction%2型糖尿病伴左室舒张功能不全患者心率变异性与B型尿钠肽的相关性分析

    Institute of Scientific and Technical Information of China (English)

    杨燕华; 刘自爱; 黄庆宁; 黄虔

    2013-01-01

    Objective To evaluate the correlation between he art rate variability and brain natriuretic peptide (BNP) in patients with type 2 diabetes and left ventricular diastolic dysfunction.Methods 100 patients with type 2 diabetes were included,all the patients' BNP level were over 100 pg/ml.SDNN-Index,RMSSD,PNN50 and BNP were measured,data were presented as (M ± SD).The correlation between heart rate variability and BNP level was assessed by Pearson Correlation Analysis (SPSS software).Results The correlation coefficient between SDNN-Index [(46.41 ± 17.74) ms] and BNP level was-0.472 (P < 0.01);The correlation coefficient between RMSSD [(37.18 ± 19.07) ms] and BNP level was-0.434 (P < 0.01); the correlation coefficient between PNN50[(18.88 ± 15.21)%] and BNP level was-0.589 (P < 0.01).Conclusion The heart rate variability in patients with type 2 diabetes and left ventricular diastolic dysfunction is obviously lower than that of normal people,and significantly correlated with BNP level.%目的 分析2型糖尿病伴左室舒张功能不全患者心率变异性与B型尿钠肽的关系.方法 收集100例B型尿钠肽≥100 pg/ml的2型糖尿病患者,研究其心率变异性与B型尿钠肽的相关性.心率变异性指标包括:SDNN-Index、RMSSD、PNN50,数据以平均值±标准差(M±SD)表示,用SPSS软件进行Pearson相关分析.结果 100例2型糖尿病伴心脏舒张功能不全患者SDNN-Index为(46.41±17.74) ms,RMSSD为(37.18±19.07) ms,PNN50为(18.88±15.21)%,SDNN-Index、RMSSD、PNN50与B型尿钠肽相关系数分别为-0.472、-0.434、-0.589,P均<0.01.结论 2型糖尿病伴心脏舒张功能不全患者的心率变异性明显低于正常人,且与B型尿钠肽水平相关.

  5. Effect of natriuretic peptide family on the oxidized LDL-induced migration of human coronary artery smooth muscle cells.

    Science.gov (United States)

    Kohno, M; Yokokawa, K; Yasunari, K; Kano, H; Minami, M; Ueda, M; Yoshikawa, J

    1997-10-01

    The migration of medial smooth muscle cells (SMCs) into the intima is proposed to be an important process of intimal thickening in atherosclerotic lesions. The present study examined the possible effect of a novel endothelium-derived relaxing peptide, C-type natriuretic peptide (CNP), on oxidized low-density lipoprotein (LDL)-induced migration of cultured human coronary artery SMCs by the Boyden's chamber method. The effect of CNP was compared with that of atrial and brain natriuretic peptides (ANP and BNP, respectively). Oxidized LDL stimulates SMC migration in a concentration-dependent manner between 20 and 200 micrograms/mL. This stimulation was chemotactic in nature but was not chemokinetic. By contrast, native LDL was without significant activity. CNP-22 clearly inhibited SMC migration stimulated with 200 micrograms/mL oxidized LDL in a concentration-dependent manner between 10(-9) and 10(-6) mol/L. ANP-(1-28) and BNP-32 also inhibited oxidized LDL-induced SMC migration at concentrations of 10(-7) and 10(-6) mol/L, but these effects were weaker than the effect of CNP-22. Such inhibition by these natriuretic peptides was paralleled by an increase in the cellular level of cGMP. Oxidized LDL-induced migration was significantly inhibited by a stable analogue of cGMP, 8-bromo-cGMP, or an activator of the cytosolic guanylate cyclase, sodium nitroprusside. These natriuretic peptides did not suppress the cell adhesion either in the absence or presence of oxidized LDL. These data indicate that oxidized LDL stimulates migration of human coronary artery SMCs and that natriuretic peptides, especially CNP, inhibit this stimulated SMC migration, at least in part, through a cGMP-dependent process. Taken together with the finding that oxidized LDL is present in the intima, CNP may play a role as a local antimigration factor during the process of intimal thickening in hypercholesterolemia-induced coronary atherosclerosis.

  6. Cardiovascular and metabolic effects of natriuretic peptides.

    Science.gov (United States)

    Moro, Cédric; Berlan, Michel

    2006-02-01

    Natriuretic peptides (NP) are essential in mammals to regulate blood volume and pressure. The functional roles of NP are not limited to natriuresis and diuresis. Several peripheral and central actions of the peptides have been characterized. Studies on transgenic mice have revealed their key function in the regulation of cardiomyocyte growth. Plasma NP levels increase in patients with cardiovascular disorders and heart failure. They represent useful clinical markers for clinicians to diagnose heart diseases. The recent discovery of their potent lipolytic action in adipose tissue is a breakthrough in cardiovascular medicine. This new function of NP in the regulation of lipid metabolism offers interesting questions in the field of obesity, diabetes and cardiovascular diseases. This review will briefly describe the effects of NP on the cardiovascular system and lipid metabolism.

  7. Clinical utility of natriuretic peptides and troponins in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Kehl, Devin W; Buttan, Anshu; Siegel, Robert J; Rader, Florian

    2016-09-01

    The diagnosis of hypertrophic cardiomyopathy (HCM) is based on clinical, echocardiographic and in some cases genetic findings. However, prognostication remains limited except in the subset of patients with high-risk indicators for sudden cardiac death. Additional methods are needed for risk stratification and to guide clinical management in HCM. We reviewed the available data regarding natriuretic peptides and troponins in HCM. Plasma levels of natriuretic peptides, and to a lesser extent serum levels of troponins, correlate with established disease markers, including left ventricular thickness, symptom status, and left ventricular hemodynamics by Doppler measurements. As a reflection of left ventricular filling pressure, natriuretic peptides may provide an objective measure of the efficacy of a specific therapy. Both natriuretic peptides and troponins predict clinical risk in HCM independently of established risk factors, and their prognostic power is additive. Routine measurement of biomarker levels therefore may be useful in the clinical evaluation and management of patients with HCM.

  8. B-type natriuretic peptide secretion following scuba diving

    DEFF Research Database (Denmark)

    Passino, Claudio; Franzino, Enrico; Giannoni, Alberto;

    2011-01-01

    To examine the neurohormonal effects of a scuba dive, focusing on the acute changes in the plasma concentrations of the different peptide fragments from the B-type natriuretic peptide (BNP) precursor....

  9. Effect of the renal natriuretic peptide, ularitide, alone or combined ...

    African Journals Online (AJOL)

    Rehab E. Abo El gheit

    2016-06-11

    Jun 11, 2016 ... Ularitide is more active than ANP as a natriuretic agent and more resistant than .... and specific markers of myocyte injury and stress respectively, ..... mesangial cells relaxation thereby increases the effective sur- face area for ...

  10. Atrial secretion of B-type natriuretic peptide

    DEFF Research Database (Denmark)

    Goetze, Jens Peter; Friis-Hansen, Lennart; Rehfeld, Jens F

    2006-01-01

    In the normal heart, the endocrine capacity resides in the atria. Atrial myocytes express and secrete natriuretic hormones that regulate fluid homeostasis and blood pressure. But in ventricular disease, atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) gene expression is also...... understanding of the endocrine atria during ventricular dysfunction is still scarce. Although ventricular disease and increased circulating concentrations are associated, it does not entail that the ventricle is the sole or even the main source in all types of heart disease. Clearly, the endocrine atria...... are also active in heart failure. Plasma measurement of cardiac natriuretic peptides and their molecular precursors can perhaps help us to discriminate when, where and how....

  11. Short-term prognosis evaluation of plasma brain natriuretic peptide concentration on the non-diabetic acute myocardial infarction patients with stress hyperglycemia%血浆脑钠肽水平对非糖尿病急性心肌梗死并发应激性高血糖患者近期预后评价

    Institute of Scientific and Technical Information of China (English)

    李永东; 董春花; 刘丹

    2012-01-01

    目的:观察非糖尿病急性心肌梗死(AMI)并发应激性高血糖患者血浆脑钠肽(BNP)水平变化,探讨血浆BNP在非糖尿病AMI并发应激性高血糖患者近期预后评估中的作用.方法:将60例AMI患者根据空腹血糖值分为2组,非糖尿病AMI并发应激性高血糖组(试验组)(血糖≥7.0 mmol/L) 36例,AMI未并发应激性高血糖组(对照组)(血糖<7.0 mmol/L)24例,对AMI患者在发病后24 h时测定血浆BNP水平.所有入选患者入院后2周行心脏彩超检查,测定和计算左室舒张末期内径(LVDd)、左室收缩末期内径(LVSd)、左室射血分数(LVEF);同时行24 h动态心电图检测,记录2组患者心律失常发生率;并观察住院2周内心绞痛、心力衰竭、心源性休克、心源性猝死等主要不良心血管事件(MACE)发生率.结果:①发病后24 h血浆BNP浓度试验组明显高于对照组[(671.87±631.71)ng/L∶(299.53±455.67)ng/L,P<0.01].②试验组LVDd、LVSd均高于对照组[(53.01±4.00)mm∶(50.50±3.20)mm,(45.32±5.92)mm∶ (42.52±3.27)mm,均P<0.05],LVEF低于对照组[(52.86±5.79)%∶(61.00±7.54)%,P<0.05].③试验组室性心律失常、室上性心律失常、严重窦性心动过缓和房室传导阻滞发生率均高于对照组(分别为66.67%∶41.67%,63.89%∶37.50%,47.22%∶20.83%,均P<0.05).④试验组与对照组住院2周内MACE发生率,包括心力衰竭(36.11%∶ 12.50%)、心源性休克(16.67%∶0.00%)、梗死后心绞痛(25.00%∶4.17%)均差异有统计学意义(均P<0.05);死亡率(2.78%∶0.00%)差异无统计学意义(P>0.05).结论:非糖尿病AMI并发应激性高血糖患者近期预后差,血浆BNP水平升高更为明显.%Objective:To observe the change of plasma brain natriuretic peptide concentration in the non-diabetic acute myocardial infarction patients with stress hyperglycemia, and to study its role in prognosis evaluation. Method:Sixty patients with acute myocardial

  12. Gene expression of the natriuretic peptide system in atrial tissue of patients with paroxysmal and persistent atrial fibrillation

    NARCIS (Netherlands)

    Tuinenburg, AE; Brundel, BJJM; Van Gelder, IC; Henning, RH; Van den Berg, MP; Driessen, C; Grandjean, JG; Van Gilst, WH; Crijns, HJGM

    1999-01-01

    Natriuretic Peptide System in AF. Introduction: Circulating cardiac natriuretic peptides play an important role in maintaining volume homeostasis, especially during conditions affecting hemodynamics. During atrial fibrillation (AF), levels of plasma atrial natriuretic peptide (ANP) becomes elevated.

  13. Assessment of blood N-terminal pro-brain natriuretic peptide levels in patients with heart failure with preserved ejection fraction%射血分数正常的心力衰竭患者全血N-末端脑钠肽前体浓度变化

    Institute of Scientific and Technical Information of China (English)

    陈广胜; 徐崇利; 张郁青; 林涛

    2012-01-01

    Objectives To assess ihe changes of blood N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels in patients with heart failure with preserved ejection fraction (HFPEF). Methods Totally 78 patients with cardiovascular diseases were classified into three groups: 22 cases with normal heart function, 33 cases with HFPEF and 23 cases with heart failure with reduced ejection fraction (HFREF). Blood NT-pro-BNP levels were measured and echoeardiograms were performed in all patients. Results Blood NT-pro-BNP levels in patients with HFPEF were significantly higher than those in patients with normal heart function [(1 424+996 )pg/mL vs. (167+ 117 )pg/mL,P<0.01 ] and significantly lower than those in patients with HFREF [(1 424±996)mg/L vs. (5 910±2828)mg/L,P<0.01 ]. For heart failure patients, blood NT-pro-BNP levels were negatively correlated with ejection fraction (r=—0.72,P<0.01 ), positively correlated with left atrial diameter (r=0.34,-P<0.05), left end-diastolic ventricular diameter (r=0.61 ,P<0.05) , left end-systolic ventricular diameter (r=0.62,P<0.05) and E/A ratio (r=0.40, P<0.05). Conclusions Compared with that of HFREF, HFPEF is associated with a less elevated level of NT-pro-BNP.%目的 评估射血分数正常的心力衰竭(心衰)患者全血N-末端脑钠肽前休(N-terminal pro-brain natriureticpeptide,NT-pro-BNP)浓度的变化.方法 入选78例心脏病患者分为3组:心功能正常组22例,射血分数正常心衰(heart failure with preserved ejection fretion,HFPEF)组33例,射血分数减低心衰(heart failure with reduced ejection fraction,HFREF)组23例.测定患者的全血NT-pro-BNP浓度并进行超声心动图检查.结果 HFPEF组患者全血NT-proBNP浓度高于心功能正常组[(1 424±996)pg/mL vs.(167±117) pg/mL,P<0.01],低于HFREF组[(1 424±996)mg/L vs.(5 910±2 828)mg/L,P<0.01],差异有统计学意义.心衰患者全血NT-proBNP浓度与射血分数呈负相关(r=-0.72,P<0.01),与左心房内径(r=0.34,P<0.05)

  14. Natriuretic peptides for the detection of paroxysmal atrial fibrillation in patients with cerebral ischemia--the Find-AF study.

    Directory of Open Access Journals (Sweden)

    Rolf Wachter

    Full Text Available BACKGROUND AND PURPOSE: Diagnosis of paroxysmal atrial fibrillation (AF can be challenging, but it is highly relevant in patients presenting with sinus rhythm and acute cerebral ischemia. We aimed to evaluate prospectively whether natriuretic peptide levels and kinetics identify patients with paroxysmal AF. METHODS: Patients with acute cerebral ischemia were included into the prospective observational Find-AF study. N-terminal pro brain-type natriuretic peptide (NT-proBNP, brain-type natriuretic peptide (BNP and N-terminal pro atrial-type natriuretic peptide (NT-proANP plasma levels were measured on admission, after 6 and 24 hours. Patients free from AF at presentation received 7 day Holter monitoring. We prospectively hypothesized that patients presenting in sinus rhythm with NT-proBNP>median were more likely to have paroxysmal AF than patients with NT-proBNPmedian (239 pg/ml, 17.9% had paroxysmal AF in contrast to 7.4% with NT-proBNP<239 pg/ml (p = 0.025. The ratio of early (0 h to late (24 h plasma levels of NT-proBNP showed no difference between both groups. For the detection of paroxysmal atrial fibrillation, BNP, NT-proBNP and NT-proANP at admission had an area under the curve in ROC analysis of 0.747 (0.663-0.831, 0.638 (0.531-0.744 and 0.663 (0.566-0.761, respectively. In multivariate analysis, BNP was the only biomarker to be independently predictive for paroxysmal atrial fibrillation. CONCLUSIONS: BNP is independently predictive of paroxysmal AF detected by prolonged ECG monitoring in patients with cerebral ischemia and may be used to effectively select patients for prolonged Holter monitoring.

  15. Plasma brain natriuretic peptide levels in COPD without pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Ahmed G. El Gazzar

    2017-01-01

    Conclusion: Plasma BNP can be used as a useful prognostic biomarker of COPD and a good predictor of exacerbation, As BNP level was significantly higher in COPD patients than in control groups, (p < 0.005 and also significantly higher in grade (IV, III than grade (II and was significantly higher in grade (II than grade (I COPD patients, BNP level significantly higher (p < 0.005 during exacerbation than during remission of COPD patients.

  16. Modulation in Natriuretic Peptides System in Experimental Colitis in Rats.

    Science.gov (United States)

    Lee, Chang Ho; Ha, Gi Won; Kim, Jong Hun; Kim, Suhn Hee

    2016-04-01

    Renin-angiotensin system is involved in the pathophysiology of colonic inflammation. However, there are a few reports about modulation of natriuretic peptide system. This study investigates whether a local atrial natriuretic peptide (ANP) system exists in rat colon and whether ANP plays a role in the regulation of colonic motility in experimental colitis rat model. Experimental colitis was induced by an intake of 5 % dextran sulfate sodium (DSS) dissolved in tap water for 7 days. After rats were killed, plasma hormone concentrations and mRNAs for natriuretic peptide system were measured. Functional analysis of colonic motility in response to ANP was performed using taenia coli. DSS-treated colon showed an increased necrosis with massive infiltration of inflammatory cells. The colonic natriuretic peptide receptor-A mRNA level and particulate guanylyl cyclase activity in response to ANP from colonic tissue membranes were higher, and the mRNA levels of ANP and natriuretic peptide receptor-B were lower in DSS-treated rats than in control rats. ANP decreased the frequency of basal motility in a dose-dependent manner but did not change the amplitude. The inhibitory responses of frequency of basal motility to ANP and 8-bromo-cGMP were enhanced in DSS-treated rat colon. In conclusion, augmentation of inhibitory effect on basal motility by ANP in experimental colitis may be due an increased expression of colonic natriuretic peptide receptor-A mRNA. These data suggest that local natriuretic peptide system is partly involved in the pathophysiology of experimental colitis.

  17. B and C types natriuretic peptides modulate norepinephrine uptake and release in the rat hypothalamus.

    Science.gov (United States)

    Vatta, M S; Presas, M; Bianciotti, L G; Zarrabeitia, V; Fernández, B E

    1996-09-16

    We previously reported that atrial natriuretic factor (ANF) regulates catecholamine metabolism in the central nervous system. ANF, B and C types natriuretic peptides (BNP and CNP) also play a regulatory role in body fluid homeostasis, cardiovascular activity and hormonal and neuro-hormonal secretions. The aim of the present work was to investigate BNP and CNP effects on the uptake and release of norepinephrine (NE) in rat hypothalamic slices incubated in vitro. Results showed that BNP (100 nM) and CNP (1, 10 and 100 nM) enhanced total and neuronal [3H]NE uptake but did not modify non-neuronal uptake. BNP (100 nM) and CNP (1 nM) caused a rapid increase in NE uptake (1 min), which was sustained for 60 min. BNP (100 nM) did not modify the intracellular distribution of NE; however, 1 nM CNP increased the granular store and decreased the cytosolic pool of NE. BNP (100 nM) and CNP (1, 10 and 100 nM), diminished spontaneous NE release. In addition, BNP (1, 10, 100 nM) and CNP (1, 10 and 100 pM, as well as 1, 10 and 100 nM) reduced NE output induced by 25 mM KCl. These results suggest that BNP and CNP may be involved in the regulation of several central as well as peripheral physiological functions through the modulation of noradrenergic neurotransmission at the presynaptic neuronal level. Present results provide evidence to consider CNP as the brain natriuretic peptide since physiological concentrations of this peptide (pM) diminished NE evoked release.

  18. Responses of cardiac natriuretic peptides after paroxysmal supraventricular tachycardia: ANP surges faster than BNP and CNP.

    Science.gov (United States)

    Kuo, Jen-Yuan; Wang, An-Mei; Chang, Sheng-Hsiung; Hung, Chung-Lieh; Chen, Chun-Yen; Shih, Bing-Fu; Yeh, Hung-I

    2016-03-15

    Atrial natriuretic peptide (ANP) secretion increases after 30 min of paroxysmal supraventricular tachycardia (PSVT). Whether this phenomenon also applies to brain or C-type natriuretic peptides (BNP or CNP) remains unknown. Blood samples of 18 patients (41 ± 11 yr old; 4 men) with symptomatic PSVT and normal left ventricular systolic function (ejection fraction 65 ± 6%) were collected from the coronary sinus (CS) and the femoral artery (FA) before and 30 min after the induction, and 30 min after the termination of PSVT. The results showed that the ANP levels rose steeply after the PSVT and then reduced at 30 min after the termination (baseline vs. post-PSVT vs. posttermination: CS: 34.0 ± 29.6 vs. 74.1 ± 42.3 vs. 46.1 ± 32.9; FA: 5.9 ± 3.24 vs. 28.2 ± 20.7 vs. 10.0 ± 4.6 pg/ml; all P tachycardia (BNP, 10.2 ± 6.4 vs. 11.3 ± 7.1 vs. 11.8 ± 7.9; CNP, 4.5 ± 1.2 vs. 4.9 ± 1.4 vs. 5.0 ± 1.4 pg/ml; all P < 0.05). The rise of BNP and CNP in FA was similarly less sharp after the PSVT and remained stationary after the termination. PSVT exerted differential effects on cardiac natriuretic peptide levels. ANP increased greater after a 30-min induced PSVT, but dropped faster after termination of PSVT, compared with BNP and CNP.

  19. Relationship Between Peritoneal Transport Characteristics and Natriuretic Peptides in Peritoneal Dialysis Patients.

    Science.gov (United States)

    Kojima, Shigeki; Sakurada, Tsutomu; Uehara, Masahiro; Okamoto, Takeshi; Kaneshiro, Nagayuki; Konno, Yusuke; Shibagaki, Yugo

    2015-01-01

    Few studies have attempted to evaluate the relationship between peritoneal permeability and fluid status in peritoneal dialysis (PD). The aim of the present study was to clarify the relationship between change in the dialysate-to-plasma ratio of creatinine (D/P Cr) and change in fluid status as evaluated by natriuretic peptides. We studied 49 PD patients (29 men, 62 ± 11 years, 36.7% with diabetes) who underwent a peritoneal equilibration test at least twice after PD initiation. We evaluated correlations between the rate of change in the D/P Cr (R C-D/P Cr), the rate of change in a human atrial natriuretic polypeptide (RC-αhANP), and the rate of change in brain natriuretic peptide (RC-BNP). The RC-αhANP was strongly correlated with RC-BNP (r = 0.637, p < 0.001). In contrast, the RC-D/P Cr was not correlated with RC-αhANP (r = 0.041, p = 0.781) or with RC-BNP (r = 0.114, p = 0.435). However, positive correlations between RC-D/P Cr and RC-αhANP (r = 0.530, p = 0.006) and between RC-D/P Cr and RC-BNP (r = 0.625, p = 0.001) were observed in patients with increased D/P Cr The present study showed a positive correlation between change in peritoneal transport characteristics and change influid status in patients whose D/P Cr increased.

  20. 慢性心力衰竭患者血浆脑钠肽浓度与体质量指数的相关性%Study on relationship between plamsa brain natriuretic peptide levels and body mass index in patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    陈雄; 崔俊友; 李健

    2012-01-01

    目的:探讨慢性心力衰竭患者脑钠肽(BNP)水平与体质量指数(BMI)的关系,明确BNP水平对慢性肥胖心力衰竭患者预后评估的影响.方法:老年充血性心力衰竭患者54例(男性30例,女性24例,左室射血分数<50%),测量患者身高、体重,根据BMI将患者分为3组:对照组(BMI<24 kg·m-2)、超重组(BMI=24~27.9kg·m-2)及肥胖组(BMI≥28kg·m-2),通过免疫荧光方法测定患者血浆BNP水平,比较各组血浆BNP水平及BNP水平与BMI的相关性.结果:(1) 肥胖组患者血浆BNP水平[(1 460±87)ng·L-1]明显低于对照组[(1 857±145)ng·L-1]及超重组[(1 756±100)ng·L-1](均为P<0.01);(2) BNP与BMI之间存在负相关关系(r=-0.91,P<0.01).结论:心力衰竭患者血浆中BNP浓度随BMI增加而降低,在应用BNP对心力衰竭患者进行心功能评价时,应同时考虑肥胖因素对其产生的影响.%Objective; To explore the relationship between levels of plasma brain natriuretic peptide(BNP) and body mass index ( BMI) , and to examine the influence of plasma BNP levels on the prognosis value for obesity heart failure patients. Methods; Fifty-four heart failure patients were enrolled in this study(30 males,24 females and LVEF < 50% ) , and heights and weights of each patient were measured and BMI were calculated with these parameter. The patients were divided into 3 groups according to BMI; controll group ( BMI < 24 kg · m ) , overweight group (BMI =24-27. 9 kg · m~ ) and obese group (BMI <28 kg · m~ ). The plasma concentrations of BNP were measured by immunofluorescence method. Results; The concentrations of BNP were significantly lower in obese group [ ( 1 460 ± 87 ) ng · L ] compared to normal group [ ( 1 857 ± 145 ) ng · L ] and overweight group [ ( 1 756 ± 100)ng · L-1 ] (P <0. 01). BNP levels were inversely correlated with BMI. Conclusion; In heart failure patients, plasma BNP levels are affected by BMI. The influence of BMI must be considered, when assessing the heart

  1. 最新糖化血红蛋白水平与急性心力衰竭患者B型尿钠肽、血肌酐的分析%The correlation between brain natriuretic peptide, creatinine and glycosylated hemoglobin in patients with acute heart failure

    Institute of Scientific and Technical Information of China (English)

    赵燕; 韩凌; 杨静娜; 陈欣; 李晓红; 马杰; 陈萍; 孙一光; 胡文泽

    2015-01-01

    Objective To investigate the correlation between brain natriuretic peptide (BNP),creatinine (Cr) and glycosylated hemoglobin in patients with heart failure,and to explore the correlation between glycosylated hemoglobin and heart failure.Methods We selected 106 cases with congestive heart failure in the Fuxing Hospital Affiliated to Capital University of Medical Sciences.We tested BNP,serum creatinine level,evaluation of glycated hemoglobin level of patients with heart failure immediately after admission.Results The BNP levels in patients whose glycosylated hemoglobin level more than 6.5% of BNP levels was (1 356.47 ± 398.69) ng/L,and significantly higher than (686.27 ± 188.31) ng/L of patients whose glycosylated hemoglobin in normal group (P < 0.01).Serum creatinine level(159.32 ±42.31) μ mol/L in patients whose glycosylated hemoglobin level more than 6.5% was significantly higher than creatinine level (105.32 ±11.03) μ mol/L in glycated hemoglobin normal group (P < 0.01).Conclusions Blood BNP,serum ereatinine level in patients with heart failure in the glycosylated hemoglobin level more than 6.5% patients was higher than glycosylated hemoglobin normal level group.The higher glycosylated hemoglobin levels in patients with severe heart failure and poor renal function.The latest glycosylated hemoglobin can be a marker for the risk of heart failure.%目的 通过检测心力衰竭患者B型尿钠肽(BNP)、血肌酐(Cr)与糖化血红蛋白(HbA1c)的水平,探讨HbA1c异常与心力衰竭患者是否存在相关性.方法 入选106例心力衰竭患者,测定患者入院即刻BNP、血Cr水平,评价HbA1c水平异常与心力衰竭患者BNP、血Cr是否存在相关性.结果 HbA1c≥6.5%患者BNP水平(1 356.47±398.69) ng/L明显高于HbA1c正常组的(686.27±188.31) ng/L (P< 0.01).HbA1c≥6.5%患者血Cr水平(159.32±42.31)μ mol/L高于HbA1c正常组的(105.32± 11.03) μmol/L (P<0.01).结论 心力衰竭患者最新HbA1c增高组患者

  2. 脓毒性休克患者血浆脑钠肽与 PiCCO 相关指标的关系%The correlation between plasma brain natriuretic peptide (BNP)levels and parameters of pulse -indicated continuous cardiac output(PiCCO)in patients with septic shock

    Institute of Scientific and Technical Information of China (English)

    吴翔; 陶飞; 胡桂芳; 邓烈华; 姚华国

    2016-01-01

    Objective To investigate the relationship between plasma brain natriuretic peptide (BNP)levels and the monito-ring indicators of pulse -indicated continuous cardiac output (PiCCO)in patients with sepstic shock.Methods 48 patients with septic shock according to the criteria of sepsis set by SC-CN /ESICM/ACCP /ATS /SIS were selected.Clinical and laboratory data including BNP were collected on the 1 d,3rd and 5 th day after admittion.The hemodynamics of the patients was monitored using PiCCO technology,and the heart function indexs were recorded,incluing CI,CFI,GEF and dP /dPmax.Acute Physiology and Chronic Health Evaluation (APACHEⅡ)and Sepsis -related Organ Failure Assessment (SOFA)score were determined.The correlation between BNP levels and the above indexs was analyzed.Results The levels of plasma BNP had negative correlation with CI,CFI,GEF (r =-0.339, -0.250, -0.241 ,P 0.05 ).The levels of plasma BNP had significant positive correlation with APACHEII scores and SOFA scores (r =0.509,0.565 ,P <0.05 ). Conclusion The cardiac function could not be reflected by BNP levels in septic shock patients.Plasma BNP levels can re-flect the severity of septic shock in certain degree,and might be considered as a valuable prognostic factor for patients with septic shock.%目的:通过监测脓毒性休克患者血浆脑钠肽(BNP)水平以及脉搏指示连续心排血量(PiCCO)相关指标的变化,探讨脓毒性休克患者脑钠肽水平与心功能的关系。方法选取48例脓毒性休克患者为研究对象,检测患者入 ICU第1、3、5天血浆 BNP 水平,通过 PiCCO 技术对患者进行血流动力学监测,记录反应心功能指标的 CI、CFI、GEF 和 dP/dP-max,并进行 APACHEⅡ、SOFA 评分,分析 BNP 与上述指标的相关性。结果脓毒性休克患者血浆 BNP 水平与 CI 、CFI、GE 呈负相关(r =-0.339、-0.25、-0.241,P <0.05),与 dP/dPmax 无显著相关性(P >0.05

  3. 围生期心肌病患者血清B型脑钠肽与超敏C反应蛋白水平变化及临床意义%The clinical significance of the level changes of B type brain natriuretic peptide and high sensitive C-reaction protein in peripartum cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    汪朝春; 杨群爱

    2013-01-01

    目的:探讨血清B型脑钠肽(BNP)与超敏C反应蛋白(hs- CRP)水平在围生期心肌病(PPCM)诊断及治疗中的价值。方法测定21例PPCM患者(观察组)BNP hs- CRP,同时行心脏彩色多普勒超声心动图检查测量左心室舒张末期内径(LVED)和左心室射血分数(LVEF),并对患者进行1个月的随访。选取同期住院的正常分娩患者20例作为对照组。结果观察组与对照组比较,BNP[(870.1±168.2)ng/L,(99.2±38.3)ng/L]、hs- CRP[(28.1±7.2)mg/L,(6.7±2.2)mg/L]明显升高(均P<0.01),hs- CRP与BNP呈正相关(r=0.67,P<0.01)。经过1个月治疗,观察组平均LVEF由(33.1±9.5)%提高至(50.3±12.1)%,BNP、hs- CRP[治疗后分别为(196.6±40.2)ng/L、(7.8±3.1)mg/L)]明显下降(均P<0.01)。结论 BNP及hs- CRP可以作为PPCM较好的诊断、治疗参考指标。%Objective To explore the clinical significances of the level changes of B type brain natriuretic peptide (BNP) and high sensitive C- reaction protein(hs- CRP) for diagnosis and treatment in peripartum cardiomyopathy(PPCM ). Methods A total of 21 PPCM and 20 normal delivery femals were randomly recruited in the current study.echocardiographic,hs- CRP,BNP were measured.21PPCM were fol owed up for a month. Results The PPCM patients compared to the controls, BNP(870.1ng/L) and hs- CRP (28.1mg/L) were significantly higher in the PPCM patients compared with the control (99.2ng/L and 6.7mg/L) hs- CRP was positively related with BNP(r=0.67,P<0.01).After a month of treatment,left ventricular ejection fraction enhanced from 33.1%to 50.3%, BNP significantly declined from 870.1ng/L to 196.6ng/L(P<0.01),hs- CRP significantly declined from 28.1mg/L to 7.8mg/L(P<0.01). Conclusion BNP and hs- CRP provide a good reference index for diagnosis and treatment in the PPCM.

  4. Correlation Analysis of CA125 and N-terminal pro-brain natriuretic peptide and cardiac function in patients with chronic heart failure%慢性心衰患者CA125与N-末端脑钠素原及心功能相关性研究

    Institute of Scientific and Technical Information of China (English)

    张建秀; 高华; 曹倩; 闫超

    2014-01-01

    目的:探讨慢性心衰患者血清肿瘤抗原糖类抗原125(C A 125)与N‐末端脑钠素原(WT‐‐ProBNP)及心功能相关性。方法:选择慢性心衰患者108例,根据NYHA 心功能分级标准进行分级,分别检测CA19‐9、CA125、NT‐ProBNP、E/E’及左心射血分数(LVEF)并检测LVEF及E/E’。结果:III级患者CA125、NT‐ProBNP较II级患者均出现显著性升高(P<0.05),IV级患者较II、III级患者均出现显著性升高(P<0.05)。III级患者LVEF、E/E’较II级患者均出现显著性差异(P<0.05),IV级患者LVEF较II级患者均出现显著性升高(P<0.05),E/E'较II、III级患者均出现显著性升高(P<0.05)。CA125与NT‐ProBNP、E/E'显著正相关(P<0.05),与LVEF显著负相关(P<0.05)。结论:CA125与心功能相关指标密切相关,对其水平检测有助于明确慢性心衰的进展。%Objective:To investigate correlation analysis of CA125 and N‐terminal pro‐brain natriuretic peptide and cardiac function in patients with chronic heart failure .Methods :108 patients with chronic heart failure were classified according to NYHA class grading standards ,CA19‐9 ,CA125 ,NT‐ProBNP ,E /E'and LVEF and detect LVEF and E /E'were detected .Results :In stage III patients CA125 ,NT‐ProBNP than stage II patients were significantly higher (P <0 .05) ,stage IV patients than stage II ,stage III patients were significantly higher (P <0 . 05) .LVEF ,E /E'in III patients compared with grade II patients were significantly different (P <0 .05) ,LVEF in grade IV was higher than that in grade II patients (P <0 .05) ,E /E'than grade II and grade III were significantly higher(P <0 .05) .CA125 and NT‐ProBNP ,E /E'showed significant positive correlation (P <0 .05) ,and LVEF was significantly negatively correlated (P <0 .05) .Conclusion:CA125 is closely related to heart function related in‐dicators ,which help to

  5. Relationship Among Plasma Brain Natriuretic Peptide (BNP) Levels, Left Ventricular Ejection Fraction (LVEF) and Left Ventricular End-Diastolic Diameter(LVEDD) in Patients with Heart Failure%心衰患者脑钠肽与左室射血分数等参数的研究

    Institute of Scientific and Technical Information of China (English)

    胡丙清; 陈森

    2011-01-01

    目的 研究慢性稳定性及失代偿性心力衰竭(选择心功能Ⅱ、Ⅲ、Ⅳ级)患者血浆中脑钠肽(BNP)水平的差异及其与左室射血分数(LVEF)、左室舒张末期内径(LVEDD)之间的相关性.方法 选择心力衰竭患者96例,入院后均经心脏彩超检查.按NYHA分级,Ⅱ级40例,其中稳定性心衰14例,失代偿性心衰26例;Ⅲ级40例,其中稳定性心衰16例,失代偿性心衰24例;Ⅳ级16例,其中稳定性心衰4例,失代偿性心衰12例.采用美国雅培12000SR全自动化学发光分析仪测定血浆BNP水平.结果 BNP数值在NYHA分级Ⅱ、Ⅲ、Ⅳ各组间(包括稳定期、失代偿期)差异有统计学意义(P<0.05).LVEDD及LVEF在慢性稳定性心衰组各分级间差异有统计学意义(P<0.05),而LVEDD及LVEF在失代偿性心衰组各分级间差异无统计学意义(P>0.05).结论 脑钠肽的升高与NYHA分级成正相关,左室射血分数及舒张末期内径与慢性稳定性心衰分级成正相关,与慢性失代偿性心衰无明显相关性.%Objective To investigate the level differences of plasma brain natriuretic peptide( BNP) in patients with chronic stable and decompensation heart failure and their relationship among BNP,left ventricular ejection fraction(LVEF) and left ventricular end-diastolic diameter(LVEDD). Methods Ninety-six patients with heart failure were examined by UCG after admission , and they were divided into three groups according to NYHA' s heart function class criterion: NYHA class II group 40 cases, including chronic stable heart failure 14 cases; decompensation heart failure 26 cases; NYH A class IQ group 40 cases; including chronic stable heart failure 16 cases;decompensation heart failure 24 cases;NYHA class IV group 16 cases,including chronic stable heart failure 4 cases; heart failure 12 cases. The concentration of BNP was measured by Achitect I2000SR full-automatic chemiluminesent immunoassay ( CLIA). Results The concentration of BNP between NYHA class

  6. Advantage study on utilization of N-terminal pro-B-brain natriuretic peptide for early diagnosis and therapeutic effect monitoring of acute coronary syndrome%N-端脑钠素前体应用于急性冠状动脉综合征早期诊断及疗效监控的优势性研究

    Institute of Scientific and Technical Information of China (English)

    唐敏儿

    2016-01-01

    Objective To explore clinical advantages of N‐terminal pro‐B‐brain natriuretic peptide(NT‐proBNP) in early diagno‐sis and therapeutic effect monitoring of acute coronary syndrome(ACS) .Methods A total of 97 cases of patients with chest pain and obvious discomfort who treated with coronary angiography in this hospital from February to December 2014 were selected .A‐mong these patients ,34 cases with non‐ACS were enrolled in the control group ,while other 63 cases with ACS were divided into the ST‐segment elevation myocardial infarction(STEM ) group ,non‐ST‐segment elevation myocardial infarction(NSTEM ) group and unstable angina pectoris(UA) group .The glycemia ,lipemia ,blood pressure and other indicators were observed .Results The levels of fasting blood‐glucose were within the normal reference interval in all groups ,while levels of lipemia ,plasma NT‐proBNP and blood pressure were higher than the upper limits of normal reference intervals ,and plasma levels of NT‐proBNP were higher than standard of good prognosis(NT‐proBNP0 .05) .The levels of lipemia and plasma NT‐proBNP and blood pressure were obviously decreased in patients with ACS at each treatment stage .Conclusion NT‐proBNP as a kind of myocardial marker has high accuracy in early diagnosis of ACS ,which could be applied in therapeutic effect monitoring and provide guidance for reasonable selection of treatment strategy .%目的:研究N‐端脑钠素前体(NT‐proBNP)在急性冠状动脉综合征(ACS)早期诊断及疗效监测中的临床优势。方法选取2014年2~12月因胸部疼痛或不适感明显在该院心内科就诊且行冠状动脉造影的患者97例,其中34例非ACS患者纳入对照组,63例ACS患者分别纳入ST段抬高型心肌梗死(STEM)组、非ST段抬高型心肌梗死(NSTEM)组、不稳定型心绞痛(UA)组。观察各组患者血糖、血脂、血压及NT‐proBNP等指标。结果各组患者空腹血糖均在

  7. Clinical value of N-terminal pro-brain natriuretic peptide for evaluating acute heart failure in patients undergoing hemodialysis%前体脑钠肽对血液透析患者发生急性心功能不全的临床诊断价值

    Institute of Scientific and Technical Information of China (English)

    刘国望; 晏德华; 叶燕丽

    2012-01-01

    目的 在维持性血液透析患者中,研究前体脑钠肽(NT-proBNP)对评价急性心功能不全的临床价值.方法 检测113人次以呼吸困难就诊,临床上怀疑存在急性心功能不全的血液透析患者的NT-proBNP水平.根据定义的临床指标判断急性左心力衰竭.结果 急性心力衰竭组NT-proBNP水平高于非急性心力衰竭组.NT-proBNP和年龄、透析时间以及左心室厚度无关,和右心房大小正相关.对于急性心力衰竭的患者,NT-proBNP水平和心力衰竭临床分级呈正相关性(rs=0.526,P=0.012).多变量分析显示,NT-proBNP水平每升高100 pg/ml,急性心力衰竭的危险性增加2.01倍(OR 3.01,95% CI 2.11~3.85).经ROC曲线分析,NT-proBNP诊断急性心力衰竭的曲线下面积为0.819(95% CI 0.728~0.842).结论 对于血液透析患者,NT-proBNP能作为诊断急性心力衰竭的生物学标志物.%Objective To investigate the clinical value of N-terminal pro-brain natriuretic peptide( NT-proBNP )for evaluating acute heart failure in patients undergoing hemodialysis. Methods NT-proBNP levels of 113 hemodialysis cases were measured,who were hospitalized with tachypnea and were suspected to be with acute heart failure. The diagnosis of acute heart failure was made by the definition of the guideline for diagnosis and therapy of acute left heart failure. Results The level of NT-proBNP was higher in the patients with acute heart failure than those without. The level of NT-proBNP was not associated with age, dialysis time and thickness of left ventricle, whereas correlated with right atrium. The level of NT-proBNP in those with acute left heart failure was also related to class of clinical heart failure( rs = 0. 526, P =0.012 ). The level of NT-proBNP increased 100 pg/ml,the risk for acute heart failure increased 2 fold( odds ratio 3. 01,95% confidence interval 1. 11-3. 85 ). The area under ROC curve of the NT-proBNP for diagnosis of acute heart failure was 0.819(95% confidence

  8. 高血压病患者的血浆肾素活性与脑钠肽水平及预后的关系%Relationship between plasma renin activity,brain natriuretic peptide level,and prognosis in patients with hypertension

    Institute of Scientific and Technical Information of China (English)

    马军; 蒋金法

    2014-01-01

    Objective To observe the difference of brain natriuretic peptide(BNP)level in hypertensive patients with various plasma renin activity,and to follow up the clinical outcome within 12 months. Methods Eight hundred and forty-five cases of new hypertensive patients as the research object. The patients on the same risk level were divided into high renin and low renin groups according by five points,the difference of BNP level between the two groups was compared,and cardiovascular events were followed up for 12 months. Results In low or moderate risk-patients with high blood pressure,plasma renin level difference had little impact on BNP concentration and clinical events. The differences of the renin activity among high-risk patients had a significant influence only on BNP level. The plasma BNP level and cardiovascular events (myocardial infarction,unstable angina,sudden cardiac death,heart failure,malignant arrhythmia,stroke) in high-rennin group were significantly higher than those in low-renin group. Conclusion Extremely high-risk hypertensive patients with high renin activity had higher BNP levels,which might participate in the target organ damage from hypertension,leading to more cardiovascular events.%目的:观察具有不同血浆肾素活性的高血压病患者中血清脑钠肽(BNP)水平的差异,并随访12个月内的临床转归情况。方法将845例新发高血压病患者作为研究对象,对同一危险分层的患者根据血浆肾素差异按5分位法分取高肾素组和低肾素组,比较两组血清BNP水平的差异,并随访12个月内心脑血管事件的发生情况。结果低、中危高血压患者中血清肾素水平差异对血浆BNP水平和临床事件的影响甚微;高危患者中肾素活性的差异仅对BNP的影响具有显著性;极高危患者的高肾素组,其血浆BNP浓度和心脑血管事件(心肌梗死、不稳定型心绞痛、心源性猝死、心力衰竭、恶性心律失常、脑卒中)

  9. 重组人脑利钠肽对急性心肌梗死后急性心力衰竭循环内分泌激素及左室功能的影响%Efficacy of recombinant human brain natriuretic peptide on endocrine hormone and left ventricular function of acute heart failure patients from acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    陈茂华; 薄小萍; 羊镇宇

    2012-01-01

    目的:了解重组人脑利钠肽(rhBNP)对急性心肌梗死(AMI)后急性失代偿性心力衰竭(HF)患者循环内分泌激素及左室功能的影响,并评判其临床疗效和安全性.方法:AMI并发急性失代偿性HF患者58例,随机分为rhBNP组26例和硝酸异山梨酯组32例,在标准抗缺血、抗HF治疗的基础上,持续静脉应用rhBNP或硝酸异山梨酯48 h,分别于治疗前和治疗后6h、24 h及72 h,检测血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)和醛固酮(ALD)浓度;治疗前及治疗后72 h测定血BNP、超声心动图测定左室舒张末期内径(LVDd)及左室射血分数(LVEF);同时比较30 d内主要不良心脏事件(MACE)的发生情况.结果:与硝酸异山梨酯组比较,rhBNP组血浆PRA、AngⅡ、ALD治疗6h后即降低(均P<0.05),72 h时仍保持较低水平(均P<0.01);治疗后72 hBNP下降(P<0.01),LVDd及LVEF明显改善(P<0.05,P<0.01),30 d MACE事件发生率rhBNP组显著低于硝酸异山梨酯组(P<0.05).结论:rhBNP对AMI伴HF患者的血浆肾素、AngⅡ和ALD水平有快速而持续的抑制作用,可以显著改善左室功能,同时降低30 d内MACE事件发生率.%Objective:To investigate the clinical efficacy of recombinant human brain natriuretic peptide (rhB-NP) on endocrine hormone and left ventricular function of acute decompensated heart failure (ADHF) patients resulted from acute myocardial infarcfion (AMI). Method: Fifty-eight patients with AMI-ADHF were randomly divided into rhBNP group (n = 26) and isosorbide mononitrate group (n=32). They were all received standard anti-ischemic and anti-heart failure treatment. We detected plasma renin activity (PRA) , angiotensin II (Ang E ) and aldosterone (ALD) concentration before treatment and after 6, 24 and 72 hours. Blood BNP, left ventricular end-diastolic diameter (LVDd) and left ventricular ejection fraction (LVEF) were determined before treatment and after 72 hours. All patients were followed up for 1 month to record

  10. Effects of intracoronary recombinant human brain natriuretic peptide on the cardiac function in patients with acute myocardial infarction after percutaneous coronary intervention%冠状动脉内注射重组人脑利钠肽对急性心肌梗死经皮冠状动脉介入治疗患者心功能的影响

    Institute of Scientific and Technical Information of China (English)

    胡国勋; 蔺鹏翔; 常江; 王凤; 闫旭丽; 李立灏

    2013-01-01

    目的:观察经皮冠状动脉(冠脉)介入治疗(PCI)急性心肌梗死(AMI)时冠脉内注射重组人脑利钠肽(rhBNP)的疗效及安全性.方法:将62例采取直接PCI治疗的前壁AMI患者随机分为冠脉内治疗组(21例)、静脉治疗组(21例)及对照组(20例),冠脉内治疗组在梗死相关血管(IRA)开通后立即给予冠脉内注射常规剂量rhBNP治疗,静脉治疗组于IRA开通后即刻静脉给予常规剂量rhBNP治疗,2组均持续使用rhBNP治疗72 h;对照组单纯给予常规药物治疗.观察所有患者的心肌酶动态变化,并于术后1、4及12周行二维超声心动图检查.结果:冠脉内治疗组和静脉治疗组肌酸激酶、肌酸激酶同工酶峰值均明显低于对照组(均P<0.01).术后4周,冠脉内治疗组每搏输出量、左室射血分数、左室舒张末期内径均优于对照组(均P<0.05);术后12周,冠脉内治疗组每搏输出量、左室射血分数、左室舒张末期内径均优于对照组和静脉治疗组(均P<0.05).结论:IRA开通后立即冠脉内使用rhBNP是安全有效的,冠脉内使用rhBNP对AMI患者PCI术后的心肌保护作用及抑制AMI后左室重构作用均优于静脉使用rhBNP.%Objective:To investigate the security and effect of intracoronary recombinant human brain natriuretic peptide (rhBNP) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Method:A total of 62 patients with AMI after PCI were randomly divided into intracoronary group (n=21),intravenous group (n=21) and control group (n =20).Intracoronary injection followed by a 72-hour continuous rhBNP infusion was administrated in the intracoronary group and intravenous injection followed by a 72-hour continuous rhBNP infusion was administrated in the intravenous group after primary PCI.In the control group,patients received a routine treatment.The security of intracoronary injection of rhBNP and the dynamic changes of myocardial enzyme in all

  11. Clinical Significance of Changes in the Level of Brain Natriuretic Peptide in Patients with Pulmonary Heart Disease%肺源性心脏病病程中脑钠肽水平变化的临床意义分析

    Institute of Scientific and Technical Information of China (English)

    王大江

    2015-01-01

    Objective:To investigate the clinical significance of brain natriuretic peptide (BNP) levels in the course of pulmonary heart disease.Method: 67 patients with chronic pulmonary heart disease in our hospital were selected, according to the progress of the disease course they were divided into episodes stage and remission stage.The BNP level was detected by double anti sandwich immunoassay, PaO2 and PaCO2 levels were determined by blood gas analysis. The different periods levels of BNP, PaCO2 and PaO2 were compared.Result:The episodes stage levels of BNP and PaCO2 were respectively (215.83±83.17)ng/L and (52.13±5.38)mm Hg,they were significantly higher than the remission stage levels,the differences were statistically significant(P<0.05). The episodes stage levels of PaO2 was (51.29±4.70) mm Hg,which was significantly lower than that in remission stage, the difference was statistically significant(P<0.05). Conclusion:In the course of pulmonary heart disease, BNP is involved in the pathophysiological process of pulmonary heart disease, which can be used as a reference index to evaluate the curative effect and prognosis.%目的:探讨脑钠肽(BNP)水平变化在肺源性心脏病病程中的临床意义。方法:选取本院收治的慢性肺心病患者67例,根据病程的进展分为发作期和缓解期。采用双抗夹心免疫酶法测定BNP水平,血气分析测定PaO2和PaCO2水平,比较患者不同时期的血浆BNP、PaCO2及PaO2水平。结果:患者发作期BNP及PaCO2水平分别为(215.83±83.17)ng/L和(52.13±5.38)mm Hg,明显高于缓解期,差异均有统计学意义(P<0.05);患者发作期PaO2水平为(51.29±4.70)mm Hg,明显低于缓解期,差异有统计学意义(P<0.05)。结论:在肺源性心脏病患者的病程进展中,血浆BNP参与肺心病的病理生理过程,可作为评估患者疗效和判定预后的参考指标。

  12. 充血性心力衰竭与肺源性心脏病患者血浆BNP水平的比较%Comparison of plasma levels of brain natriuretic peptide in patients with congestive heart failure or lung-derived heart disease

    Institute of Scientific and Technical Information of China (English)

    韦彩雯; 李宏松; 章敬玉; 姚能才; 窦存芳; 石来新; 卢英民

    2011-01-01

    目的:比较充血性心力衰竭(congestive heart failure,CHF)及肺源性心脏病(pulmonary heart disease,PHD)患者急性呼吸困难发作时及缓解后1周血浆脑钠尿肽(BNP)水平的变化并分析其临床意义.方法:采用全血化学发光法测定CHF及PHD患者急性呼吸困难发作时及缓解后1周血浆BNP水平.结果:CHF患者呼吸困难发作时血浆BNP水平明显高于病情缓解后1周血浆BNP水平[(1997 ±865)ng/L vs.(184±114)ng/L,P<0.05],PHD患者呼吸困难发作时血浆BNP水平明显高于病情缓解后1周血浆BNP水平[(679±202)ng/L vs.(145±48)ng/L,P<0.05],呼吸困难发作时CHF组患者血浆BNP水平明显高于PHD组(P<0.05),呼吸困难缓解后1周两组间无显著差异.结论:BNP水平可作为CHF患者病情严重程度及疗效判断的评价指标.也可作为临床协助鉴别CHF呼吸困难与PHD重度肺功能不全呼吸困难的检测指标之一.%AIM: To compare the changes of plasma brain natriuretic peptide ( BNP) levels in patients with congestive heart failure (CHF) or lung-derived heart disease (pulmonary heart disease, PHD) with dyspnea at onset and 1 week after remission. METHODS: Using the whole blood chemiluminescence method, plasma BNP levels in patients with dyspnea were determined at onset and 1 week after remission. RESULTS: At the onset of dyspnea in patients with CHF, plasma BNP levels were significantly higher than those 1 week after remission [ (1997 ±865) ng/L vs. (184 ± 114) ng/L, P <0.05]. Likewise, at the onset of dyspnea in patients with PHD, plasma BNP levels were also significantly higher than those 1 week after remission [(679 ±202) ng/L vs. (145 ±48) ng/L, P<0.05]. However, at the onset of dyspnea, plasma BNP levels in patients with CHF were significantly higher than those in patients with PHD (P <0.05), but no significant difference was observed between groups at 1 week after remission. CONCLUSION; BNP levels reduce with dyspnea remission. BNP levels can serve

  13. 类风湿关节炎合并急性冠状动脉综合征患者血清脑钠肽水平及心功能特点分析%Cardiac function and brain natriuretic peptide in patients with acute coronary syndrome complicated with rheumatoid arthritis

    Institute of Scientific and Technical Information of China (English)

    潘丽丽; 王天

    2015-01-01

    Objective To investigate the cardiac function and brain natriuretic peptide (BNP) level in patients with acute coronary syndrome (ACS) complicated with rheumatoid arthritis (RA).Methods Sixty-eight ACS patients complicated with RA (observation group) and 65 ACS patients without RA (control group) from January 2012 to June 2013 were enrolled.The age,gender,body mass index (BMI),blood pressure,relative risk factors of cardiovascular disease were recorded and compared between the two groups.The levels of high sensitivity C reactive protein (hs-CRP),erythrocyte sedimentation rate (ESR),serum triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),homocysteine (Hcy) and serum brain natriuretic peptide (BNP) were compared between the two groups.The echocardiography was used to determine the changes of cardiac morphology and function.Results The BMI was significantly higher in observation group than that in control group [(28 ±4) kg/m2 vs (25 ±4) kg/m2].There were no differences regarding the age,gender,blood pressure,relative risk factors of cardiovascular disease,and the levels of TG,TC and LDL-C between the two groups.The HDL level was significantly lower in observation group than that in control group[(1.0 ±0.3) mmol/L vs (1.2 ± 0.2) mmol/L] (P < 0.05).The serum CRP,ESR and Hcy levels in observation group were significantly higher than those in control group[(10 ± 6) mg/L vs (4 ± 3) mg/L,(28 ± 16) mm/1 h vs (9 ±4) mm/1 h,(17 ±6) μmol/L vs (14 ±4) μmol/L] (P<0.05).The level of BNP was significantly higher and the LVEF was significantly lower in observation group than that in control group [(387 ± 226)ng/L vs (258 ± 139) ng/L,(44 ± 13)% vs (61 ± 10)%].Reduction of diastolic function was found in 66 cases (96.7%) of observation group,higher than that in control group [62.3% (40/65)] (P < 0.01).Conclusions ACS patients complicated with RA are more likely to be afflicted

  14. 21 CFR 862.1117 - B-type natriuretic peptide test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false B-type natriuretic peptide test system. 862.1117... Systems § 862.1117 B-type natriuretic peptide test system. (a) Identification. The B-type natriuretic peptide (BNP) test system is an in vitro diagnostic device intended to measure BNP in whole blood...

  15. Dwarfism and early death in mice lacking C-type natriuretic peptide

    Science.gov (United States)

    Chusho, Hideki; Tamura, Naohisa; Ogawa, Yoshihiro; Yasoda, Akihiro; Suda, Michio; Miyazawa, Takashi; Nakamura, Kenji; Nakao, Kazuki; Kurihara, Tatsuya; Komatsu, Yasato; Itoh, Hiroshi; Tanaka, Kiyoshi; Saito, Yoshihiko; Katsuki, Motoya; Nakao, Kazuwa

    2001-01-01

    Longitudinal bone growth is determined by endochondral ossification that occurs as chondrocytes in the cartilaginous growth plate undergo proliferation, hypertrophy, cell death, and osteoblastic replacement. The natriuretic peptide family consists of three structurally related endogenous ligands, atrial, brain, and C-type natriuretic peptides (ANP, BNP, and CNP), and is thought to be involved in a variety of homeostatic processes. To investigate the physiological significance of CNP in vivo, we generated mice with targeted disruption of CNP (Nppc−/− mice). The Nppc−/− mice show severe dwarfism as a result of impaired endochondral ossification. They are all viable perinatally, but less than half can survive during postnatal development. The skeletal phenotypes are histologically similar to those seen in patients with achondroplasia, the most common genetic form of human dwarfism. Targeted expression of CNP in the growth plate chondrocytes can rescue the skeletal defect of Nppc−/− mice and allow their prolonged survival. This study demonstrates that CNP acts locally as a positive regulator of endochondral ossification in vivo and suggests its pathophysiological and therapeutic implication in some forms of skeletal dysplasia. PMID:11259675

  16. Breed differences in natriuretic peptides in healthy dogs

    DEFF Research Database (Denmark)

    Sjöstrand, K.; Wess, G.; Ljungvall, I.

    2014-01-01

    BACKGROUND: Measurement of plasma concentration of natriuretic peptides (NPs) is suggested to be of value in diagnosis of cardiac disease in dogs, but many factors other than cardiac status may influence their concentrations. Dog breed potentially is 1 such factor. OBJECTIVE: To investigate breed...... variation in plasma concentrations of pro-atrial natriuretic peptide 31-67 (proANP 31-67) and N-terminal B-type natriuretic peptide (NT-proBNP) in healthy dogs. ANIMALS: 535 healthy, privately owned dogs of 9 breeds were examined at 5 centers as part of the European Union (EU) LUPA project. METHODS: Absence...... the median concentration in Doberman Pinschers. CONCLUSIONS AND CLINICAL IMPORTANCE: Considerable interbreed variation in plasma NP concentrations was found in healthy dogs. Intrabreed variation was large in several breeds, especially for NT-proBNP. Additional studies are needed to establish breed...

  17. Imidazoline receptors in the heart: a novel target and a novel mechanism of action that involves atrial natriuretic peptides

    Directory of Open Access Journals (Sweden)

    S. Mukaddam-Daher

    2004-08-01

    Full Text Available Chronic stimulation of sympathetic nervous activity contributes to the development and maintenance of hypertension, leading to left ventricular hypertrophy (LVH, arrhythmias and cardiac death. Moxonidine, an imidazoline antihypertensive compound that preferentially activates imidazoline receptors in brainstem rostroventrolateral medulla, suppresses sympathetic activation and reverses LVH. We have identified imidazoline receptors in the heart atria and ventricles, and shown that atrial I1-receptors are up-regulated in spontaneously hypertensive rats (SHR, and ventricular I1-receptors are up-regulated in hamster and human heart failure. Furthermore, cardiac I1-receptor binding decreased after chronic in vivo exposure to moxonidine. These studies implied that cardiac I1-receptors are involved in cardiovascular regulation. The presence of I1-receptors in the heart, the primary site of production of natriuretic peptides, atrial natriuretic peptide (ANP and brain natriuretic peptide (BNP, cardiac hormones implicated in blood pressure control and cardioprotection, led us to propose that ANP may be involved in the actions of moxonidine. In fact, acute iv administration of moxonidine (50 to 150 µg/rat dose-dependently decreased blood pressure, stimulated diuresis and natriuresis and increased plasma ANP and its second messenger, cGMP. Chronic SHR treatment with moxonidine (0, 60 and 120 µg kg-1 h-1, sc for 4 weeks dose-dependently decreased blood pressure, resulted in reversal of LVH and decreased ventricular interleukin 1ß concentration after 4 weeks of treatment. These effects were associated with a further increase in already elevated ANP and BNP synthesis and release (after 1 week, and normalization by 4 weeks. In conclusion, cardiac imidazoline receptors and natriuretic peptides may be involved in the acute and chronic effects of moxonidine.

  18. Raised Plasma Aldosterone and Natriuretic Peptides in Atrial Fibrillation

    DEFF Research Database (Denmark)

    Dixen, Ulrik; Ravn, Lasse Steen; Soeby-Rasmussen, Christian;

    2006-01-01

    BACKGROUND AND AIMS: During atrial fibrillation (AF), the renin-angiotensin-aldosterone system (RAAS) may be activated. In this study, our aim was to evaluate at a long-term follow-up visit the levels of plasma aldosterone and natriuretic peptides as markers of neurohormonal remodeling in patients...... with earlier, documented AF in relation to present heart rhythm, clinical data, and the left ventricular ejection fraction (LVEF). We hypothesized that increased levels of aldosterone and natriuretic peptides were significantly associated with present AF as markers of RAAS activation during the arrhythmia...

  19. Raised plasma aldosterone and natriuretic peptides in atrial fibrillation

    DEFF Research Database (Denmark)

    Dixen, U; Ravn, L; Soeby-Rasmussen, C;

    2007-01-01

    During atrial fibrillation (AF), the renin-angiotensin-aldosterone system (RAAS) may be activated. In this study, our aim was to evaluate at a long-term follow-up visit the levels of plasma aldosterone and natriuretic peptides as markers of neurohormonal remodeling in patients with earlier......, documented AF in relation to present heart rhythm, clinical data, and the left ventricular ejection fraction (LVEF). We hypothesized that increased levels of aldosterone and natriuretic peptides were significantly associated with present AF as markers of RAAS activation during the arrhythmia....

  20. Natriuretic pro-peptides in idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Skau, Maren Cecilie Kloppenbor; Gøtze, Jens Peter; Rehfeld, Jens F.;

    2010-01-01

    Idiopathic intracranial hypertension is a disorder of unknown pathogenesis. Natriuretic peptides may be involved in intracranial pressure regulation, but cerebrospinal fluid (CNS) and plasma concentrations in this disorder are unknown. We evaluated venous and intrathecal concentrations of ANP, BNP...... and CNP precursor peptides in 40 patients with idiopathic intracranial hypertension and in 20 controls. Natriuretic pro-peptides were quantitated using processing-independent assays. In CSF, no differences in peptide concentrations between patients and controls were found (proANP: 239 + or - 23 vs 231...

  1. Assessment of atrial natriuretic peptide resistance in cirrhosis with head-out water immersion and atrial natriuretic peptide infusion.

    Science.gov (United States)

    Legault, L; Warner, L C; Leung, W M; Logan, A G; Blendis, L M; Skorecki, K L

    1993-02-01

    The nature of sodium retention in cirrhosis complicated by ascites has been studied for the last 30 years. Resistance to the natriuretic action of atrial natriuretic peptide (ANP) may play a potential role in this sodium retention. To further evaluate this possibility, we studied 12 patients with biopsy-proven cirrhosis and ascites on 2 consecutive days after a 7-day period off diuretics while receiving a 20 mmol/day sodium restricted diet. Following a crossover design, patients underwent head-out water immersion (HWI) for 3 h and were infused with a alpha-human ANP for 2 h on 2 consecutive days. Blood and urine samples were collected hourly. Five patients displayed a natriuretic response to HWI, sufficient to achieve negative sodium balance, and these patients were termed responders. Each of these five patients also displayed a natriuretic response to ANP infusion. In contrast, the other seven patients (nonresponders) consistently failed to develop a natriuretic response to either maneuver. The two groups had similar elevations in plasma ANP concentrations, but at baseline differed in terms of plasma sodium, plasma renin activity, and serum aldosterone. Despite higher serum aldosterone concentrations, nonresponders excreted less potassium than responders during the peak effect of the interventions, suggesting greater sodium delivery to the aldosterone-sensitive nephron segment in responders. We conclude that the inability to mount an adequate sodium excretory response to HWI in patients with cirrhosis may be conveyed through increased antinatriuretic factors that decrease the sodium delivery to the medullary collecting duct and inhibit the natriuretic effect of ANP at that site.

  2. EFFECTS OF DIABETES ON THE AMINO TERMINAL PROBRAIN TYPE NATRIURETIC PEPTIDE (NT-PROBNP LEVELS IN ELDERLY PATIENTS

    Directory of Open Access Journals (Sweden)

    Muzaiyan Ahmed Khan

    2012-02-01

    Full Text Available The Amino terminal portion of the precursor of brain natriuretic peptide (NT-proBNP has been reported to be elevated in left ventricular dysfunction. The NT-proBNP is a split product from the proBNP molecule, and its level in the circulation is not, as the mature Brain type natriuretic peptide, dependent on the peripheral number of brain natriuretic peptide (BNP receptors. We aimed to test the hypothesis that asymptomatic left ventricular dysfunction (ALVD, as estimated by NT-proBNP, would be more prevalent in patients with type 2 diabetes without overt cardiovascular disease in comparison with matched control subjects. The study population consisted of [N=100] out of which 75 patients including Type-II diabetes and 25 matched control subjects aged 40–70 years heart disease from OPD Escorts Heart Institute and Research centre Okhla New Delhi. NT-proBNP was measured in plasma by competitive enzyme immunosorbent assay. Patients with type-II diabetes were shown to have higher NT-proBNP values than control subjects. NT-proBNP levels were independently related to diabetes after adjustment for age, sex, systolic and diastolic blood pressure, BMI, heart rate, drug treatment, serum creatinine, and cystatin-C. The secretion of NT-proBNP is increased in type-II diabetic patients, suggesting that type 2 diabetes is associated with a higher prevalence of ALVD. NT-proBNP may thus serve as a screening tool to select patients with type-II diabetes who could benefit from an echocardiographical examination.

  3. Utilidad del péptido natriurético cerebral en la evaluación de pacientes con falla cardiaca tratados con resincronización cardiaca y su correlación con la evolución clínica Utility of brain natriuretic peptide in patients with heart failure treated with cardiac re-synchronization and its correlation with clinical evolution

    Directory of Open Access Journals (Sweden)

    Jorge E Marín

    Full Text Available La terapia de resincronización cardiaca es una herramienta novedosa y efectiva para el tratamiento de los pacientes con falla cardiaca que no han respondido a medidas farmacológicas óptimas y que además tienen deterioro en su clase funcional y disincronía ventricular. Se ha demostrado que el péptido natriurético cerebral (BNP determina de manera cuantitativa la severidad de la falla cardiaca y que su concentración sanguínea guarda correlación directamente proporcional con el grado de falla cardiaca. En este trabajo se hace una evaluación prospectiva de los niveles de BNP, función ventricular, clase funcional, evolución clínica, duración del QRS, caminata de seis minutos, hospitalización no programada y mortalidad en los pacientes, antes y a 3, 6 y 9 meses de seguimiento, luego del implante de la terapia de resincronización cardiaca. Se incluyó un total de 34 pacientes quienes se siguieron durante un promedio de nueve meses. Se demostró una disminución en los niveles de BNP (645 pg/mL, 320 pg/mL y 147 pg/mL preimplante, a 6 y 9 meses; p Cardiac resynchronization therapy (CRT is a novel and effective tool for the treatment of patients with severe heart failure (HF, left ventricular systolic dysfunction and desynchrony, that have not responded to the optimal pharmacological therapy. It has been demonstrated that brain natriuretic peptide (BNP quantitative determines severity of the HF and their blood levels keep direct proportional correlation to the severity of HF. We prospectively evaluated levels of brain natriuretic peptide (BNP, left ventricular function, New York Heart Association (NYHA class, QRS duration, and 6-minute hall walk test in a group of patients before biventricular device implantation at 3-6 and 12 months of follow-up. Clinical evolution, not programmed hospitalization and mortality were also evaluated. A total of 34 patients were enrolled and followed for a mean of nine months. A decrease in BNP levels (645

  4. The Early Diagnosis and Prognosis Evaluation of Elderly Pulmonary Heart Disease Patients by High-sensitivity Cardiac Tro pon in a nd Amino Terminal Brain Natriuretic Peptide Precursor%高敏肌钙蛋白及氨基末端脑钠肽前体在老年肺心病患者早期诊断及预后评估的临床意义

    Institute of Scientific and Technical Information of China (English)

    郑咏仪; 郑国雄; 朱建宏; 陈厅厅; 苏小虎

    2014-01-01

    Objective:To study the early diagnosis and prognosis evaluation clinical significance of eld-erly pulmonary heart disease patients by high-sensitivity cardiactroponin and amino terminal brain natriuretic peptide precursor .Method: 60 elderly pulmonary heart disease patients were selected as the observation group, The patients with chronic obstructive pulmonary disease were divided into mild moderate and severe according to the pulmonary arterial hypertension 20 cases patients were selected as the control group ,the NT-proBNP and hs-TnT were measured at the acute exacerbation and remission , NT-proBNP and hs-TnT and the readmission rate and mortality rate after six months were compared .Resutl :In acute aggravating period , NT-proBNP and hs-TnT level of the observation group patients was significantly higher than that of the con-trol group (P<0.05),There was statistically significant difference among light , medium and severe pulmona-ry artery pressure , even in remission , NT-proBNP and hs-TnT level of the observation group patients was still higher than that of the control group ,the readmission rate and mortality after six months was significantly higher than that of the control group .Conclusion:High-sensitivity cardiactroponin and amino terminal brain natriuretic peptide precursor can obviously increase the elderly pulmonary heart disease diagnostic sensitivity , it was an indicator of the severity of CCP as long-term prognostic risk factors .%目的:探讨高敏肌钙蛋白( hs-TnT)及氨基末端脑钠肽前体( NT-proBNP )对老年肺心病早期诊断以及预后临床价值。方法:选60例老年肺心病患者为观察组,分别按肺动脉高压分成轻中重度各20例,慢性阻塞性肺疾病20例作为对照组,测定各组急性加重期和缓解期的NT-proBNP 及hs-TnT,比较各组间两指标的差异及缓解期6个月的再入院率及死亡率。结果:在急性加重期,观察组患者hs-TnT及NT-proBNP 的含量明

  5. Low prevalence of B-type natriuretic peptide levels

    NARCIS (Netherlands)

    Hogenhuis, J; Voors, AA; Jaarsma, T; Hillege, HL; Hoes, AW; van Veldhuisen, DJ

    2006-01-01

    Background In patients with acute heart failure (HF) presenting at the emergency department, a B-type natriuretic peptide (BNP) level <100 pg/mL was found in only 10% of the patients. However, in a more stable outpatient HF population from another study, a BNP level <100 pg/mL was found in as many a

  6. B-type natriuretic peptides and mortality after stroke

    DEFF Research Database (Denmark)

    García-Berrocoso, Teresa; Giralt, Dolors; Bustamante, Alejandro;

    2013-01-01

    To measure the association of B-type natriuretic peptide (BNP) and N-terminal fragment of BNP (NT-proBNP) with all-cause mortality after stroke, and to evaluate the additional predictive value of BNP/NT-proBNP over clinical information....

  7. Atrial natriuretic peptide induces postprandial lipid oxidation in humans.

    NARCIS (Netherlands)

    Birkenfeld, A.L.; Budziarek, P.; Boschmann, M.; Moro, C.; Adams, F.; Franke, G.; Berlan, M.; Marques, M.A.; Sweep, F.C.; Luft, F.C.; Lafontan, M.; Jordan, J.

    2008-01-01

    OBJECTIVE: Atrial natriuretic peptide (ANP) regulates arterial blood pressure. In addition, ANP has recently been shown to promote human adipose tissue lipolysis through cGMP-mediated hormone-sensitive lipase activation. We hypothesized that ANP increases postprandial free fatty acid (FFA) availabil

  8. Practical application of natriuretic peptides in paediatric cardiology

    DEFF Research Database (Denmark)

    Smith, Julie; Goetze, Jens P; Andersen, Claus B

    2010-01-01

    It is still uncertain if cardiac natriuretic peptides are useful biomarkers in paediatric cardiology. In this review we identify four clinical scenarios in paediatric cardiology, where clinical decision-making can be difficult, and where we feel the paediatric cardiologists need additional...

  9. Practical application of natriuretic peptides in paediatric cardiology

    DEFF Research Database (Denmark)

    Smith, Julie; Goetze, Jens P; Andersen, Claus B

    2010-01-01

    It is still uncertain if cardiac natriuretic peptides are useful biomarkers in paediatric cardiology. In this review we identify four clinical scenarios in paediatric cardiology, where clinical decision-making can be difficult, and where we feel the paediatric cardiologists need additional...

  10. Perfusão da artéria pulmonar não melhora os índices de fator natriurético cerebral (BNP em estudo experimental em suínos Pulmonary artery perfusion does not improve brain natriuretic peptide (BNP levels in suine experimental research

    Directory of Open Access Journals (Sweden)

    Edmo Atique Gabriel

    2010-12-01

    controlled perfusion over cardiopulmonary bypass (CPB modifies BNP levels expressed by the ventricular myocardium. METHODS: Experimental research involving 32 pigs, divided into two groups according to CPB strategy - group I (cardioplegia and group II (beating heart. Both groups were allocated into three subgroups according to lung perfusion strategy - subgroup A (control: no lung perfusion, subgroup B (lung perfusion with arterial blood and subgroup C (lung perfusion with venous blood. In subgroups B and C, lung was perfused for 30 minutes, using preoperative mean pulmonary artery pressure (MPAP as perfusion pressure, which was monitored through manometer. MPAP and pulmonary vascular resistance (PVR were measured after coming off CPB using Swan-Ganz catheter. At preoperative time and 30 minutes after lung perfusion, specimens were taken from the right ventricular myocardium aiming to assess brain natriuretic peptide (BNP and histologic pattern. Immunohistochemical and hematoxylin-eosin techniques were used to determine, respectively, BNP expression and inflammatory myocardial lesions. RESULTS: In animals submitted to controlled lung perfusion, there was a postoperative reduction of MPAP (P=0.03 and PVR (P=0.005.There was no differences among subgroups within the group, I (P=0.228 and subgroups within group II (P=0.325 as to postoperative BNP expression. There were no differences among subgroups with and without lung perfusion as to postoperative inflammatory lesions (P>0.05. CONCLUSION: Main pulmonary artery controlled perfusion for 30 minutes did not yield substantial modifications in BNP expression and histologic pattern of the right ventricular myocardium.

  11. 心脏移植术前血N端B型利钠肽原水平与术后早期受者存活率的关系%Relationship between preoperative N-terminal-pro-brain natriuretic levels and early survival of HT recipients

    Institute of Scientific and Technical Information of China (English)

    黄燕; 黄洁; 胡盛寿; 宋云虎; 王巍; 廖中凯; 朱俊

    2013-01-01

    目的 探讨心脏移植术前血N端B型利尿钠肽原(NT-proBNP)水平与术后早期受者存活率的关系.方法 采用免疫法测定284例拟接受心脏移植的心力衰竭患者移植前血NT-proBNP水平,按NT-proBNP水平将284例患者分为≤5000 nmol/L组(≤5000组,237例)和>5000 nmol/L组(>5000组,47例),比较两组受者的术前一般情况、不同原发病者的NT-proBNP水平、两组围手术期体外膜肺氧合(ECMO)技术应用率及死亡率.采用Kaplan-Meier法计算两组受者1年存活率.结果 >5000组术前肺毛细血管楔压为(25.1±7.4)mm Hg(1 mm Hg=0.133 kPa),明显高于≤5000组的(21.4±9.2)mm Hg(P<0.05);心脏指数为(1.8±0.5)L·min-1·m-2,明显低于≤5000组的(2.1±0.6)L·min-1·m-2 (P<0.05).>5000组围手术期需用ECMO支持者占14.9%(7/47),ECMO相关死亡率为71.4%(5/7),1年存活率为91.3%;≤5000组围手术期需用ECMO支持者占6.8%(16/237),ECMO相关死亡率为12.5%(2/16),1年存活率为96.9%,2个组ECMO应用率、ECMO相关死亡率以及受者1年存活率的差异均有统计学意义(P<0.05).结论 术前血NT-proBNP水平较高(>5000 nmol/L)者围手术期ECMO应用率和1年死亡率均较高;术前测定血NT-proBNP水平有助于心脏移植时机的把握.%Objective To assess the correlation between pre-operative N-terminal-pro-brain natriuretic levels and early survival rate among heart transplantion (HT) recipients in a single Chinese center.Methods According to the pre-operative NT-proBNP level of 284 HT recipients,the recipients were divided into two distinctive groups,≤5000 nmol/L group (237 cases) and >5000 nmol/L group (47 cases).The baseline characteristics and mortality for recipients with different primary cardiac diseases and on extracorporeal membrane oxygenation (ECMO) support were compared.Kaplan Meier method was used to calculate the 1-year survival rate of the two groups.Results The pre-operative NT-proBNP >5000 nmol/L group

  12. Signiifcance of changes of plasma neuropeptide Y and brain natriuretic peptide levels in community adults with salt sensitive hypertension%社区成年盐敏感性高血压患者血浆神经肽Y和脑钠肽水平变化的意义研究

    Institute of Scientific and Technical Information of China (English)

    梁引红; 廉秋芳; 师静梅; 杨若冰; 吴朝; 牟建军

    2016-01-01

    Objective To study the community adult salt sensitivity the related factors of high blood pressure, especially of plasma neuropeptide Y (NPY) and brain natriuretic peptide (BNP) level changes associated with eye sensitivity of high blood pressure. Methods This study investigated the jurisdiction of the community residents of 1986 people, the survey of 100 patients with essential hypertension (eh), salt sensitivity 65 hypertension patients (modified Sullivan, acute oral saline load test assessment), at the same time pick up against 105 people from the hypertension patients' families (hypertension). Questionnaire investigation and analysis on the measurement of height, body mass, waist circumference and blood pressure, to detect Cr level, FBG, NPY and BNP. Modified Sullivan, acute oral saline load test for salt sensitivity, residents can be divided into salt sensitivity hypertension group (n=65) with the salt sensitive hypertension group (n=100), compare three groups in general, the multi-factor Logistic regression analysis the influence factors of high blood pressure, salt sensitivity. Results Two groups of patients with high blood pressure levels of Cr, NPY and BNP levels were higher than normal control group;Salt sensitivity of patients with high blood pressure, serum creatinine (Cr), NPY levels in three groups in the highest, and family history of high blood pressure and the difference is statistically significant;Essential hypertension in patients with BNP level is highest, the difference was statistically significant. Hypertensive patients with high blood pressure level increases, salt sensitivity of NPY levels and BNP levels are higher, there are statistically significant. Logistic regression models were analyzed, and the single factor and multiple factors analysis results suggest that FBG with a low probability of high blood pressure, salt sensitivity;And NPY levels increased, BNP levels increased, abnormal level of serum Cr, and family history of

  13. 卡维地洛与比索洛尔对心力衰竭患者心功能及心型脂肪结合蛋白、脑钠肽的影响%Effect of Carvedilol and Bisoprolol on the Changes of Heart Type Fatty Acid Binding Protein and Brain Natri-uretic Peptide in Patients with Congestive Heart Failure

    Institute of Scientific and Technical Information of China (English)

    张海涛; 邵辉; 王兴宏; 董秋立; 王忠明

    2015-01-01

    OBJECTIVE:To observe the changes of heart type fatty binding protein (H-FABP) and brain natriuretic peptide (BNP)when carvedilol and bisoprolol in the treatment of elderly patients with chronic heart failure(CHF). METHODS:110 CHF patients were randomly assigned into carvedilol group and bisoprolol group (n=55). Carvedilol group was given carvedilol 3.125 mg,bid,doubling dose every 2 weeks to reach target dose 25mg or maximum tolerant dose;bisoprolol group was given bisoprolol 1.25 mg,qd,doubling dose every 2 weeks to reach target dose 10 mg or maximum tolerant dose. Treatment course lasted for 6 months. Clinical effective rate of 2 groups were observed after treatment. Echocardiography was used to measure the changes of LVEDD,LVEF,SBP and DBP before and after treatment. The plasma concentration of BNP and H-FABP were measured by radio-immunoassay. RESULTS:After treatment,total effective rate of carvedilol group(96.4%)was higher than that of bisoprolol group (89.2%),with statistical significance(P<0.05). Compared with before treatment,the levels of LVEDD,LVEF,BNP,H-FABP, SBP and DBP in 2 groups were all decreased significantly after treatment,with statistical significance (P<0.01 or P<0.05). CON-CLUSIONS:Both carvedilol and bisoprolol can significantly improve cardiac function,but carvedilol efficacy is more significant. At the same time,significant decrease of H-FABP before and after treatment indicate that H-FABP can be used as a reliable index of heart failure treatment effect.%目的:观察卡维地洛与比索洛尔对老年心力衰竭(CHF)患者心功能及心型脂肪结合蛋白(H-FABP)、脑钠肽(BNP)水平的影响。方法:选取CHF患者110例,按随机数字表法分为卡维地洛组和比索洛尔组,各55例。卡维地洛组患者给予卡维地洛3.125 mg,bid,每2周剂量加倍,直至达目标靶剂量25 mg或耐受最大剂量;比索洛尔组患者给予比索洛尔1.25 mg,qd,每2周剂量加

  14. Relationship between N-terminal pro brain natriuretic peptide and insulin sensitivity index in pa-tients with unstable angina pectoris%血浆NT-proBNP水平及胰岛素敏感性指标与不稳定型心绞痛危险分层相关研究

    Institute of Scientific and Technical Information of China (English)

    王培; 郑晓晖; 胡丰朝; 杨睿

    2014-01-01

    Objective To study the correlation of N-terminal pro brain natriuretic peptide( NT-proBNP)with insulin sensitivity index( FBG,FINS,FINS/FBG,ISI)in UAP patients,and its clinical significance. Methods One hundred patients with UAP were enrolled as the observation group,30 pa-tients with stable angina pectoris( SAP)as SAP group,and 30 healthy people as the normal control (COM)group. According to the Braunwald UAP,patients in UAP group were graded into 3 sup-groups( grade 1 ,grade 2 and grade 3 ). The plasma NT-proBNP and insulin sensitivity indexes were detected in each group,and then the results were analyzed and the linear correlation analysis was made. Results The concentration of plasma NT-proBNP,FINS,FINS/FBG in patients with UAP and SAP group were significantly higher than those in COM group( P﹤0. 05 ),but ISI was lower than that in COM group( P ﹤0. 05 ). The concentration of plasma NT-proBNP,FINS,FINS/FBG in patients with UAP were significantly higher than those in patients with SAP( P﹤0. 05 ),but ISI was lower than that in patients with SAP(P﹤0. 05),and there was no significant difference in FBG between the two groups. The concentration of plasma NT-proBNP,FINS,FINS/FBG in patients with grade 2 and grade 3 were significantly higher than those in patients with grade 1( P﹤0. 05 ),but ISI was lower in the grade 2( P﹤0. 05). No significant diference was found between grade 2 and grade 3. In UAP patients,the plasma NT-proBNP concentration was positively correlated with FINS,FINS/FBG( r =0. 38,P =0. 046,r =0. 56 ,P=0. 039 ),and negative correlated with ISI( r = -0. 62 ,P =0. 028 ),and with no correlation with FBG. Conclusions The concentration of plasma NT-proBNP was elevated and insulin sensitivity decreased in UAP, especially in Braunwald UAP grade 2 and grade 3( rest angina ),the concentration of NT-proBNP was negatively cor-related with insulin sensitivity. The combined determination is significant in risk grading reference of UAP.%目的:

  15. N末端B型利钠肽原与慢性心力衰竭患者心功能相关性的临床研究%Clinical research of the correlation between N-terminal pro-brain natriuretic peptide and cardiac function of the patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    范倩; 李秀珍; 邱明峰; 刘暐; 娄序笙; 李冬梅; 张秀静; 鲁卫星

    2012-01-01

    Objective To observe the correlation between N-terminal pro-brain natriuretic peptide (NT-proBNP)and cardiac function of chronic heart failure(CHF).Methods Eighty patients of CHF were chosen as the observation group,and were classified according to the NYHA classification standard.Twenty healthy people were chosen as control group.The results of NT-proBNP and echocardiography indexes,such as left ventricular enddiastolic dimension(LVEDD),left ventricular end systolic diameter (LVESD),left ventricular ejection fraction (LVEF)were compared.Results ①In the same grade of NYHA,compared with the baseline of the observation group,the results of NT-proBNP after treatment were much lower [ grade Ⅱ (1913±707 )ng/L vs (2657±368)ng/L,grade Ⅲ (3403±1003 )ng/L vs (6037±1742)ng/L,grade Ⅳ (6429±1348 )ng/L vs (8324±679)ng/L,all P<0.01 ];②Compared with the baseline of the observation group,the results of indexes of echocardiography including LVEDD,LVESD and LVEF improved after treatment [ LVEDD (49±9 )mm vs (53±8)mm,LVESD(33±9)mm vs(39±10)mm,LVEF(58±9)% vs(53±10)%,P <0.01 ];③NT-proBNP and LVEDD/LVESD were positively correlated (r =0.640,r =0.694,P <0.01 ),while NT-proBNP and LVEF had negative correlation (r=-0.652,P< 0.01 ).Conclusions NT-proBNP can be used in clinical diagnosis of CHF.NT-proBNP shows a good correlation to NYHA and echocardiography indexes.%目的 观察慢性心力衰竭(CHF)患者N末端B型利钠肽原(NT-proBNP)与心功能的相关性.方法 选择80例CHF患者为观察组,另选20例健康人为对照组.观察组采用β受体阻滞剂、血管紧张素转换酶抑制剂小血管紧张素受体拮抗剂等规范治疗,共28 d.比较治疗前后NT-proBNP浓度、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)各指标的变化.结果 ①对照组NT-proBNP为(87±23)ng/L,观察组NYHAⅡ、Ⅲ、Ⅳ级患者(分别为27、40、13例)治疗后NT-proBNP浓度均明显低

  16. Effects of recombinant human brain natriuretic peptide on gastric emptying and gastrointestinal transit of liquid in rats%重组人脑利钠肽对大鼠液体胃排空和小肠传输功能的影响

    Institute of Scientific and Technical Information of China (English)

    刘世雄; 严祥; 王晶; 赵丽

    2012-01-01

    目的 探讨重组人脑利钠肽对大鼠液体胃排空和小肠传输的影响.方法 将72只健康雄性Wistar大鼠随机分为治疗组和对照组,分别每日腹腔注射1次重组人脑利钠肽和生理盐水,1周后用葡萄糖酚红溶液灌胃,分别于灌胃后10、20、30 min处死大鼠,切取胃和小肠近、中、远各段留取内容物后,使用分光光度计测定胃肠各段酚红残留率.取治疗组和对照组大鼠各5只在灌胃前2h分别腹腔注射奥美拉唑,灌胃后10 min处死大鼠,测定胃内酚红残留率.结果 灌胃后10、20、30 min治疗组胃内酚红残留率分别为59.4%±1.9%、42.2%±1.7%和36.9%±2.7%,对照组为50.2%±2.0%、29.8%±1.1%和21.7%±1.3%,治疗组胃内酚红残留率高于对照组(P<0.05);治疗组和对照组小肠近段与中段酚红残留率差异无统计学意义;治疗组远段小肠酚红残留率分别为0.2%±0.2%、0.4%±0.1%和2.1%±1.9%,对照组分别为2.7%±0.6%、5.9%±1.4%和7.8%±2.1%,两组比较治疗组酚红残留率低于对照组(P<0.05);奥美拉唑预处理灌胃后10 min治疗组较对照组胃内酚红残留率增多,分别为60.7%±8.1%和49.8%±6.4%(P<0.05),与未给予奥美拉唑预处理组比较,差异无统计学意义.结论 重组人脑利钠肽可使大鼠液体胃排空减慢,小肠传输延迟.%Objective To assess the effects of recombinant human brain natriuretic peptide (rhB-NP) on gastric emptying and gastrointestinal transit of liquid in rats. Methods The male Wistar rats were randomly divided into rhBNP treatment group and control group. The rats in treatment group received intraperitoneal injection of rhBNP (15 /μg/kg, once daily), while the rats of control group only received an equal volume saline. They were gavage fed (1.5 mL) next week with phenol red in 5% glucose solution and sacrificed 10, 20, 30 min later. Dye recovery in the stomach, proximal, mid, and distal small

  17. N末端脑钠肽和大内皮素-1对心衰的预后价值%Prognostic Value of N-Terminal Pro-Brain Natriuretic Peptide and Big Endothelin-1 in Patients with Chronic Heart Failure

    Institute of Scientific and Technical Information of China (English)

    汪隆海; 陈启松; 夏芳; 张平; 何海军

    2011-01-01

    Objective This study was prospectively desigued to investigate the prognostic factors for chronic heart failure and the prognostic ability of N-terminal pro-brain natriuretic peptide (NT-proBNP) and big endothelin-l (Big ET-1) in patients with chronic heart failure. Methods To study 143 consecutive patients hospitalized for chronic heart failure. Serum concentration of NT-proBNP,cTnI,CKMB and plasma Big ET-1 as well as left ventricular ejection fraction (LVEF) and NYHA class I to IV on admission were measured. Cardiac events were found by patients to discharge after 360~480 days, prospectively. Results During a median follow-up period of 380 days,the endpoint of recurrence for cardiac events was reached in 57 patients with 143 heart failure. Patients with endpoint events were older (82 vs 52,P = 0. 000),in a higher functional class (3 vs l,P=0. 000),had higher levels of NT-proBNP (3 802 pmol/L vs 891 pmol/L,P=0. 000) and Big ET-1 (5.13 pmol/L vs 3. 53 pmol/L,P = 0. 000) compared with those without endpoint events. On a Cox proportional hazards regression models analyses, age NT-proBNP and Big ET-1 were found to be the independent predictors of cardiac events. Risk ratio (RR) were 1.175,3. 987 and 2. 691,respectively. Logistic regression models analyses,NT-proBNP and Big ET-1 were found independent predictors of death. Odd ratio (OR) were 2.515 and 1. 978,respectively. Conclusion Measurement of NT-proBNP and Big ET-1 in patients with chronic heart failure could help to identify patients at higher risk for cardiac events and patients for prognosis.%目的 通过对心衰患者的随访研究,探讨N末端脑钠肽(NT-proBNP)和大内皮素-1(Big ET-1)对心衰患者的预后价值.方法 研究143例心衰住院患者,检测入院时NT-proBNP,Big ET-1,肌钙蛋白I,CK-MB和左室射血分数以及NYHA分级.并随访观察患者出院后360~480 d的心血管事件再发生情况.结果 143例心衰患者的中位随访380 d,发生心脏事件57例.发生与未发生

  18. 脑钠肽前体及肌钙蛋白I在老年急性有机磷中毒心肌损伤中的价值%Clinical significance of N-terminal pro-brain natriuretic peptide and cardiac troponin I in myocardium damage of elderly acute organophosphate poisoning patients

    Institute of Scientific and Technical Information of China (English)

    胡鹏; 朱庆祝; 林涛; 程庆荣

    2014-01-01

    目的:探讨脑钠肽前体(NT-proBNP)及肌钙蛋白I(cTnI)在老年急性有机磷农药中毒(AOPP)心肌损伤中的变化及病情判断、评估中的临床价值。方法102例老年患者按入院时中毒的程度分为轻度中毒24例(轻度组),中度中毒38例(中度组),重度中毒40例(重度组)。于患者入院后4 h、3 d、7 d抽取静脉血4 ml,同步测定NT-proBNP、cTnI、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)值,与同期40例健康查体者(对照组)比较;合并发生中间型综合征(IMS)33例(IMS组),未发生IMS 69例(非IMS组),比较对照组、IMS组和非IMS组血清各项指标水平及心电监护情况。结果中、重度组老年AOPP患者的血清NT-proBNP、cTnI、CK、CK-MB较对照组显著升高(P<0.05),且随中毒程度和病情加重而升高,各组间两两比较差异均有统计学意义(P<0.05),血清NT-proBNP的敏感性和特异性均高于cTnI、心肌酶谱。IMS组入院后4 h内检测值显著高于非IMS组,差异均有统计学意义(P<0.05);IMS组较非IMS组出现心电图异常的比例更高。结论老年 AOPP 患者中毒越重,血清 cTnI、NT-proBNP 升高越显著,血清 NT-proBNP检测可以更详细地反映心肌的损害程度,早期联合检测可以更好地协助老年AOPP临床分级、病情判断、指导救治和预后评估。%Objective To investigate the changes significance of N-terminal pro-brain natriuretic peptide and cardiac troponin I simultaneously in the myocardium damage of elderly acute organophosphate poisoning patients and the clinical value in disease condition judgment.Methods 102 older acute organophosphate poisoning patients were divided into three groups according to the degree of poisoning on admission: mild poisoning 24 cases (mild), moderate poisoning 38 cases (moderate) and severe poisoning 40 cases(severe). All patients were extracted 4 ml of venous

  19. Effects of trimetazidine on left ventricular remodeling and plasma brain natriuretic peptide level in rats with chronic renal failure%曲美他嗪对慢性肾衰竭大鼠左心室重塑及血浆脑钠素的影响

    Institute of Scientific and Technical Information of China (English)

    唐琦; 梅长林; 张黎明; 芦怡舟; 邬碧波; 苏定冯

    2011-01-01

    目的 观察曲美他嗪对慢性肾衰竭大鼠左心室重塑的影响及血浆脑钠素(BNP)的变化.方法 SD大鼠随机分为假手术组、手术对照组及曲美他嗪小、中、大剂量(3、6、9 mg/kg)治疗组,每组10只;后4组大鼠建立5/6肾切除术慢性肾衰竭模型,后3组大鼠每日灌胃给药,手术对照组则给予等量生理盐水,持续17周.实验结束时,对大鼠心脏进行超声检查,监测收缩压、舒张压、平均动脉压及心率,测定血浆BNP,并取心脏组织进行病理形态学观察.结果 心超检查结果表明: 曲美他嗪中、大剂量组大鼠左室收缩末内径、左室舒张末期前壁厚度、左室收缩末期前壁厚度、左室舒张末期后壁厚度均低于手术对照组(P<0.05).假手术组收缩压、舒张压及平均动脉压、血浆BNP水平均低于其余4组(P<0.01,P<0.05);曲美他嗪中、大剂量治疗组BNP均低于手术对照组(P<0.05).光镜下可见手术对照组心肌细胞排列紊乱、肥大,部分心肌纤维化;电镜下手术对照组可见大片心肌纤维溶解,线粒体增多、肿胀、空泡化;曲美他嗪治疗组心肌损伤均较手术对照组改善,且随曲美他嗪剂量增大有进一步好转趋势.结论 曲美他嗪降低血浆BNP水平,可改善慢性肾衰竭大鼠左心室重塑.%Objective To observe the effects of trimetazidine (TMZ) on left ventricular remodeling and plasma brain natriuretic peptide (BNP) level in rats with chronic renal failure (CRF). Methods Male Sprague-dawley (SD) rats were randomly divided into sham group, CRF group, small- (3 mg/kg), medium- (6 mg/kg), and high-TMZ (9 mg/kg) treatment groups, with each group containing 10 rats. Animals in the latter four groups received 5/6 subtotal nephrectomies. TMZ was intragastrically administered to rats for 17 weeks in three TMZ groups, while normal saline was given to rats in CRF group. At the end of the study, transthoracic echocardiography was performed, the systolic

  20. Therapeutic efficacy of recombinat human brain natriuretic peptide on elderly acute myocardial infarction with heart failure%重组人脑利钠肽治疗老年患者急性心肌梗死泵衰竭的疗效

    Institute of Scientific and Technical Information of China (English)

    姜胜; 周宁; 王庸晋; 王治平; 王少黎; 李启富

    2012-01-01

    Objective To evaluate the clinical efficacy of recombinat human brain natriuretic peptide (rhBNP) in the treatment of acute myocardial infarction (AMI) with heart failure in aged patients. Methods Totally 63 elderly patients with AMI and heart failure were randomly divided into therapy (29 cases) and control (34 cases) groups.Besides routine treatment,the therapy group received rhBNP in continuous intravenous infusion, while control group was treated with nitroglycerin.Both drugs were administered for 3-5 days.The dyspnea remission rates after treatment were recorded.At the same time,heart rates and blood oxygen saturation,left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVDD),serum interleukin 6 (IL-6) and high sensitivity C reactive protein (hsCRP) were recorded before and after treatment. Results The total effective rate after the treatment was 79.3 % (23/29) in therapy group and 64.7% (22/34) in control group(P =0.017).The dyspnea remission rate was better in therapy group than in control group (P<0.05).The heart rate,blood oxygen saturation,LVEF,hsCPR and IL-6 in therapy group were [(120± 11) times/min,(78 ± 6) %,(28 ± 32) %,(25.78 ± 2.44) mg/L,(40.74 ± 5.43) μg/L]before treatment,and after treatment [ ( 89 ± 9) times/min,( 97 ± 6 ) %,(43 ±± 20) %,( 12.78 ± 2.54 )mg/L,(28.45±2.34) μg/L] (all P<0.05).The above indexes in control group were [(117±8)times/min,(80±8) %,(29±31)%,(21.44±1.33) mg/L,(41.87±5.46) μg/L] before treatment,and after treatment[(109± 10) times/min,(34±18) %,(43±20) %,(17.63± 1.62) mg/L,(36.56±3.02) μg/L].The heart rate and the levels of IL-6 and hsCPR were reduced,blood oxygen saturation and LVEF were increased in therapy group than those in control group. Conclusions rhBNP is efficient in the treatment of elderly AMI with heart failure.%目的 探讨重组人脑利钠肽(rhBNP)治疗老年急性心肌梗死泵衰竭患者的效果.方法 选取

  1. B-Type Natriuretic Peptide: From Posttranslational Processing to Clinical Measurement

    DEFF Research Database (Denmark)

    Goetze, Jens P

    2012-01-01

    BACKGROUND:Plasma cardiac natriuretic peptides and peptide fragments from their molecular precursors are markers of heart disease. Clinical studies have defined the current diagnostic utility of these markers, whereas biochemical elucidation of peptide structure and posttranslational processing has......-atrial natriuretic peptide and pro-B-type natriuretic peptide are useful plasma markers in heart failure. New data have defined cardiac myocytes as competent endocrine cells in posttranslational processing and cellular secretion....

  2. N-terminal Pro-B-type natriuretic peptide: a measure of significant patent cuctus arteriosus

    LENUS (Irish Health Repository)

    OFarombi-Oghuvbu, IO

    2008-01-24

    Background: B type natriuretic peptide (BNP) is a marker for ventricular dysfunction secreted as a pre-prohormone, Pro-B-type natriuretic peptide (ProBNP), and cleaved into BNP and a biologically inactive fragment, N-terminal pro-B-type natriuretic peptide (NT-proBNP). Little is known about the clinical usefulness of NT-proBNP in preterm infants.\\r\

  3. Control of lipolysis by natriuretic peptides and cyclic GMP.

    Science.gov (United States)

    Lafontan, Max; Moro, Cédric; Berlan, Michel; Crampes, François; Sengenes, Coralie; Galitzky, Jean

    2008-01-01

    Human fat cell lipolysis was, until recently, thought to be mediated exclusively by a cAMP-dependent protein kinase (PKA)-regulated pathway under the control of catecholamines and insulin. We have shown that atrial- and B-type natriuretic peptides (ANP and BNP respectively) stimulate lipolysis in human fat cells through a cGMP-dependent protein kinase (PKG) signaling pathway independent of cAMP production and PKA activity. Pharmacological or physiological (exercise) increases in plasma ANP levels stimulate lipid mobilization in humans. This pathway becomes important during chronic treatment with beta-adrenoceptor antagonists, which inhibit catecholamine-induced lipolysis but enhance cardiac ANP release. These findings have metabolic implications and point to potential problems when natriuretic peptide secretion is altered or during therapeutic use of recombinant BNP.

  4. Plasma atrial natriuretic peptide and spontaneous diuresis in sick neonates.

    OpenAIRE

    Kojima, T; Hirata, Y; Fukuda, Y; Iwase, S.; Kobayashi, Y.

    1987-01-01

    Plasma concentrations of immunoreactive human atrial natriuretic peptide (human ANP) were sequentially determined in 12 infants with respiratory distress syndrome (RDS) or meconium aspiration syndrome (MAS) during various phases of diuresis to elucidate the role of human ANP in the occurrence of spontaneous diuresis in the newborn. Plasma immunoreactive ANP concentrations during the diuretic as well as the maximum diuretic phase were significantly (p less than 0.001) higher than during the pr...

  5. 131Ⅰ治疗甲亢性心脏病患者尿脑钠肽水平变化的研究%The dynamic changes of brain natriuretic peptide level in patients with hyperthyroid heart disease after 131Ⅰ therapy

    Institute of Scientific and Technical Information of China (English)

    苏应瑞; 查金顺; 周竟雄; 林夏鸿; 许朝祥; 王耀国; 杜心清

    2012-01-01

    Objective To investigate the application value of urine brain natriuretic peptide (BNP) level in 131Ⅰ treatment of hyperthyroid heart disease.Methods One hundred and eleven hyperthyroidism patients who received 131Ⅰ therapy were divided into two groups,hyperthyroidism group(51 cases) and hyperthyroid heart disease group (60 cases),and 30 healthy subjects as control.Sixty patients in the hyperthyroid heart disease group all received ultrasonic cardiogram.The hyperthyroid heart disease group was divided into two subgroups according to New York Heart Association (NYHA) functional classification (hyperthyroid heart disease A subgroup and hyperthyroid heart disease B subgroup).The urine and serum BNP level and serum free triiodothyronine (FT3),free thyroxine (FT4) level were measured through chemiluminescence before and after therapy.Results The urine and serum BNP level before 131Ⅰ therapy of the hyperthyroid heart disease group were significantly higher than those of hyperthyroidism group (serum:t=8.98 and 9.52,both P<0.01;urine:t=10.83 and 12.73,both P<0.01)and the control group (serum:t=8.97 and 9.52,both P<0.01; urine:t=9.21 and 5.64,both P<0.01).The urine and serum BNP level before and 6,12 months after 131Ⅰ therapy of the hyperthyroid heart disease A subgroup were significantly higher than those of hyperthyroid heart disease B subgroup (serum:t=5.98,5.87 and 6.35,all P<0.01; serum:t=4.33,4.09 and 5.02,all P<0.01).The urine level of BNP was gradually increased with the severity of cardiac insufficiency and it was positively correlated with the serum level of BNP(r=0.829,P<0.01),the NYHA functional classification (r=0.751,P<0.01)and the serum level of FT3 and FT4 (FT3:r=0.635,P<0.01; FT4:r=0.672,P<0.01).Conclusions The urine BNP level of hyperthyroid heart disease patient increased with the severity of cardiac insufficiency.The urine BNP level could accurately reflect cardiac function of hyperthyroid heart disease patient,and could be

  6. Natriuretic Peptides as Biomarkers for Congestive States: The Cardiorenal Divergence

    Directory of Open Access Journals (Sweden)

    Abhilash Koratala

    2017-01-01

    Full Text Available Congestion represents the primary reason for hospitalization of patients with heart failure and is associated with adverse outcomes. Fluid overload has been shown to be inadequately addressed in a significant subset of these patients in part due to lack of robust, reliable, and readily available biomarkers for objective assessment and monitoring of therapy. Natriuretic peptides have long been used in this setting, often in conjunction with other assessment tools such as imaging studies. Patients presenting with concomitant cardiac and renal dysfunction represent a unique population with regard to congestion in that the interactions between the heart and the kidney can affect the utility and performance of biomarkers of fluid overload. Herein, we provide an overview of the currently available evidence on the utility of natriuretic peptides in these patients and discuss the clinical conundrum associated with their use in the setting of renal dysfunction. We highlight the potential divergence in the role of natriuretic peptides for assessment of volume status in a subset of patients with renal dysfunction who receive renal replacement therapy and call for future research to elucidate the utility of the biomarkers in this setting.

  7. Clinical study on the changes of serum brain natriuretic peptide,C reactive protein and glycosylated hemoglobin in patients with diabetes and hypertension complicated with heart failure with preserved ejection fraction%糖尿病合并高血压射血分数保留的心力衰竭患者血清脑钠肽、C反应蛋白、糖化血红蛋白变化的临床研究

    Institute of Scientific and Technical Information of China (English)

    赵英丽; 李志娟

    2016-01-01

    Objective:To investigate the significance of the changes of serum brain natriuretic peptide,C reactive protein and glycosylated hemoglobin in patients with diabetes and hypertension complicated with heart failure with preserved ejection fraction. Methods:241 cases of HFPEF patients with hypertension and (or) diabetes were divided into the diabetic group and the non-diabetic group.The HbA1c,C reactive protein,NT-proBNP of the two groups were compared.Results:The HbA1c,C reactive protein,NT-proBNP and the incidence of major adverse cardial events(MACE) in the diabetic group were significantly higher than those in the non-diabetic group(P<0.05).There were positive correlation between HbA1cC reactive protein,NT-proBNP and the incidence of MACE.Conclusion:NT-proBNP, HbA1c,C reactive protein had higher clinical application value in predicting the incidence of diabetes and hypertension complicated with heart failure with preserved ejection fraction.%目的:探讨糖尿病合并高血压射血分数保留的心力衰竭(HFPEF)患者血清脑钠肽、C反应蛋白、糖化血红蛋白变化的意义。方法:收治合并高血压和(或)糖尿病的 HFPEF 患者241例,分为糖尿病组和非糖尿病组。比较两组HbA1c、C反应蛋白、NT-proBNP。结果:糖尿病组的HbA1c、C反应蛋白、NT-proBNP、MACE发生率显著高于非糖尿病组(P<0.05)。HbA1c、C反应蛋白、NT-proBNP与MACE发生率呈正相关。结论:NT-proBNP、HbA1c、C反应蛋白对糖尿病合并高血压HFPEF发生率的预测具有较高的临床应用价值。

  8. GUANYLYL CYCLASE/NATRIURETIC PEPTIDES RECEPTOR-A SIGNALING ANTAGONIZES PHOSPHOINOSITIDE HYDROLYSIS, Ca2+ RELEASE, AND ACTIVATION OF PROTEIN KINASE C

    Directory of Open Access Journals (Sweden)

    Kailash N Pandey

    2014-08-01

    Full Text Available Thus far, three related natriuretic peptides (NPs and three distinct sub-types of cognate NP receptors have been identified and characterized based on the specific ligand binding affinities, guanylyl cyclase activity, and generation of intracellular cGMP. Atrial and brain natriuretic peptides (ANP and BNP specifically bind and activate guanylyl cyclase/natriuretic peptide receptor-A (GC-A/NPRA, and C-type natriuretic peptide (CNP shows specificity to activate guanylyl cyclase/natriuretic peptide receptor-B (GC-B/NPRB. All three NPs bind to natriuretic peptide receptor-C (NPRC, which is also known as clearance or silent receptor. The NPRA is considered the principal biologically active receptor of NP family; however, the molecular signaling mechanisms of NP receptors are not well understood. The activation of NPRA and NPRB produces the intracellular second messenger cGMP, which serves as the major signaling molecule of all three NPs. The activation of NPRB in response to CNP also produces the intracellular cGMP; however, at lower magnitude than that of NPRA, which is activated by ANP and BNP. In addition to enhanced accumulation of intracellular cGMP in response to all three NPs, the levels of cAMP, Ca2+ and inositol triphosphate (IP3 have also been reported to be altered in different cells and tissue types. Interestingly, ANP has been found to lower the concentrations of cAMP, Ca2+, and IP3; however, NPRC has been proposed to increase the levels of these metabolic signaling molecules. The mechanistic studies of decreased and/or increased levels of cAMP, Ca2+, and IP3 in response to NPs and their receptors have not yet been clearly established. This review focuses on the signaling mechanisms of ANP/NPRA and their biological effects involving an increased level of intracellular accumulation of cGMP and a decreased level of cAMP, Ca2+, and IP3 in different cells and tissue systems.

  9. DMPD: The atrial natriuretic peptide regulates the production of inflammatorymediators in macrophages. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 11890659 The atrial natriuretic peptide regulates the production of inflammatorymedia...tml) (.csml) Show The atrial natriuretic peptide regulates the production of inflammatorymediators in macrop...hages. PubmedID 11890659 Title The atrial natriuretic peptide regulates the production of inflammatorymedi

  10. Contribution of Kv7 channels to natriuretic peptide mediated vasodilation in normal and hypertensive rats

    DEFF Research Database (Denmark)

    Stott, Jennifer B; Barrese, Vincenzo; Jepps, Thomas Andrew;

    2015-01-01

    -cAMP-linked vasodilator pathways has not been investigated. Natriuretic peptides are potent vasodilators, which operate primarily through the activation of a cGMP-dependent signaling pathway. This study investigated the putative role of Kv7 channels in natriuretic peptide-dependent relaxations in the vasculature...

  11. Atrial Natriuretic Peptide and Renal Dopaminergic System: A Positive Friendly Relationship?

    Directory of Open Access Journals (Sweden)

    Marcelo Roberto Choi

    2014-01-01

    Full Text Available Sodium metabolism by the kidney is accomplished by an intricate interaction between signals from extrarenal and intrarenal sources and between antinatriuretic and natriuretic factors. Renal dopamine plays a central role in this interactive network. The natriuretic hormones, such as the atrial natriuretic peptide, mediate some of their effects by affecting the renal dopaminergic system. Renal dopaminergic tonus can be modulated at different steps of dopamine metabolism (synthesis, uptake, release, catabolism, and receptor sensitization which can be regulated by the atrial natriuretic peptide. At tubular level, dopamine and atrial natriuretic peptide act together in a concerted manner to promote sodium excretion, especially through the overinhibition of Na+, K+-ATPase activity. In this way, different pathological scenarios where renal sodium excretion is dysregulated, as in nephrotic syndrome or hypertension, are associated with impaired action of renal dopamine and/or atrial natriuretic peptide, or as a result of impaired interaction between these two natriuretic systems. The aim of this review is to update and comment on the most recent evidences demonstrating how the renal dopaminergic system interacts with atrial natriuretic peptide to control renal physiology and blood pressure through different regulatory pathways.

  12. RENAL TUBULAR SENSITIVITY TO ATRIAL-NATRIURETIC-FACTOR IN ESSENTIAL-HYPERTENSION

    NARCIS (Netherlands)

    JANSSEN, WMT; DEZEEUW, D; VANDERHEM, GK; DEJONG, PE

    1994-01-01

    Objective: To study the tubular site or sites of the natriuretic action of atrial natriuretic factor and the possible differences between healthy subjects and patients with essential hypertension. Design: Nine healthy volunteers and six patients with essential hypertension were studied on four test

  13. Natriuretic Peptide Receptor B modulates the proliferation of the cardiac cells expressing the Stem Cell Antigen-1

    Science.gov (United States)

    Rignault-Clerc, Stéphanie; Bielmann, Christelle; Liaudet, Lucas; Waeber, Bernard; Feihl, François; Rosenblatt-Velin, Nathalie

    2017-01-01

    Brain Natriuretic Peptide (BNP) injections in adult “healthy” or infarcted mice led to increased number of non-myocyte cells (NMCs) expressing the nuclear transcription factor Nkx2.5. The aim of this study was to identify the nature of the cells able to respond to BNP as well as the signaling pathway involved. BNP treatment of neonatal mouse NMCs stimulated Sca-1+ cell proliferation. The Sca-1+ cells were characterized as being a mixed cell population involving fibroblasts and multipotent precursor cells. Thus, BNP treatment led also to increased number of Sca-1+ cells expressing Nkx2.5, in Sca-1+ cell cultures in vitro and in vivo, in the hearts of neonatal and adult infarcted mice. Whereas BNP induced Sca-1+ cell proliferation via NPR-B receptor and protein kinase G activation, CNP stimulated Sca-1+ cell proliferation via NPR-B and a PKG-independent mechanism. We highlighted here a new role for the natriuretic peptide receptor B which was identified as a target able to modulate the proliferation of the Sca-1+ cells. The involvement of NPR-B signaling in heart regeneration has, however, to be further investigated. PMID:28181511

  14. Plant natriuretic peptides control of synthesis and systemic effects

    KAUST Repository

    Wang, Yuhua

    2011-10-01

    Plant natriuretic peptides (PNPs) are signaling molecules that are secreted into the apoplast particularly under conditions of biotic and abiotic stress. At the local level, PNPs modulate their own expression via feed forward and feedback loops to enable tuning of the response at the transcript and protein level and to prevent overexpression. PNPs also employ a systemic signal, possibly electrical, to rapidly alter photosynthesis and respiration not only in treated leaves but also in upper and lower leaves thereby modulating and integrating physiological responses at the level of the whole plant. © 2011 Landes Bioscience.

  15. Inhibition of natriuretic factors increases blood pressure in rats

    OpenAIRE

    Banday, Anees Ahmad; Lokhandwala, Mustafa F.

    2009-01-01

    Renal dopamine and nitric oxide contribute to natriuresis during high-salt intake which maintains sodium and blood pressure homeostasis. We wanted to determine whether concurrent inhibition of these natriuretic factors increases blood pressure during high-sodium intake. Male Sprague-Dawley rats were divided into the following groups: 1) vehicle (V)-tap water, 2) NaCl-1% NaCl drinking water, 3) 30 mM l-buthionine sulfoximine (BSO), an oxidant, 4) BSO plus NaCl, and 5) BSO plus NaCl with 1 mM t...

  16. Interaction of atrial natriuretic peptide and ouabain in the myocardium.

    Science.gov (United States)

    Nesher, Maoz; Bai, Yan; Li, Daxiang; Rosen, Haim; Lichtstein, David; Liu, Lijun

    2012-10-01

    Natriuretic peptides and digitalis-like compounds serve as regulators of homeostasis, including control of volume expansion and blood pressure. The aim of the present study was to explore possible interactions between atrial natriuretic peptide (ANP) and ouabain in the heart. ANP (1 nmol/L) had no effect in papillary muscle preparations from guinea pigs. Ouabain (1 µmol/L) induced positive inotropic effect. The addition of ANP prior to ouabain resulted in a significant decrease in the ouabain-induced positive inotropic effect, manifested as an attenuated increase in twitch maximal upward force slope and resting muscular tension. In addition, ANP caused an increase in Na⁺-K⁺-ATPase activity in heart microsomal preparations. The effect of ouabain on Na⁺-K⁺-ATPase activity was shown in a biphasic manner. Ouabain (0.01-1 nmol/L) had a small but significant increase on pump activity, but higher doses of ouabain inhibited activity. ANP attenuated ouabain-induced Na⁺-K⁺-ATPase activity. Furthermore, ouabain (50 nmol/L) or ANP (10 nmol/L) alone induced Akt activation in cardiomyocytes. However, ANP blocked ouabain-induced Akt activation. These results point to the existence of interactions between ANP and ouabain on Na⁺-K⁺-ATPase signaling and function in the heart, which may be mediated by regulation of Na⁺-K⁺-ATPase activity and (or) signal transduction mechanisms.

  17. Atrial natriuretic factor: is it responsible for hyponatremia and natriuresis in neurosurgery?

    Science.gov (United States)

    Gasparotto, Ana Paula Devite Cardoso; Falcão, Antonio Luis Eiras; Kosour, Carolina; Araújo, Sebastião; Cintra, Eliane Araújo; de Oliveira, Rosmari Aparecida Rosa Almeida; Martins, Luiz Claudio; Dragosavac, Desanka

    2016-01-01

    Objective To evaluate the presence of hyponatremia and natriuresis and their association with atrial natriuretic factor in neurosurgery patients. Methods The study included 30 patients who had been submitted to intracranial tumor resection and cerebral aneurism clipping. Both plasma and urinary sodium and plasma atrial natriuretic factor were measured during the preoperative and postoperative time periods. Results Hyponatremia was present in 63.33% of the patients, particularly on the first postoperative day. Natriuresis was present in 93.33% of the patients, particularly on the second postoperative day. Plasma atrial natriuretic factor was increased in 92.60% of the patients in at least one of the postoperative days; however, there was no statistically significant association between the atrial natriuretic factor and plasma sodium and between the atrial natriuretic factor and urinary sodium. Conclusion Hyponatremia and natriuresis were present in most patients after neurosurgery; however, the atrial natriuretic factor cannot be considered to be directly responsible for these alterations in neurosurgery patients. Other natriuretic factors are likely to be involved. PMID:27410411

  18. Influence of resting tension on immunoreactive atrial natriuretic peptide secretion by rat atria superfused in vitro

    Energy Technology Data Exchange (ETDEWEB)

    Schiebinger, R.J.; Linden, J.

    1986-07-01

    Atrial natriuretic peptide is a potent diuretic hormone secreted by the atria in response to volume expansion. We examined the effect of resting tension on atrial natriuretic peptide secretion by rat atria superfused in vitro. Left atria were hooked between an electrode and force transducer and superfused with medium 199. The atria were studied at a pacing frequency of 0 or 3 Hz. Atrial natriuretic peptide content of the superfusate was measured by radioimmunoassay. In nonpaced and paced atria, increasing resting tension three- to five-fold caused immunoreactive atrial natriuretic peptide secretion to increase by 35 +/- 5% (mean +/- SEM, n = 6, p less than 0.01) and 30 +/- 3% (n = 4, p less than 0.01), respectively. Lowering resting tension by 50% in nonpaced and paced atria lowered immunoreactive atrial natriuretic peptide secretion by 30 +/- 3% (n = 7, p less than 0.01) and 24 +/- 3% (n = 6, p less than 0.01), respectively. To exclude the possibility that release of norepinephrine or acetylcholine from endogenous nerve endings was mediating this effect, the atria were superfused with the combination of propranolol 0.1 microM, phentolamine 1.0 microM, and atropine 10 microM. These concentrations of the antagonists were 125-fold or higher than their Kd for binding to their respective receptors. The antagonists did not block the rise in immunoreactive atrial natriuretic peptide secretion; neither did they inhibit an established rise in immunoreactive atrial natriuretic peptide secretion induced by increasing the resting tension.

  19. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease

    DEFF Research Database (Denmark)

    Kragelund, Charlotte; Grønning, Bjørn; Køber, Lars;

    2005-01-01

    BACKGROUND: The level of the inactive N-terminal fragment of pro-brain (B-type) natriuretic peptide (BNP) is a strong predictor of mortality among patients with acute coronary syndromes and may be a strong prognostic marker in patients with chronic coronary heart disease as well. We assessed...... the relationship between N-terminal pro-BNP (NT-pro-BNP) levels and long-term mortality from all causes in a large cohort of patients with stable coronary heart disease. METHODS: NT-pro-BNP was measured in baseline serum samples from 1034 patients referred for angiography because of symptoms or signs of coronary...... of myocardial infarction, angina, hypertension, diabetes, or chronic heart failure; creatinine clearance rate; body-mass index; smoking status; plasma lipid levels; LVEF; and the presence or absence of clinically significant coronary artery disease on angiography. CONCLUSIONS: NT-pro-BNP is a marker of long...

  20. The Efficacy of Spironolactone Plus Metoprolol for Elderly Patients with Chronic Heart Failure and the Effects on the Endothelin,Brain Natriuretic Peptide and Cardiac Function%螺内酯联合美托洛尔治疗老年慢性心力衰竭的疗效及对血浆内皮素、脑钠肽与心功能的影响

    Institute of Scientific and Technical Information of China (English)

    刘玉茹; 徐慧敏; 杨克雅; 吴昌维

    2016-01-01

    Objective To investigate the efficacy of spironolactone plus metoprolol treatment for elderly patients with chronic heart failure and the effects on endothelin,brain natriuretic peptide(BNP) and cardiac function.Methods Total of 240 elderly patients with chronic heart failure in Huaihe Hospital of Henan Uni-versity from Dec.2014 to Feb.2015 were included in the study and divided into an observation group and a control group according to the random number table method,120 cases in each group.The control group received conventional drug treatment,i.e.inotropic drugs,angiotensin-converting enzyme inhibitors,and diu-retics etc.,for cardiac function Ⅳ stage patients digitalis cardiac drugs could be appropriately added; the observation group was added with spironolactone plus metoprolol,oral spironolactone 40 mg,once every morn-ing and night respectively,50 mg oral metoprolol at the same time.The clinical efficacy,endothelin and BNP level changes,cardiac function(left ventricular ejection fraction, left ventricular end-diastolic volume and left ventricular end-systolic volume) changes of the two groups were observed and compared.Results After treatment,the total effective rate of the observation group was higher than the control group [96.6%(116/120) vs 80.0%(96/120)],the difference was statistically significant(P<0.05).After treatment,endothe-lin and brain natriuretic peptide of the observation group were lower than the control group [(38 ±5) ng/L vs (49 ±6) ng/L,(87 ±6) ng/L vs (98 ±6) ng/L],the differences were statistically significant(P <0.01).After treatment,left ventricular ejection fraction of the observation group was higher than the control group[ ( 46 ±5 )% vs ( 41 ±5 )%] , left ventricular end-diastolic volume and left ventricular end-systolic volume were lower than the control group[(87 ±9 ) mL vs (98 ±9) mL, (42 ±6) mL vs (51 ±6) mL], the differences were statistically significant ( P <0.01 ) .The incidence of complications of the observation

  1. B-type natriuretic peptide modulates ghrelin, hunger, and satiety in healthy men.

    Science.gov (United States)

    Vila, Greisa; Grimm, Gabriele; Resl, Michael; Heinisch, Birgit; Einwallner, Elisa; Esterbauer, Harald; Dieplinger, Benjamin; Mueller, Thomas; Luger, Anton; Clodi, Martin

    2012-10-01

    Chronic heart failure is accompanied by anorexia and increased release of B-type natriuretic peptide (BNP) from ventricular cardiomyocytes. The pathophysiological mechanisms linking heart failure and appetite regulation remain unknown. In this study, we investigated the impact of intravenous BNP administration on appetite-regulating hormones and subjective ratings of hunger and satiety in 10 healthy volunteers. Participants received in a randomized, placebo-controlled, crossover, single-blinded study (subject) placebo once and 3.0 pmol/kg/min human BNP-32 once administered as a continuous infusion during 4 h. Circulating concentrations of appetite-regulating peptides were measured hourly. Subjective ratings of hunger and satiety were evaluated by visual analog scales. BNP inhibited the fasting-induced increase in total and acylated ghrelin concentrations over time (P = 0.043 and P = 0.038, respectively). In addition, BNP decreased the subjective rating of hunger (P = 0.009) and increased the feeling of satiety (P = 0.012) when compared with placebo. There were no significant changes in circulating peptide YY, glucagon-like peptide 1, oxyntomodulin, pancreatic polypeptide, leptin, and adiponectin concentrations. In summary, our results demonstrate that BNP exerts anorectic effects and reduces ghrelin concentrations in men. These data, taken together with the known cardiovascular properties of ghrelin, support the existence of a heart-gut-brain axis, which could be therapeutically targeted in patients with heart failure and obesity.

  2. Prognostic Value of Adrenomedullin and Natriuretic Peptides in Uroseptic Patients Induced by Ureteroscopy

    Directory of Open Access Journals (Sweden)

    Wei Hu

    2016-01-01

    Full Text Available The aim of this paper is to investigate whether urosepsis is related to irrigation pressure of ureteroscopy (URS and evaluate the prognostic value of adrenomedullin (ADM and atrial and brain natriuretic peptides (ANP and BNP in URS-induced uroseptic patients. From July 2008 to October 2013, we enrolled 332 patients with untreated unilateral ureteral obstruction (UUO. The UUO group included three subgroups of, respectively, 118, 132, and 82 patients who underwent URS under intermittent stable irrigation pressure of, respectively, 80, 120, and 160 mmHg. The plasma concentrations of ADM, ANP, and BNP were measured in all subjects. URS was performed for all UUO patients; the values of the three peptides were measured again after URS. Irrigation pressure and stone size were independent risk factors of urosepsis. After URS, the plasma concentrations of ADM, ANP, and BNP were significantly higher in uroseptic patients. Moreover, the concentrations were significantly higher depending on the disease severity. Plasma concentrations of the three peptides were correlated with plasma ET concentration in the uroseptic patients. The areas under receiver operating characteristic (ROC curve of ADM, ANP, and BNP for predicting urosepsis were 0.811, 0.728, and 0.764, respectively. In conclusion, ADM, along with ANP and BNP, is valuable for prognosis in urosepsis secondary to URS which is associated with irrigation pressure.

  3. Natriuretic peptide vs. clinical information for diagnosis of left ventricular systolic dysfunction in primary care

    Directory of Open Access Journals (Sweden)

    Wachter Rolf

    2008-02-01

    Full Text Available Abstract Background Screening of primary care patients at risk for left ventricular systolic dysfunction by a simple blood-test might reduce referral rates for echocardiography. Whether or not natriuretic peptide testing is a useful and cost-effective diagnostic instrument in primary care settings, however, is still a matter of debate. Methods N-terminal pro-brain natriuretic peptide (NT-proBNP levels, clinical information, and echocardiographic data of left ventricular systolic function were collected in 542 family practice patients with at least one cardiovascular risk factor. We determined the diagnostic power of the NT-proBNP assessment in ruling out left ventricular systolic dysfunction and compared it to a risk score derived from a logistic regression model of easily acquired clinical information. Results 23 of 542 patients showed left ventricular systolic dysfunction. Both NT-proBNP and the clinical risk score consisting of dyspnea at exertion and ankle swelling, coronary artery disease and diuretic treatment showed excellent diagnostic power for ruling out left ventricular systolic dysfunction. AUC of NT-proBNP was 0.83 (95% CI, 0.75 to 0.92 with a sensitivity of 0.91 (95% CI, 0.71 to 0.98 and a specificity of 0.46 (95% CI, 0.41 to 0.50. AUC of the clinical risk score was 0.85 (95% CI, 0.79 to 0.91 with a sensitivity of 0.91 (95% CI, 0.71 to 0.98 and a specificity of 0.64 (95% CI, 0.59 to 0.67. 148 misclassifications using NT-proBNP and 55 using the clinical risk score revealed a significant difference (McNemar test; p Conclusion The evaluation of clinical information is at least as effective as NT-proBNP testing in ruling out left ventricular systolic dysfunction in family practice patients at risk. If these results are confirmed in larger cohorts and in different samples, family physicians should be encouraged to rely on the diagnostic power of the clinical information from their patients.

  4. C-type natriuretic peptide in prostate cancer

    DEFF Research Database (Denmark)

    Nielsen, Soeren Junge; Iversen, Peter; Rehfeld, Jens F.;

    2009-01-01

    C-type natriuretic peptide (CNP) is expressed in the male reproductive organs in pigs. To examine whether the human prostate also expresses the CNP gene, we measured CNP and N-terminal proCNP in prostate cancer tissue extracts and performed immunohistochemical biopsy staining. Additionally, pro......CNP-derived peptides were quantitated in plasma from patients with prostate cancer. Blood was collected from healthy controls and patients before surgery for localized prostate cancer. Tissue extracts were prepared from tissue biopsies obtained from radical prostatectomy surgery. N-terminal proCNP, proCNP (1...... demonstrated the presence of the peptides in prostatic epithelial cells. The N-terminal proCNP concentrations in plasma were marginally lower in patients with localized prostate cancer compared with control subjects [13.8 pmol/l (11.0-17.2) vs. 15.1 pmol/l (10.4-23.2), p=0.002] but not enough to justify...

  5. Natriuretic Peptides in Kawasaki Disease: the Myocardial Perspective

    Directory of Open Access Journals (Sweden)

    Nagib Dahdah

    2013-01-01

    Full Text Available Making a diagnosis of Kawasaki disease with certainty may be challenging, especially since the recognition of cases with incomplete diagnostic criteria and its consequences. In order to build the diagnostic case in daily practice, clinicians rely on clinical criteria established over four decades ago, aided by non specific laboratory tests, and above all inspired by experience. We have recently studied the diagnostic value of N-terminal pro B-type natriuretic peptide to improve the diagnostic certainty of cases with complete or incomplete clinical criteria. Our working hypothesis was based on the fact that myocarditis is present in nearly all Kawasaki disease patients supported by histology data. In this paper, we review these facts and the myocardial perspective from the diagnostic and the mechanistic standpoints.

  6. Elevated levels of natriuretic peptides in patients with pulmonary thromboembolism.

    Science.gov (United States)

    Kiely, David G; Kennedy, Norman S; Pirzada, Omar; Batchelor, Sheila A; Struthers, Allan D; Lipworth, Brian J

    2005-10-01

    Pulmonary thromboembolism (PTE) occurs in a wide variety of clinical settings and presents a diagnostic challenge to clinicians, often requiring extensive imaging of the vascular bed. Management increasingly requires accurate risk stratification to rapidly identify those with massive and submassive PTE requiring different therapeutic strategies such as thrombolysis. Provision of a rapid blood test that improves diagnostic certainty and helps stratify risk could therefore bridge the gap between uncertainty and delivery of immediate early life-saving treatment. One hundred and fourteen consecutive patients with suspected PTE underwent prospective evaluation. Venous blood samples were obtained from an unselected group referred for ventilation-perfusion scintigraphy. B-type natriuretic peptide (BNP), atrial natriuretic peptide (ANP) and N-terminal pro-ANP (N-ANP) were measured by radioimmunoassay using commercially available kits. The scans were classified into three groups according to standard criteria (PIOPED); normal scan (N) (n=20), low/intermediate probability (L/I) of PTE (n=77) and high probability (H) of PTE (n=17). Comparisons were also made between patients with high probability scans who died (n=3) and those who survived (n=14). Values are quoted for the median and interquartile ranges. There were statistically significant differences between groups for levels of (a) BNP (P<0.001): N=6.7 pmol/l (5.6-11.9), L/I=12.5 pmol/l (6.7-28.2) and H=18.5 pmol/l (12.6-74.6); (b) ANP (P<0.005): N=12.6 pmol/l (7.1-16.0), L/I=19.51 pmol/l (12.5-28.2) and H=19.1 pmol/l (15.7-31.7) and (c) N-ANP (P<0.05): N=177 pmol/l (119-200), L/I=302 pmol/l (152-576) and H=322 pmol/l (223-563). Levels of BNP and ANP were significantly (P<0.05) higher in patients with high probability scans and a diagnosis of PTE who died (n=3) than in those who survived (n=14); BNP: 91.6 pmol/l (77.5-336.2) vs. 14.4 pmol/l (11.9-27.4) and ANP 32.5 pmol/l (21.7-105.5) vs. 17.6 pmol/l (15

  7. C-type natriuretic peptide and its precursor

    DEFF Research Database (Denmark)

    Lippert, Solvej; Iversen, Peter; Brasso, Klaus;

    2015-01-01

    AIM: Seminal plasma offer a more organ-specific matrix for markers in prostatic disease. We hypothesized that C-type natriuretic peptide (CNP) expression may constitute such a new target. METHODS: Patients with benign prostatic hyperplasia, clinically localized and metastatic prostate cancer were...... examined for CNP and CNP precursor (proCNP) concentrations in blood and seminal plasma. Furthermore, CNP and the CNP receptor (NPR-B) mRNA contents in tissue from prostate and seminal vesicles were analyzed by qPCR. RESULTS: CNP and NPR-B concentrations decreased with increasing tumor burden (p = 0.......0027 and p = 0.0096, respectively). In contrast, seminal plasma CNP and proCNP concentrations were markedly increased with increased tumor burden (p prostate cancer....

  8. B-Type Natriuretic Peptide: From Posttranslational Processing to Clinical Measurement

    DEFF Research Database (Denmark)

    Goetze, Jens P

    2012-01-01

    BACKGROUND:Plasma cardiac natriuretic peptides and peptide fragments from their molecular precursors are markers of heart disease. Clinical studies have defined the current diagnostic utility of these markers, whereas biochemical elucidation of peptide structure and posttranslational processing has...... revealed new plasma peptide forms of potential clinical use.CONTENT:Natriuretic propeptide structures undergo variable degrees of endo- and exoproteolytic cleavages as well as amino acid modifications, which leave the plasma phase of the peptides highly heterogeneous and dependent on cardiac......-atrial natriuretic peptide and pro-B-type natriuretic peptide are useful plasma markers in heart failure. New data have defined cardiac myocytes as competent endocrine cells in posttranslational processing and cellular secretion....

  9. N-terminal pro-B-type natriuretic peptide in patients with growth hormone disturbances

    DEFF Research Database (Denmark)

    Andreassen, Mikkel; Faber, Jens; Vestergaard, Henrik;

    2007-01-01

    Acromegaly is associated with hypertrophic cardiomyopathy, hypertension and subsequent congestive heart failure. Impairment of cardiac function has also been associated with growth hormone deficiency (GHD). B-type natriuretic peptides (BNPs) have emerged as strong diagnostic and prognostic risk...

  10. Plant natriuretic peptides are apoplastic and paracrine stress response molecules

    KAUST Repository

    Wang, Yuhua

    2011-04-07

    Higher plants contain biologically active proteins that are recognized by antibodies against human atrial natriuretic peptide (ANP). We identified and isolated two Arabidopsis thaliana immunoreactive plant natriuretic peptide (PNP)-encoding genes, AtPNP-A and AtPNP-B, which are distantly related members of the expansin superfamily and have a role in the regulation of homeostasis in abiotic and biotic stresses, and have shown that AtPNP-A modulates the effects of ABA on stomata. Arabidopsis PNP (PNP-A) is mainly expressed in leaf mesophyll cells, and in protoplast assays we demonstrate that it is secreted using AtPNP-A:green fluorescent protein (GFP) reporter constructs and flow cytometry. Transient reporter assays provide evidence that AtPNP-A expression is enhanced by heat, osmotica and salt, and that AtPNP-A itself can enhance its own expression, thereby generating a response signature diagnostic for paracrine action and potentially also autocrine effects. Expression of native AtPNP-A is enhanced by osmotica and transiently by salt. Although AtPNP-A expression is induced by salt and osmotica, ABA does not significantly modulate AtPNP-A levels nor does recombinant AtPNP-A affect reporter expression of the ABA-responsive RD29A gene. Together, these results provide experimental evidence that AtPNP-A is stress responsive, secreted into the apoplastic space and can enhance its own expression. Furthermore, our findings support the idea that AtPNP-A, together with ABA, is an important component in complex plant stress responses and that, much like in animals, peptide signaling molecules can create diverse and modular signals essential for growth, development and defense under rapidly changing environmental conditions. © 2011 The Author.

  11. Natriuretic Hormones, Endogenous Ouabain, and Related Sodium Transport Inhibitors

    Directory of Open Access Journals (Sweden)

    John eHamlyn

    2014-12-01

    Full Text Available The work of deWardener and colleagues stimulated longstanding interest in natriuretic hormones (NH. In addition to the atrial peptides (APs, the circulation contains unidentified physiologically-relevant NHs. One NH is controlled by the central nervous system (CNS and likely secreted by the pituitary. Its circulating activity is modulated by salt intake and the prevailing sodium concentration of the blood and intracerebroventricular fluid, and contributes to postprandial and dehydration natriuresis. The other NH, mobilized by atrial stretch, promotes natriuresis by increasing the production of intrarenal dopamine and/or nitric oxide. Both NHs have short (<35 minutes circulating half lives, depress renotubular sodium transport, and neither requires the renal nerves. The search for NHs led to endogenous cardiotonic steroids (CTS including ouabain-, digoxin-, and bufadienolide-like materials. These CTS, given acutely in high nanomole to micromole amounts into the general or renal circulations, inhibit sodium pumps and are natriuretic. Among these CTS, only bufalin is cleared sufficiently rapidly to qualify for an NH-like role. Ouabain-like CTS are cleared slowly, and when given chronically in low daily nanomole amounts, promote sodium retention, augment arterial myogenic tone, reduce renal blood flow and glomerular filtration, suppress nitric oxide in the renal vasa recta, and increase sympathetic nerve activity and blood pressure. Moreover, lowering total body sodium raises circulating endogenous ouabain. Thus, ouabain-like CTS have physiological actions that, like aldosterone, support renal sodium retention and blood pressure. In conclusion, the mammalian circulation contains two non-AP NHs. Identification of the CNS NH should be a priority.

  12. Insulin/glucose induces natriuretic peptide clearance receptor in human adipocytes: a metabolic link with the cardiac natriuretic pathway.

    Science.gov (United States)

    Bordicchia, M; Ceresiani, M; Pavani, M; Minardi, D; Polito, M; Wabitsch, M; Cannone, V; Burnett, J C; Dessì-Fulgheri, P; Sarzani, R

    2016-07-01

    Cardiac natriuretic peptides (NP) are involved in cardiorenal regulation and in lipolysis. The NP activity is largely dependent on the ratio between the signaling receptor NPRA and the clearance receptor NPRC. Lipolysis increases when NPRC is reduced by starving or very-low-calorie diet. On the contrary, insulin is an antilipolytic hormone that increases sodium retention, suggesting a possible functional link with NP. We examined the insulin-mediated regulation of NP receptors in differentiated human adipocytes and tested the association of NP receptor expression in visceral adipose tissue (VAT) with metabolic profiles of patients undergoing renal surgery. Differentiated human adipocytes from VAT and Simpson-Golabi-Behmel Syndrome (SGBS) adipocyte cell line were treated with insulin in the presence of high-glucose or low-glucose media to study NP receptors and insulin/glucose-regulated pathways. Fasting blood samples and VAT samples were taken from patients on the day of renal surgery. We observed a potent insulin-mediated and glucose-dependent upregulation of NPRC, through the phosphatidylinositol 3-kinase pathway, associated with lower lipolysis in differentiated adipocytes. No effect was observed on NPRA. Low-glucose medium, used to simulate in vivo starving conditions, hampered the insulin effect on NPRC through modulation of insulin/glucose-regulated pathways, allowing atrial natriuretic peptide to induce lipolysis and thermogenic genes. An expression ratio in favor of NPRC in adipose tissue was associated with higher fasting insulinemia, HOMA-IR, and atherogenic lipid levels. Insulin/glucose-dependent NPRC induction in adipocytes might be a key factor linking hyperinsulinemia, metabolic syndrome, and higher blood pressure by reducing NP effects on adipocytes. Copyright © 2016 the American Physiological Society.

  13. Recent advances in natriuretic peptide family genes and cardiovascular diseases%利钠肽家族基因与心血管疾病研究新进展

    Institute of Scientific and Technical Information of China (English)

    吴志俊; 金玮; 张凤如; 刘艳

    2012-01-01

    Natriuretic peptide family consists of several hormones produced by cardiomyocyte, including atrial natri-uretic peptide (ANP), brain natriuretic peptide (BNP) and C-type natriuretic peptide (CNP). They possess similar gene structures and protective effects of cardiovascular physiology, such as anti-hypertrophy, anti-fibrosis, myocardial relaxation and blood pressure regulation. The corresponding natriuretic peptide receptor A, B and C mediate multiple effects of natriuretic peptides to maintain cardiovascular homeostasis. Specially, natriuretic peptide receptor-A preferentially binds ANP and BNP, while natriuretic peptide receptor-B is more selective for C-type natriuretic peptides. Natriuretic peptide recep-tor-C(NPR-C), binding all kinds of natriuretic peptides, clears natriuretic peptides from the circulation through recep-tor-mediated internalization and degradation. BNP levels were reported to be a good predictor of left ventricular dysfunction and decompensated heart failure from a clinical standpoint. BNP infusion is an effective treatment for acute heart failure. Investigations on natriuretic peptides' single nucleotide polymorphisms and biological function suggested that they could be associated with several cardiovascular diseases, such as atrial fibrillation, cardiomyopathy, heart failure and so on. Transgenic mice with natriuretic peptides and their receptors gene deletion display myocardial hypertrophy and fibrosis, which are associated with the development of hypertension, cardiomyopathy and heart failure. Certain stimuli triggering cardiac hypertrophy and ischemic injuries may be involved in regulating gene expression of natriuretic peptides and their receptors. Therefore, advances in understanding of natriuretic peptide family genes and their regulatory mechanisms will lead to greater insight into the pathogenesis of cardiovascular diseases and blaze a new trail in clinical treatment.%利钠肽家族是一组由心肌细胞分泌的激素,主要

  14. Effects of cardiac natriuretic peptides on oxidized low-density lipoprotein- and lysophosphatidylcholine-induced human mesangial cell migration.

    Science.gov (United States)

    Kohno, M; Yasunari, K; Maeda, K; Kano, H; Minami, M; Hanehira, T; Yoshikawa, J

    2000-04-01

    The objectives of the present study were (1) to determine whether oxidized LDL and lysophosphatidylcholine (lyso-PtdCho), a major phospholipid component of oxidized LDL, stimulate the migration of cultured human mesangial cells and (2) to investigate the possible effects on mesangial cell migration of the cardiac natriuretic peptides atrial and brain natriuretic peptide (ANP and BNP). Oxidized LDL (10 and 100 microg/mL) and lyso-PtdCho (10(-7) to 10(-5) mol/L) stimulated migration in a concentration-dependent manner. In contrast, the effects of native LDL and phosphatidylcholine were modest or nonexistent. Protein kinase C (PKC) inhibitor and downregulation of PKC activity by phorbol ester inhibited oxidized LDL- and lyso-PtdCho-induced migration. Human ANP(1-28) and human BNP-32 significantly inhibited oxidized LDL- and lyso-PtdCho-induced migration in a concentration-dependent manner. C-ANF (des-[Glu(18),Ser(19),Gly(20),Leu(21),Gly(22)]ANP(4-23)), a specific ligand for ANP clearance receptors, could not inhibit oxidized LDL- and lyso-PtdCho-induced migration. Inhibition by ANP and BNP of lyso-PtdCho-induced migration was paralleled by an increase in the cellular level of GMP. Oxidized LDL- and lyso-PtdCho-induced migrations were inhibited by 8-bromo-cGMP. The results suggest that oxidized LDL and lyso-PtdCho stimulate the migration of human mesangial cells, at least in part, through a PKC-dependent process and that ANP and BNP inhibit this stimulated migration, probably through a cGMP-dependent process.

  15. 慢性心力衰竭患者血浆视黄醇结合蛋白、胱抑素、NT-proBNP 浓度与体质量指数的关系%Relationship among plamsa retinol binding protein, cystatin C, N-teminal pro-brain natriuretic peptides levels with body mass index in patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    古忆; 卢新政; 周建松; 夏思良; 黄红娟; 郑宏健; 秦晓毅; 曹克将; 黄峻

    2011-01-01

    目的 探讨慢性心力衰竭患者血浆视黄醇结合蛋白(RBP)、胱抑素(Cys-C)、NT-proB-NP 浓度与体质量指数(BMI)的关系,及其对慢性心力衰竭患者心功能、预后评估的价值.方法 135例慢性心力衰竭患者(男70 例,女65 例,左心室射血分数28 kg/m2 ),测定慢性心力衰竭患者血浆RBP、Cys-C、NT-proBNP 浓度,探讨其与BMI 的相关性及其对慢性心力衰竭患者心功能、预后的影响.结果 (1)肥胖组患者血浆RBP 水平[(70.45 ±8.74)mg/L]明显高于BMI 正常组[(56.45 ±7.15)mg/L]及超重组[(64.61 ±7.24)mg/L],胱抑素水平[(2.78 ±0.38)mg/L]明显高于BMI 正常组[(1.90 ±0.48)mg/L]及超重组[(2.39 ±0.41)mg/L],血浆NT-proBNP 水平[(1536 ±69)ng/L]明显低于BMI 正常组[(1857 ±145)ng/L]及超重组[(1726 ±115)ng/L](P 均<0.01);(2)慢性心力衰竭患者血浆RBP、Cys-C 与BMI 之间存在显著正相关(r =0.621,P <0.01;r =0.680,P <0.01),且随肥胖程度加重而逐渐增高;NT-proBNP 与BMI 之间存在显著负相关(r =-0.865,P <0.01).结论 慢性心力衰竭患者血浆RBP、Cys-C 水平均随BMI 增加而增加,而NT-proBNP 随BMI 增加而降低,联合检测血浆NT-proBNP靇_氋;_岪、Cys-C、RBP 水平有利于肥胖合并慢性心力衰竭的诊断及预后评估.%Objective To explore the relationship among levels of plasma retinol binding protein , cystatin C,N-teminal pro-brain natriuretic peptide(NT-proBNP) with body mass index(BMI) ,and to identify whether the simultaneous determination of the three markers is valuable to evaluate the cardiac function and prognosis for patients with chronic heart failure. Methods 135 patients with chronic heart failure were enrolled in this study (70 males ,65 females and LVEF <50% ) ,and height and weight of each patient were measured and BMI were calculated with these parameter. The patients were divided into 3 groups according to BMI; normal group (BMI <24 kg/m2) , overweight group (BMI 24-27. 9 kg/m2) and obese group

  16. 不同剂量重组人脑利钠肽联合小剂量多巴胺治疗慢性重度心功能不全并血压偏低患者60例疗效观察%Observation on clinical efficacy of different doses of recombinant brain natriuretic peptide combined with low-dose dopa-mine in treating 60 cases of chronic severe cardiac insufficiency complicating low blood pressure

    Institute of Scientific and Technical Information of China (English)

    范利斌; 张战波; 许立; 孟浩; 张乐

    2016-01-01

    Objective To investigate the efficacy and adverse reactions of early using different doses of recom‐binant human brain natriuretic peptide (rhBNP) combined with low‐dose dopamine in treating 60 cases chronic severe cardiac insufficiency complicating low blood pressure .Methods Sixty cases of New York Heart Association (NY‐HA) cardiac function grade Ⅲ - Ⅳ in emergency ICU of our hospital were selected and divided into the observation group and the control group randomly ,30 cases in each group .The observation group was given small load dose of rh‐BNP 0 .75μg/kg (1/2 of routinely recommended load dose 1 .5μg/kg) by intravenous pulse plus maintenance dose of 0 .007 5 μg/(kg · min) by 24 h continuous intravenous drip ,while the control group was given rhBNP without load‐ing dose ,only maintenance dose of 0 .007 5μg/(kg · min) ,by 24 h continuous intravenous drip .The two groups were combined with using low dose of dopamine ,its dose was adjusted according to the blood pressure for maintaining the systolic pressure at 90-110 mm Hg and diastolic pressure at 60-70 mm Hg .The improvement situation of cardiac function grade ,serum sodium ,potassium ,left ventricular ejection fraction (LVEF) ,BNP level and medication adverse reactions before treatment and on 3 d after treatment were compared between the two groups .Results The total ef‐fective rate after treatment in the observation group was 93 .33% ,which was significantly higher than 73 .33% in the control group ,the difference was statistically significant(χ2 =5 .250 ,P0 .05);there was no statistic difference in the incidence of adverse reactions between the two groups(χ2 =1 .689 ,P> 0 .05) .Conclusion The efficacy of early using small load dose of rhBNP plus maintenance dose combined with small dose of dopamine is superior to the pure maintenance dose combined with small dose of dopamine in treating chronic severe cardiac insufficiency complicating low blood pressure ,moreover which has high

  17. Effect of Tirofiban on the Prognosis of Heart Function and B-type Brain Natriuretic Peptide Levels of Acute Myocardial Infarction Patients Received Primary Percutaneous Coronary Artery Interventional Therapy%替罗非班对急性心肌梗死行直接冠状动脉介入治疗患者血浆B型脑钠肽及心功能的影响

    Institute of Scientific and Technical Information of China (English)

    高海; 段小春; 李南

    2012-01-01

    Objective To evaluate the effect of Tirofiban on the prognosis of heart function and B - type brain natri-uretic peptide ( BNP) levels of acute myocardial infarction ( AMI ) patients who received primary percutaneous coronary artery interventional therapy. Methods 172 AMI patients were randomly divided into Tirofiban group ( n =82 ) and control group ( n = 90 ). The resolution of the sum of ST - segment elevation ( sumSTR ) 90 minutes after the operation was compared between the two groups. The changes of serum BNP levels, left ventricular ejection fraction ( LVEF ), left ventricular end diastolic dimension ( LVEDD ) and left ventricular end systolic dimension ( LVESD ) were measured and compared between the two groups 7 days and 30 days after operation. Major adverse cardiovascular events ( MACE ) and bleeding complications occurred during hos-pitalization and 30 days in the following - up period were recorded and compared between the two groups. Results The blood flow rate of TIMI 3 showed no statistically significant difference between the two groups after IRA was opened ( P > 0. 05 ). Patients received Tirofiban were more likely to achieve higher sumSTR and complete ST resolution 90 minutes after the procedure, the differences between the two groups were statistically significant ( P 0. 05 ). Conclusion Application of Tirofiban in patients accompanied with acute ST elevation myocardial infarction who received primary PCI can effectively and safely improve the heart function of the patients and can reduce adverse events after operation.%目的 探讨血小板膜糖蛋白(GP)Ⅱb/Ⅲa 受体拮抗剂替罗非班在急性心肌梗死(AMI)患者行直接冠状动脉介入(PCI)治疗后对B型脑钠肽(BNP)及心功能的影响.方法 将172例AMI患者随机分为替罗非班组(替罗非班+直接PCI)82例和对照组(直接PCI)90例.比较两组患者术后90 min心电图ST段回落百分比(sumSTR);7 d和30 d的BNP变化;术后7 d及30 d左室射血分数(LVEF)

  18. 早期无创正压通气对慢性阻塞性肺疾病急性发作并呼吸衰竭患者血清N末端脑钠肽前体及超敏C反应蛋白的影响%Effect of noninvasive positive pressure ventilation on Brain Natriuretic Peptide and high sensitive C-reactive protein of acute exacerbation of chronic obstructive pulmonary disease patients with respiratory failur

    Institute of Scientific and Technical Information of China (English)

    孙丽; 杨欣荣; 杨勇; 刘琴

    2014-01-01

    目的 观察早期联合应用双水平无创正压通气(BiPAP)治疗对慢性阻塞性肺疾病急性发作(AECOPD)并呼吸衰竭患者血清N末端脑钠肽前体(NT-pro BNP)及血清超敏C反应蛋白(hs-CRP)的影响.方法 将100例AECOPD并呼吸衰竭患者应用计算机随机分成研究组和对照组各50例.两组均给予抗感染、舒张支气管、止咳化痰、氧疗等常规治疗.研究组在常规治疗基础上增加BiPAP呼吸机辅助治疗.在治疗前及治疗3d分别抽取患者的静脉血标本,测定血清NT-pm BNP和hs-CRP浓度进行比较分析,并对两组住院费用及住院时间进行比较.结果 治疗后研究组及对照组血清NT-pro BNP水平分别为(105.79 ±4.56)、(113.33±3.26) ng/L,差异有统计学意义(t=3.03,P<0.05);血清hs-CRP水平分别为(10.83±16.35)、(26.39±26.87) mg/L,差异有统计学意义(t=-3.44,P<0.05).研究组住院时间及住院费用均较对照组减少[(11.15±1.86)、(12.78±2.25)d,(6 659.11±1 609.49)、(8 031.31±1 449.79)元,t值分别为-3.87、-4.38,P均<0.05].结论 AECOPD并呼吸衰竭患者早期联合应用BiPAP治疗,能使血清NT-pro BNP及hs-CRP水平下降更快,病情更快缓解;对患者病情监测及判断临床疗效有一定价值.%Objective To investigate the concentrations of serum N-terminal brain natriuretic peptide (NT-pm BNP) and high-sensitivity C-reactive protein (hs-CRP) of acute exacerbation of chronic obstrnctive pulmonary disease(AECOPD) patients treated by bi-level positive airway pressure(BiPAP) for with respiratory failure.Methods A total of 100 respiratory failure in patients with AECOPD were divided into study group and control group,and 50 cases of each group.Patients in study group were received the conventional treatment(anti infection,diastolic bronchial,cough and phlegm and oxygen therapy) combined with BiPAP therapy,while in control group were received the conventional treatment.Blood samples were drawn at beginning and 3 d later

  19. A Novel Variable Number of Tandem Repeat of the Natriuretic Peptide Precursor B gene's 5'-Flanking Region is Associated with Essential Hypertension among Japanese Females

    Directory of Open Access Journals (Sweden)

    Kotoko Kosuge, Masayoshi Soma, Tomohiro Nakayama, Noriko Aoi, Mikano Sato, Yoichi Izumi, Koichi Matsumoto

    2007-01-01

    Full Text Available Background: Brain natriuretic peptide (BNP acts primarily as a cardiac hormone; it is produced by the ventricle and has both vasodilatory and natriuretic actions. Therefore, the BNP gene is thought to be a candidate gene for essential hypertension (EH. The present study identified variants in the 5'-flanking region of natriuretic peptide precursor B (NPPB gene and assessed the relationship between gene variants and EH. Methods: The polymerase chain reaction-single strand conformation polymorphism method and nucleotide sequencing were used to identify variants. Results: A novel variable number of tandem repeat (VNTR polymorphism in the 5'-flanking region (-1241 nucleotides from the major transcriptional initiation site was discovered. This VNTR polymorphism is a tandem repeat of the 4-nucleotide sequence TTTC. There were 8 alleles, ranging from 9-repeat to 19-repeat. An association study was done involving 317 EH patients and 262 age-matched normotensive (NT subjects. The 11-repeat allele was the most frequent (88.2%; the 16-repeat allele was the second most frequent (10.5% in the NT group. The observed and expected genotypes were in agreement with the predicted Hardy-Weinberg equilibrium values (P=0.972. Among females, the overall distribution of genotypes was significantly different between the EH and NT groups (p=0.039. The frequency of the 16-repeat allele was significantly lower in the female EH group (6.5% than in the female NT group (12.2%, p=0.046. Conclusions: The 16-repeat allele of the VNTR in the 5'-flanking region of NPPB appears to be a useful genetic marker of EH in females.

  20. Does the relationship between natriuretic hormones and diastolic function differ by race?

    Science.gov (United States)

    Kapuku, Gaston K; Davis, Harry C; Thomas, Patrick; Januzzi, James; Harshfield, Gregory A

    2012-08-01

    Heart failure develops earlier and is more prevalent in blacks than whites because of their higher incidence of hypertension and diabetes and likely subsequent diastolic dysfunction. Natriuretic peptides (NP) prevent cardiac malfunction through pressure, natriuresis action. However, whether race affects the relationships of NP action with cardiac function is unknown. To assess this, 55 (21 whites and 27 males) normotensive adults underwent a 2-hour protocol of 40 minutes rest, video game stressor and recovery. Mitral inflow and myocardial velocities (tissue Doppler) were recorded every 20 minutes. Blood pressure and heart rate were obtained at 10-minute intervals. Blood samples for pro-atrial NP and pro-brain NP (pro-BNP) were collected every 40 minutes. There were differences in the association between (1) the changes from rest to stress for E/A ratio and double product (whites, r = -0.42; blacks, r = 0. 10; P = 0.034 for difference between correlations); (2) stress E(m) and pro-atrial NP (whites, r = 0.59; blacks, r = -0.25; P = 0.025); (3) rest E(m) and BNP (whites, r = 0.83; blacks r = -0.17; P = 000); (4) rest E(m)/A(m) and pro-BNP (whites, r = 0.70; blacks, r = -0.42; P = 0.003); (5) rest E/E(m) and pro-BNP (whites, r = -0.61; blacks, r = 0.31; P = 0.015) and (6) stress E and pro-BNP (whites, r = 0.56; blacks, r = -0.18; P = 0.043). The higher correlations between levels of NP and diastolic function indices both at rest and stress suggest that NP protective action is more pronounced in whites than in blacks.

  1. Atrial natriuretic peptide prevents cancer metastasis through vascular endothelial cells.

    Science.gov (United States)

    Nojiri, Takashi; Hosoda, Hiroshi; Tokudome, Takeshi; Miura, Koichi; Ishikane, Shin; Otani, Kentaro; Kishimoto, Ichiro; Shintani, Yasushi; Inoue, Masayoshi; Kimura, Toru; Sawabata, Noriyoshi; Minami, Masato; Nakagiri, Tomoyuki; Funaki, Soichiro; Takeuchi, Yukiyasu; Maeda, Hajime; Kidoya, Hiroyasu; Kiyonari, Hiroshi; Shioi, Go; Arai, Yuji; Hasegawa, Takeshi; Takakura, Nobuyuki; Hori, Megumi; Ohno, Yuko; Miyazato, Mikiya; Mochizuki, Naoki; Okumura, Meinoshin; Kangawa, Kenji

    2015-03-31

    Most patients suffering from cancer die of metastatic disease. Surgical removal of solid tumors is performed as an initial attempt to cure patients; however, surgery is often accompanied with trauma, which can promote early recurrence by provoking detachment of tumor cells into the blood stream or inducing systemic inflammation or both. We have previously reported that administration of atrial natriuretic peptide (ANP) during the perioperative period reduces inflammatory response and has a prophylactic effect on postoperative cardiopulmonary complications in lung cancer surgery. Here we demonstrate that cancer recurrence after curative surgery was significantly lower in ANP-treated patients than in control patients (surgery alone). ANP is known to bind specifically to NPR1 [also called guanylyl cyclase-A (GC-A) receptor]. In mouse models, we found that metastasis of GC-A-nonexpressing tumor cells (i.e., B16 mouse melanoma cells) to the lung was increased in vascular endothelium-specific GC-A knockout mice and decreased in vascular endothelium-specific GC-A transgenic mice compared with control mice. We examined the effect of ANP on tumor metastasis in mice treated with lipopolysaccharide, which mimics systemic inflammation induced by surgical stress. ANP inhibited the adhesion of cancer cells to pulmonary arterial and micro-vascular endothelial cells by suppressing the E-selectin expression that is promoted by inflammation. These results suggest that ANP prevents cancer metastasis by inhibiting the adhesion of tumor cells to inflamed endothelial cells.

  2. C-type natriuretic peptide in prostate cancer

    DEFF Research Database (Denmark)

    Nielsen, Soeren Junge; Iversen, Peter; Rehfeld, Jens F.

    2009-01-01

    C-type natriuretic peptide (CNP) is expressed in the male reproductive organs in pigs. To examine whether the human prostate also expresses the CNP gene, we measured CNP and N-terminal proCNP in prostate cancer tissue extracts and performed immunohistochemical biopsy staining. Additionally, pro......CNP-derived peptides were quantitated in plasma from patients with prostate cancer. Blood was collected from healthy controls and patients before surgery for localized prostate cancer. Tissue extracts were prepared from tissue biopsies obtained from radical prostatectomy surgery. N-terminal proCNP, proCNP (1......-50) and CNP were measured in plasma and tissue extracts. Biopsies were stained for CNP-22 and N-terminal proCNP. Tissue extracts from human prostate cancer contained mostly N-terminal proCNP [median 5.3 pmol/g tissue (range 1.0-12.9)] and less CNP [0.14 pmol/g tissue (0.01-1.34)]. Immunohistochemistry...

  3. Angiotensin II modulates the intrarenal effects of atrial natriuretic peptide.

    Science.gov (United States)

    Siragy, H M; Lamb, N E; Rose, C E; Peach, M J; Carey, R M

    1988-09-01

    The mechanism by which atrial natriuretic peptide (ANP) increases renal water and solute excretion is not fully understood. We studied the renal effects of ANP and angiotensin II (ANG II) separately and together in uninephrectomized conscious dogs (n = 7) in sodium metabolic balance (80 meq/day). Exogenous ANG II and ANP were without measurable systemic effects as demonstrated by absence of changes in blood pressure, plasma aldosterone concentration, and plasma renin activity. The quantity of ANG II that had significant renal effects that were without measurable systemic effects was 0.2 pmol.kg-1.min-1. Three infusion rates of ANP had significant renal effects (1, 10, and 20 pmol.kg-1.min-1). These quantities of ANP caused significant diuresis, natriuresis, kaliuresis, and increased glomerular filtration rate without significant changes in renal plasma flow. ANG II alone caused significant antidiuresis, antinatriuresis, and decreased glomerular filtration rate and renal plasma flow. When ANG II and ANP were given together, no change in urinary flow rate, urinary sodium or potassium excretion, or renal plasma flow was observed, whereas glomerular filtration rate increased. Filtration fraction increased significantly with ANG II and ANP separately and together. Intrarenal ANP prevents the ANG II-induced decrement in urinary sodium excretion and urine flow rate. ANP may play an important role in escape from the sodium-retaining action of intrarenal ANG II.

  4. Diuretic and natriuretic activity of two mistletoe species in rats

    Directory of Open Access Journals (Sweden)

    Namita Jadhav

    2010-01-01

    Full Text Available In different cultural groups, the hemiparasitic plants of the families Loranthaceae and Viscaceae (mistletoes are frequently used in the treatment of hypertension and/or as diuretic agents. However, it remains unclear as to what commonality makes them diuretic agents or a remedy for hypertension. In this article, the diuretic activity of methanol extracts of Viscum articulatum (VA Burm. f. and Helicanthus elastica (HE (Ders. Dans. in rats is reported. The extracts were administered orally at doses of 100, 200 and 400 mg/kg to rats that had been fasted and deprived of water for 18 hours. Investigations were carried out for diuretic, saluretic and natriuretic effects. The polyphenolic and triterpenoid contents were determined quantitatively using chemical assays and high performance liquid chromatography (HPLC analysis, respectively. The extracts of VA and HE demonstrated significant and dose-dependent diuretic activity in rats. It was found that while VA mimics the furosemide pattern, HE demonstrated a dose-dependent increase in diuresis, along with an increase in potassium-sparing effects. Phytochemical analysis revealed that polyphenolics and triterpenoids, such as oleanolic acid and lupeol, are the major phytochemicals involved. It was also found that in different combinations, these phytochemicals differed in the way they influenced the electrolyte excretion. A higher content of polyphenolics in association with lower triterpenoid content was found to favor potassium-sparing effects.

  5. Atrial natriuretic peptide increases resistance to venous return in rats

    Energy Technology Data Exchange (ETDEWEB)

    Chien, Y.W.; Frohlich, E.D.; Trippodo, N.C.

    1987-05-01

    To examine mechanisms by which administration of atrial natriuretic peptide (ANP) decreases venous return, the authors compared the hemodynamic effects of ANP furosemide (FU), and hexamethonium (HEX) with those of vehicle (VE) in anesthetized rats. Compared with VE, ANP reduced mean arterial pressure, central venous pressure, and cardiac index and increased calculated resistance to venous return. /sup 141/Ce-labeled microspheres were used to determine cardiac output. Mean circulatory filling pressure, distribution of blood flow between splanchnic organs and skeletal muscles, and total peripheral resistance remained unchanged. FU increased urine output similar to that of ANP, yet produced no hemodynamic changes, dissociating diuresis, and decreased cardiac output. HEX lowered arterial pressure through a reduction in total peripheral resistance without altering cardiac output or resistance to venous return. The results confirm previous findings that ANP decreases cardiac output through a reduction in venous return and suggest that this results partly from increased resistance to venous return and not from venodilation or distribution of blood flow.

  6. Atrial natriuretic polypeptide-like material in rat lung

    Energy Technology Data Exchange (ETDEWEB)

    Chang, J.K.; Chang, D.; Xie, C.W.; Song, D.L.; Li, X.R.; Zhang, S.X.; Wang, T.L.; Tang, J.

    1986-03-05

    Atrial natriuretic polypeptide-like immunoreactive material (ANP-IR) was found in rat lung by radioimmunoassay, with the concentration ranging from 0.6-1.2 pmol/g of tissue in each lobe. PAP-immunohistochemical study demonstrated that specific staining of granules for ..cap alpha..-human ANP are mainly located in the muscular layer of the pulmonary vein. Fractionation of lung extract by gel filtration and reserve phase HPLC revealed the presence of multiple forms of ANP-IR, which possibly possessed molecular structure partially different from rat ANP, atriopeptin I and III. Intravenous injection of lung extract induced potent diuresis and natriuresis in rats. These responses could be abolished when the lung extract was preincubated with antiserum for ..cap alpha..-human ANP. Specific binding sites for /sup 125/I-labeled rat ANP were also found in lung membrane preparation by radioreceptor assay. Incubation of synthetic atriopeptin III (10/sup -9/ to 10/sup -6/M) with lung tissue induced 1-28 fold increase in lung cGMP content. The results suggest that ANP-IR and its receptors existing in rat lung may be involved in the regulation of pulmonary function and have a synergic effect with ANP of cardiac origin in the control of water-electrolytes balance.

  7. Glucocorticoids and atrial natriuretic factor receptors on vascular smooth muscle.

    Science.gov (United States)

    Yasunari, K; Kohno, M; Murakawa, K; Yokokawa, K; Takeda, T

    1990-11-01

    The effect of glucocorticoids on the atrial natriuretic factor (ANF)-mediated formation of cyclic guanosine monophosphate (cGMP) by intact vascular smooth muscle cells (VSMC) was studied in rats. Cultured VSMC were obtained from the renal arteries of 14-week-old Wistar rats by the explant method. Micromolar concentrations of dexamethasone, given as pretreatment for 48 hours, suppressed the ANF-mediated response. The dexamethasone-induced suppression was detectable at 6 hours and reached a maximum 24 hours after administration in a dose-dependent manner. Inhibitors of protein synthesis blocked this effect of the glucocorticoid. The basal activity of guanylate cyclase in the dexamethasone-treated cells was lower than in the control cells. Other steroids having glucocorticoid action mimicked this suppression of the ANF-mediated response. This suppression was blocked by a glucocorticoid receptor antagonist. The results suggest that glucocorticoids suppress ANF-mediated cGMP formation by VSMC through glucocorticoid type II receptors and the induction of protein synthesis. Suppression of the ANF-mediated response may play a role in glucocorticoid-induced hypertension.

  8. Pharmacologic Atrial Natriuretic Peptide Reduces Human Leg Capillary Filtration

    Science.gov (United States)

    Watenpaugh, Donald E.; Vissing, Susanne F.; Lane, Lynda D.; Buckey, Jay C.; Firth, Brian G.; Erdman, William; Hargens, Alan R.; Blomqvist, C. Gunnar

    1995-01-01

    Atrial natriuretic peptide (ANP) is produced and secreted by atrial cells. We measured calf capillary filtration rate with prolonged venous-occlusion plethys-mography of supine health male subjects during pharmacologic infusion of ANP (48 pmol/kg/min for 15 min; n equals 6) and during placebo infusion (n equals 7). Results during infusions were compared to prior control measurements. ANP infusion increased plasma (ANP) from 30 plus or minus 4 to 2,568 plus or minus 595 pmol/L. Systemic hemoconcentration occurred during ANP infusion; mean hematocrit and plasma colloid osmotic pressure increased 4.6 and 11.3 percent respectively, relative to pre-infusion baseline values (p is less than 0.05). Mean calf filtration, however was significantly reduced from 0.15 to 0.08 ml/100 ml/min with ANP. Heart rate increased 20 percent with ANP infusion, wheras blood pressure was unchanged. Calf conductance (blood flow/arterial pressure) and venous compliance were unaffected by ANP infusion. Placebo infusion had no effect relative to prior baseline control measurements. Although ANP induced systemic capillary filtration, in the calf, filtration was reduced with ANP. Therefore, phamacologic ANP infusion enhances capillary filtration from the systemic circulation, perhaps at upper body or splanchic sites or both, while having the opposite effect in the leg.

  9. A possible role of atrial natriuretic peptide in ethanol-induced acute diuresis

    Energy Technology Data Exchange (ETDEWEB)

    Colantonio, D.; Casale, R.; Mammarella, M.; Pasqualetti, P. (Univ. of L' Aquila (Italy)); Desiati, P.; De Michele, G. (General Hospital of Coppito, L' Aquila (Italy))

    1991-01-01

    The acute effects of ethanol on plasma atrial natriuretic peptide levels were investigated in 4 clinically healthy males, aged 24-26 years, consumed either 750 ml of water as a control study, or the same beverage with 1 ml/kg alcohol added, which increased the plasma alcohol concentration to 99.12{plus minus}15.10 mg/dl at 60 min. Plasma atrial natriuretic peptide levels were significantly higher in the alcohol study compared to the control study at each time point, and with a peak at 10 min. Atrial natriuretic peptide levels showed a positive significant correlation with plasma antidiuretic hormone in the control group, while no relationship was found between the two peptides in the alcohol study. Moreover, a significant correlation exists between plasma atrial natriuretic peptide levels and systolic arterial blood pressure, and heart rate, and between the variations in atrial natriuretic peptide values and the variations in plasma sodium, serum ethanol, and plasma osmolality in the alcohol study. Acute ethanol intake causes an increase in urinary volume, and a decrease in urinary potassium excretion and urinary osmolality, and no change in urinary sodium excretion.

  10. A case of marked diuresis by combined dopamine and atrial natriuretic peptide administration without renal injury in acute decompensated heart failure.

    Science.gov (United States)

    Kamiya, Masataka; Sato, Naoki; Akiya, Mai; Okazaki, Hirotake; Takahashi, Yasuhiro; Mizuno, Kyoichi

    2013-01-01

    Renal injury is an important factor for worsening outcome in acute decompensated heart failure (ADHF). An 81-year-old woman was admitted due to ADHF with dyspnea and mild peripheral edema. The patient was managed with intravenous administration of atrial natriuretic peptide (ANP) at a dose of 0.0125 μg/kg/minute, which did not control volume overload even at an increased dose of 0.025 μg/kg/minute. After a low dose of dopamine (DA) of 1.0 μg/kg/ minute was added, urine output increased markedly to 120 from 30 mL/hour. Furthermore, her heart rate decreased to 80-100 from 120 bpm and the congestion improved with a reduced brain natriuretic peptide level. Interestingly, the combination of ANP and DA therapy reduced serum creatinine as well as the levels of urinary liver-type fatty acid binding protein, a novel reno-tubular stress marker, by 98.9%, and an oxidative stress marker, urinary 8-hydroxydeoxyguanosine, by 88.2% from baseline levels. Thus, this ADHF patient, a nonresponder to ANP alone, improved without renal injury when administered combination therapy consisting of low doses of ANP and DA, suggesting that this combined therapy might be useful for better management of ADHF in patients without diuretic responses with ANP alone. Further prospective studies are warranted.

  11. Natriuretic peptides: prediction of cardiovascular disease in the general population and high risk populations

    DEFF Research Database (Denmark)

    Hildebrandt, Per

    2009-01-01

    The natriuretic peptides, especially the B-type peptide (BNP) and its inactive split-product N-terminal proBNP (Nt-proBNP) are increasingly used in screening for heart failure, primarily with reduced systolic function, in patients with symptoms suggestive of heart failure, as well in the stable......, hypertension and coronary artery disease. This has of course raised interest for the use of the natriuretic peptides as a risk marker and for screening for heart failure with reduced systolic function in these populations. In symptomatic persons and in high risk populations, the natriuretic peptides have...... demonstrated a high sensitivity for ruling out the disease, if the right decision limits are choosen. Thus the number of normal echocardiographies can be reduced. More recently, the use in screening asymptomatic persons for left ventricular systolic dysfunction has gained more interest. In the unselected...

  12. Mid-regional pro-atrial natriuretic peptide and blood pressure in adolescents

    DEFF Research Database (Denmark)

    Goharian, Tina S; Gimsing, Anders N; Goetze, Jens P

    2015-01-01

    Little is known about blood pressure in relation to circulating natriuretic peptide concentrations and gender in generally healthy adolescents. We studied 15-year-old females and males (n = 335) from the Danish site of the European Youth Heart Study (EYHS). Blood pressure was measured using...... a standardized protocol, sexual maturity was assessed according to Tanner stage, and as a surrogate for atrial natriuretic peptide, we measured mid-regional pro-atrial natriuretic peptide (MR-proANP) in plasma. Compared with boys, girls had lower systolic blood pressure (SBP) (mean ± SD: 109.6 ± 9.9 mmHg vs 116.......9 ± 11.4 mmHg, p adolescents were further subdivided according to Tanner stage, there were no differences in blood pressure...

  13. Atrial natriuretic peptide regulates Ca channel in early developmental cardiomyocytes.

    Directory of Open Access Journals (Sweden)

    Lin Miao

    Full Text Available BACKGROUND: Cardiomyocytes derived from murine embryonic stem (ES cells possess various membrane currents and signaling cascades link to that of embryonic hearts. The role of atrial natriuretic peptide (ANP in regulation of membrane potentials and Ca(2+ currents has not been investigated in developmental cardiomyocytes. METHODOLOGY/PRINCIPAL FINDINGS: We investigated the role of ANP in regulating L-type Ca(2+ channel current (I(CaL in different developmental stages of cardiomyocytes derived from ES cells. ANP decreased the frequency of action potentials (APs in early developmental stage (EDS cardiomyocytes, embryonic bodies (EB as well as whole embryo hearts. ANP exerted an inhibitory effect on basal I(CaL in about 70% EDS cardiomyocytes tested but only in about 30% late developmental stage (LDS cells. However, after stimulation of I(CaL by isoproterenol (ISO in LDS cells, ANP inhibited the response in about 70% cells. The depression of I(CaL induced by ANP was not affected by either Nomega, Nitro-L-Arginine methyl ester (L-NAME, a nitric oxide synthetase (NOS inhibitor, or KT5823, a cGMP-dependent protein kinase (PKG selective inhibitor, in either EDS and LDS cells; whereas depression of I(CaL by ANP was entirely abolished by erythro-9-(2-Hydroxy-3-nonyl adenine (EHNA, a selective inhibitor of type 2 phosphodiesterase(PDE2 in most cells tested. CONCLUSION/SIGNIFICANCES: Taken together, these results indicate that ANP induced depression of action potentials and I(CaL is due to activation of particulate guanylyl cyclase (GC, cGMP production and cGMP-activation of PDE2 mediated depression of adenosine 3', 5'-cyclic monophophate (cAMP-cAMP-dependent protein kinase (PKA in early cardiomyogenesis.

  14. Useulness of B Natriuretic Peptides and Procalcitonin in Emergency Medicine

    Directory of Open Access Journals (Sweden)

    P. Ray

    2008-01-01

    Full Text Available Congestive heart failure (CHF is the main cause of acute dyspnea in patients presented to an emergency department (ED, and it is associated with high morbidity and mortality. B-type natriuretic peptide (BNP is a polypeptide, released by ventricular myocytes directly proportional to wall tension, for lowering renin-angiotensin-aldosterone activation. For diagnosing CHF, both BNP and the biologically inactive NT-proBNP have similar accuracy. Threshold values are higher in elderly population, and in patients with renal dysfunction. They might have also a prognostic value. Studies demonstrated that the use of BNP or NT-proBNP in dyspneic patients early in the ED reduced the time to discharge, total treatment cost. BNP and NT-proBNP should be available in every ED 24 hours a day, because literature strongly suggests the beneficial impact of an early appropriate diagnosis and treatment in dyspneic patients. Etiologic diagnosis of febrile patients who present to an ED is complex and sometimes difficult. However, new evidence showed that there are interventions (including early appropriate antibiotics, which could reduce mortality rate in patients with sepsis. For diagnosing sepsis, procalcitonin (PCT is more accurate than C-reactive protein. Thus, because of its excellent specificity and positive predictive value, an elevated PCT concentration (higher than 0.5 ng/mL indicates ongoing and potentially severe systemic infection, which needs early antibiotics (e.g. meningitis. In lower respiratory tract infections, CAP or COPD exacerbation, PCT guidance reduced total antibiotic exposure and/or antibiotic treatment duration.

  15. Clinical value of natriuretic peptides in chronic kidney disease.

    Science.gov (United States)

    Santos-Araújo, Carla; Leite-Moreira, Adelino; Pestana, Manuel

    2015-01-01

    According to several lines of evidence, natriuretic peptides (NP) are the main components of a cardiac-renal axis that operate in clinical conditions of decreased cardiac hemodynamic tolerance to regulate sodium homeostasis, blood pressure and vascular function. Even though it is reasonable to assume that NP may exert a relevant role in the adaptive response to renal mass ablation, evidence gathered so far suggest that this contribution is probably complex and dependent on the type and degree of the functional mass loss. In the last years NP have been increasingly used to diagnose, monitor treatment and define the prognosis of several cardiovascular (CV) diseases. However, in many clinical settings, like chronic kidney disease (CKD), the predictive value of these biomarkers has been questioned. In fact, it is now well established that renal function significantly affects the plasmatic levels of NP and that renal failure is the clinical condition associated with the highest plasmatic levels of these peptides. The complexity of the relation between NP plasmatic levels and CV and renal functions has obvious consequences, as it may limit the predictive value of NP in CV assessment of CKD patients and be a demanding exercise for clinicians involved in the daily management of these patients. This review describes the role of NP in the regulatory response to renal function loss and addresses the main factors involved in the clinical valorization of the peptides in the context of significant renal failure. Copyright © 2015 The Authors. Published by Elsevier España, S.L.U. All rights reserved.

  16. Inhibition of natriuretic factors increases blood pressure in rats.

    Science.gov (United States)

    Banday, Anees Ahmad; Lokhandwala, Mustafa F

    2009-08-01

    Renal dopamine and nitric oxide contribute to natriuresis during high-salt intake which maintains sodium and blood pressure homeostasis. We wanted to determine whether concurrent inhibition of these natriuretic factors increases blood pressure during high-sodium intake. Male Sprague-Dawley rats were divided into the following groups: 1) vehicle (V)-tap water, 2) NaCl-1% NaCl drinking water, 3) 30 mM l-buthionine sulfoximine (BSO), an oxidant, 4) BSO plus NaCl, and 5) BSO plus NaCl with 1 mM tempol (antioxidant). Compared with V, NaCl intake for 10 days doubled sodium intake and increased urinary dopamine level but reduced urinary nitric oxide content. NaCl intake also reduced basal renal proximal tubular Na-K-ATPase activity with no effect on blood pressure. However, NaCl intake in BSO-treated rats failed to reduce basal Na-K-ATPase activity despite higher urinary dopamine levels. Also, dopamine failed to inhibit proximal tubular Na-K-ATPase activity and these rats exhibited reduced urinary nitric oxide levels and high blood pressure. Tempol supplementation in NaCl plus BSO-treated rats reduced blood pressure. BSO treatment alone did not affect the urinary nitric oxide and dopamine levels or blood pressure. However, dopamine failed to inhibit proximal tubular Na-K-ATPase activity in BSO-treated rats. BSO treatment also increased basal protein kinase C activity, D1 receptor serine phosphorylation, and oxidative markers like malondialdehyde and 8-isoprostane. We suggest that NaCl-mediated reduction in nitric oxide does not increase blood pressure due to activation of D1 receptor signaling. Conversely, oxidative stress-provoked inhibition of D1 receptor signaling fails to elevate blood pressure due to presence of normal nitric oxide. However, simultaneously decreasing nitric oxide levels with NaCl and inhibiting D1 receptor signaling with BSO elevated blood pressure.

  17. C-Type Natriuretic Peptide Analog as Therapy for Achondroplasia.

    Science.gov (United States)

    Legeai-Mallet, Laurence

    2016-01-01

    Fibroblast growth factor receptor 3 (FGFR3) is an important regulator of bone formation. Gain-of-function mutations in the FGFR3 gene result in chondrodysplasias which include achondroplasia (ACH), the most common form of dwarfism, in which skull, appendicular and axial skeletons are affected. The skeletal phenotype of patients with ACH showed defective proliferation and differentiation of the chondrocytes in the growth plate cartilage. Both endochondral and membranous ossification processes are disrupted during development. At cellular level, Fgfr3 mutations induce increased phosphorylation of the tyrosine kinase receptor FGFR3, which correlate with an enhanced activation of its downstream signaling pathways. Potential therapeutic strategies have emerged for ACH. Several preclinical studies have been conducted such as the C-type natriuretic peptide (CNP) analog (BMN111), intermittent parathyroid hormone injections, soluble FGFR3 therapy, and meclozine and statin treatments. Among the putative targets to antagonize FGFR3 signaling, CNP (or BMN111) is one of the most promising strategies. BMN111 acts as a key regulator of longitudinal bone growth by downregulating the mitogen-activated protein kinase pathway, which is activated as a result of a FGFR3 gain-of-function mutation. Preclinical studies showed that BMN111 treatment led to a large improvement in skeletal parameters in Fgfr3Y367C/+ mice mimicking ACH. In 2014, a clinical trial (phase 2) of BMN111 in pediatric patients with ACH has started. This first clinical trial marks the first big step towards real treatment for these patients. © 2016 S. Karger AG, Basel.

  18. Atrial natriuretic factor in the acute nephritic and nephrotic syndromes.

    Science.gov (United States)

    Rodríguez-Iturbe, B; Colic, D; Parra, G; Gutkowska, J

    1990-09-01

    Because the role of systemic hormones in the pathophysiology of edema in acute renal disease remains incompletely understood, we compared the levels of atrial natriuretic factor (ANF) and plasma renin activity (PRA) in patients with acute glomerulonephritis (AGN), nephrotic syndrome (NS), and normal individuals during salt deprivation and salt loading. Sixteen patients with AGN (10 males) and nine patients with NS and hypoalbuminemia (7 males) were studied on admission, and after recovery (12 AGN patients) or remission (4 NS patients). Eighteen normal controls were each studied after five days on a low (20 mEq Na/day), regular (120 mEq Na/day) and high (300 mEq Na/day) dietary salt intake. Patients with AGN and NS had comparable edema (AGN 2.8 +/- 0.53 kg; NS 3.36 +/- 0.47 kg; SE) and urinary Na excretion (mean +/- SEM: AGN 0.97 +/- 0.11 mEq/hr; NS 1.06 +/- 0.16 mEq/hr), but AGN patients had five times higher ANF (AGN 27.2 +/- 4.06 fmol/ml; NS 5.51 +/- 1.02 fmol/ml; P less than 0.001) and six times lower PRA ng/liter.sec levels (AGN 0.187 +/- 0.047; NS 1.144 +/- 0.222; P less than 0.001) than NS patients. The degree of edema was correlated with ANF levels in AGN patients (P less than 0.001) but not in NS patients. There was a strong exponential negative correlation (r = -0.773, P less than 0.0001) between ANF and PRA, in which AGN patients and Na-restricted controls were located in the opposite ends of the volume sensing-response, and NS patients in the middle, alongside controls with regular Na intake.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Impaired atrial natriuretic peptide-mediated lipolysis in obesity.

    Science.gov (United States)

    Rydén, M; Bäckdahl, J; Petrus, P; Thorell, A; Gao, H; Coue, M; Langin, D; Moro, C; Arner, P

    2016-04-01

    Catecholamines and natriuretic peptides (NPs) are the only hormones with pronounced lipolytic effects in human white adipose tissue. Although catecholamine-induced lipolysis is well known to be impaired in obesity and insulin resistance, it is not known whether the effect of NPs is also altered. Catecholamine- and atrial NP (ANP)-induced lipolysis was investigated in abdominal subcutaneous adipocytes in vitro and in situ by microdialysis. In a cohort of 122 women, both catecholamine- and ANP-induced lipolysis in vitro was markedly attenuated in obesity (n=87), but normalized after substantial body weight loss (n=52). The impairment of lipolysis differed between the two hormones when expressing lipolysis per lipid weight, the ratio of stimulated over basal (spontaneous) lipolysis rate or per number of adipocytes. Thus, while the response to catecholamines was lower when expressed as the former two measures, it was higher when expressed per cell number, a consequence of the significantly larger fat cell size in obesity. In contrast, although ANP-induced lipolysis was also attenuated when expressed per lipid weight or the ratio stimulated/basal, it was similar between non-obese and obese subjects when expressed per cell number suggesting that the lipolytic effect of ANP may be even more sensitive to the effects of obesity than catecholamines. Obesity was characterized by a decrease in the protein expression of the signaling NP A receptor (NPRA) and a trend toward increased levels of the clearance receptor NPRC. The impairment in ANP-induced lipolysis observed in vitro was corroborated by microdialysis experiments in situ in a smaller cohort of lean and overweight men. ANP- and catecholamine-induced lipolysis is reversibly attenuated in obesity. The pro-lipolytic effects of ANP are relatively more impaired compared with that of catecholamines, which may in part be due to specific changes in NP receptor expression.

  20. Caffeine-induced diuresis and atrial natriuretic peptides.

    Science.gov (United States)

    Nussberger, J; Mooser, V; Maridor, G; Juillerat, L; Waeber, B; Brunner, H R

    1990-05-01

    After a single-blind, randomized, cross-over protocol using decaffeinated coffee in a control experiment, the effect of an oral 250-mg caffeine dose on plasma immunoreactive atrial natriuretic peptide (ANF) was assessed in eight healthy students who had been on a methylxanthine-free diet for 1 week. One to 2 h after caffeine ingestion, both systolic blood pressure (SBP) and diastolic BP (DBP) increased by 12 mm Hg while heart rate (HR) also tended to increase. An increase in diuresis and in urinary sodium, potassium, and osmol excretion was observed within 1 h. Decaffeinated coffee induced no change in any of these parameters. Plasma epinephrine (EPI) increased gradually from 16.6 +/- 3.2 pg/ml (mean +/- SEM) to 45.1 +/- 7.9 pg/ml within 2 h after caffeine ingestion, but did not change after decaffeinated coffee (p less than 0.001). Plasma norepinephrine (NE), renin activity (PRA), aldosterone, and vasopressin remained unchanged. Plasma ANF was measured by radioimmunoassay (RIA) using an extremely sensitive antiserum (Kd = 10(-12) M) after rapid and virtually complete (90-103%) extraction from plasma. In 0.2 ml plasma, the theoretical detection limit is 1.1 fmol/ml. Normal plasma ANF concentrations in supine subjects were 17.9 +/- 8.1 fmol/ml (mean +/- SD) and 11.0 +/- 3.3 fmol/ml in subjects in the upright position. Plasma ANF levels were not affected by coffee drinking. In conclusion, by using a new and sensitive assay for plasma ANF, we did not find that caffeine-induced diuresis is mediated by ANF.

  1. Clinical Applications of Natriuretic Peptides in Assessment of Valvular Heart Disease.

    Science.gov (United States)

    Sharma, Abhishek; Ahmed, Vaseem; Garg, Aakash; Aggarwal, Chirag

    2015-01-01

    Biomarkers such as natriuretic peptides (NPs) have evolving clinical utility beyond the scope of heart failure. The role of NPs in the management of valvular heart disease is a growing area of investigation. NPs have much potential in the assessment of asymptomatic patients with hemodynamically significant valvular lesions who have traditionally been excluded from consideration of surgical intervention. NPs also have a role in the risk stratification of these patients as well as in routine surveillance and monitoring. Together with echocardiographic data and functional status, NPs are being incorporated into the management of valvular heart disease. In this review we examine the evidence for the role of natriuretic peptides in assessment of VHD.

  2. Atrial natriuretic peptide signal pathway upregulated in stomach of streptozotocin-induced diabetic mice

    Institute of Scientific and Technical Information of China (English)

    Young-Chul; Kim

    2010-01-01

    AIM:To investigate atrial natriuretic peptide(ANP) secretion from gastric mucosa and the relationship between the ANP/natriuretic peptide receptor type A (NPR-A)pathway and diabetic gastroparesis. METHODS:Male imprinting control region(ICR)mice (4 wk old)were divided into two groups:control mice, and streptozotocin-induced diabetic mice.Eight weeks after injection,spontaneous gastric contraction was recorded by using physiography in control and streptozotocin-induced diabetic mice.The ANP-positive cells in ...

  3. Processing-independent analysis for pro-C-type natriuretic peptide

    DEFF Research Database (Denmark)

    Lippert, Solvej Kølvraa; Rehfeld, Jens F.; Gøtze, Jens Peter

    2010-01-01

    C-type natriuretic peptide (CNP) is expressed in several human tissues. We designed a specific processing-independent assay for proCNP-derived products and quantitated the concentrations in human seminal plasma from normal and vasectomized men. Antibodies were raised against the N-terminus of human...

  4. Impact of hemoglobin on plasma pro-B-type natriuretic peptide concentrations in the general population

    DEFF Research Database (Denmark)

    Nybo, Mads; Benn, Marianne; Mogelvang, Rasmus

    2007-01-01

    Age, sex, and renal function contribute to variations in plasma concentrations of B-type natriuretic peptide (BNP) and its molecular precursor (proBNP). Recent studies indicate that anemia may also affect proBNP concentrations in patients with heart failure or stroke. However, the impact...

  5. Renal effects of urodilatin and atrial natriuretic peptide in volume expanded conscious dogs

    DEFF Research Database (Denmark)

    Bestle, M H; Bie, P

    1993-01-01

    The renal effects of urodilatin and atrial natriuretic peptide (ANP) were examined in conscious dogs during acute volume expansion maintained through independent infusions of water and NaCl. Peptide was infused in a step-up fashion, in 40-min periods at rates of 2.5, 12.5 and 50.0 ng kg-1 min-1 (...

  6. Elevated glucose concentration and natriuretic peptides receptor response on vascular smooth muscle of spontaneously hypertensive rats.

    Science.gov (United States)

    Yasunari, K; Kohno, M; Kano, H; Hanehira, T; Minami, M; Ikeda, M; Horio, T; Yokokawa, K; Takeda, T

    1995-12-01

    1. Hyperglycaemia is believed to be a major cause of diabetic vascular complications such as accelerated atherosclerosis. In order to elucidate the effect of hyperglycaemia on vascular response in spontaneously hypertensive rats (SHR), the natriuretic peptides receptor responses to vascular smooth muscle cells (VSMC) which are thought to suppress atherosclerosis were studied under high glucose (HG:22.2 mmol/L) conditions. 2. The total number of cells in SHR is higher and natriuretic peptides receptor response is smaller than that of cells in the Wistar-Kyoto (WKY) rat. Membrane bound protein kinase C (PKC) activity in HG or SHR is higher compared to that of cells in normal glucose (NG:5.6 mmol/L) or WKY. Cells cultured in HG for at least 2 passages had higher total cell number and receptor mediated cGMP formation were suppressed compared to cells cultured in NG both in SHR and WKY. Specific PKC inhibitor PKC (19-36) 1 mu mol/L prevented HG induced suppression of natriuretic peptides response. 3. These results show that hyperglycaemia may be linked to suppressed natriuretic peptides receptor response which is caused by increased PKC activity both in WKY and SHR. This suppressed response may cause the accelerated atherosclerosis by hyperglycaemia.

  7. Relative Atrial Natriuretic Peptide Deficiency and Inadequate Renin and Angiotensin II Suppression in Obese Hypertensive Men

    DEFF Research Database (Denmark)

    Asferg, Camilla L; Nielsen, Søren J; Andersen, Ulrik B

    2013-01-01

    Obesity is a strong risk factor for hypertension, but the mechanisms by which obesity leads to hypertension are incompletely understood. On this background, we assessed dietary sodium intake, serum levels of natriuretic peptides (NPs), and the activity of the renin-angiotensin system in 63 obese...

  8. Responses of Plasma Atrial Natriuretic Peptide to High Intensity Submaximal Exercise in the Heat,

    Science.gov (United States)

    1987-06-01

    Natriuretic Peptide to LnHigh Intensity Submaximal Exercise in the Heat 0 " William J. Kraemer. Lawrence E. Armstrong, Roger W. Hubbard. :I[_] Louis J...atriopeptins in rat adrenal cells. Cir Res 57: 113-118. f V-0C -- V- - IF -I 7 - % 7 -. 17 Chartier L. Schiffrin EL. Thibault G (1984). Effects of atrial

  9. EFFECT OF ELECTROACUPUNCTURE ON PLASMA ANGIOTENSIN-ALDOSTERONE AND ATRIAL NATRIURETIC POLYPEPTIDE IN RABBITS WITH ACUTE CEREBRAL INFARCTION

    Institute of Scientific and Technical Information of China (English)

    吴绪平; 王述菊; 刘玲; 周华

    2004-01-01

    Objective: To observe the therapeutic effect of electroacupuncture (EA) on plasma angiotensin (Ang*.Ⅱ), aldosterone (ALD) and atrial natriuretic polypeptide (ANP) contents in experimental cerebral infarction rabbits for analyzing the underlying mechanism of acupuncture in ameliorating blood supply of the brain tissue. Methods: A total of 80 rabbits were randomized into control (n=8), pseudo-operation (n=24), model (n=24) and EA (n=24) groups. Cerebral infarction model was established by infusion of self-thrombus into the carotid artery. EA (1 mA, 2 Hz) was applied to "Baihui"(百会GV 20) and "Shuigou"(水沟GV 26) for 30 min, once every 12 hours. Plasma Ang-II, ALD and ANP contents were detected with radioimmunoassay method. In the later 3 groups, blood samples were taken at 6 h, 24 h and 48 h after cerebral ischemia. Results: Compared with control and pseudo-operation groups, Ang-II and ALD contents of model group at 6 h, 24 h and 48 h after cerebral ischemia increased significantly while plasma ANP of the 3 time-courses of model group decreased considerably (P<0.01). In comparison with model group, results showed that Ang-II and ALD contents of EA group decreased significantly whereas ANP level of EA group increased strikingly (P<0.01). Conclusion: Electroacupuncture has the effects of raising plasma ANP level and lowering plasma Ang-II and ALD in cerebral infarction rabbits.

  10. Intracerebroventricular administration of C-type natriuretic peptide suppresses food intake via activation of the melanocortin system in mice.

    Science.gov (United States)

    Yamada-Goto, Nobuko; Katsuura, Goro; Ebihara, Ken; Inuzuka, Megumi; Ochi, Yukari; Yamashita, Yui; Kusakabe, Toru; Yasoda, Akihiro; Satoh-Asahara, Noriko; Ariyasu, Hiroyuki; Hosoda, Kiminori; Nakao, Kazuwa

    2013-05-01

    C-type natriuretic peptide (CNP) and its receptor are abundantly distributed in the brain, especially in the arcuate nucleus (ARC) of the hypothalamus associated with regulating energy homeostasis. To elucidate the possible involvement of CNP in energy regulation, we examined the effects of intracerebroventricular administration of CNP on food intake in mice. The intracerebroventricular administration of CNP-22 and CNP-53 significantly suppressed food intake on 4-h refeeding after 48-h fasting. Next, intracerebroventricular administration of CNP-22 and CNP-53 significantly decreased nocturnal food intake. The increment of food intake induced by neuropeptide Y and ghrelin was markedly suppressed by intracerebroventricular administration of CNP-22 and CNP-53. When SHU9119, an antagonist for melanocortin-3 and melanocortin-4 receptors, was coadministered with CNP-53, the suppressive effect of CNP-53 on refeeding after 48-h fasting was significantly attenuated by SHU9119. Immunohistochemical analysis revealed that intracerebroventricular administration of CNP-53 markedly increased the number of c-Fos-positive cells in the ARC, paraventricular nucleus, dorsomedial hypothalamus, ventromedial hypothalamic nucleus, and lateral hypothalamus. In particular, c-Fos-positive cells in the ARC after intracerebroventricular administration of CNP-53 were coexpressed with α-melanocyte-stimulating hormone immunoreactivity. These results indicated that intracerebroventricular administration of CNP induces an anorexigenic action, in part, via activation of the melanocortin system.

  11. The role of n terminal - probrain natriuretic peptide in the diagnosis of hemodynamic persistent asrteriosus ductus in premature neonates patient

    Science.gov (United States)

    Dasraf, D.; Djer, M. M.; Advani, N.

    2017-08-01

    Persistent ductus arteriosus is one of the most frequent congenital heart diseases found in infants, mainly in preterms. Echocardiography is the gold standard for the diagnosis of hemodynamically significant patent ductus arteriosus (hs-PDA) in preterm neonates. A few studies have suggested that the use of a simple blood assay to detect N-terminal pro-brain natriuretic peptide (NT-proBNP) may be useful in determining the diagnosis and management of hs-PDA. No such studies have been conducted in Indonesia, although the assay kit and characteristics of the patient (gestational age and chronological age) influence the accuracy of NT-proBNP levels in determining hs-PDA. The aim of this study was to determine the association between the NT-proBNP level and the prevalence of hs-PDA in an Indonesian patient population. A cross-sectional study was conducted at Dr. Cipto Mangunkusumo Hospital. PDA was determined using echocardiography in 49 preterm neonates (gestational age <37 weeks and birthweight <2000 g). Subsequently, these patients were divided into three groups: non-PDA, non-hsPDA, and hs-PDA. The blood NT-proBNP level was then determined in the non-hsPDA and hs-PDA groups, and between-group differences were compared. Among the 49 neonates, 33 patients had PDA, and 16 of these had hs-PDA. The results revealed a significant association between the NT-proBNP level and hs-PDA (p < 0.001).

  12. Changes of adrenomedullin and natriuretic peptides in patients with adrenal medullary hyperplasia prior to and following pharmacological therapy and adrenalectomy

    Science.gov (United States)

    Zhou, Pang-Hu; Shi, Lei; Hu, Wei; Zhang, Xiao-Bin; Wang, Wei; Zhang, Li-Jun

    2016-01-01

    The aim of the present study was to investigate the pathophysiological functions of adrenomedullin (ADM), atrial and brain natriuretic peptides (ANP and BNP) in patients with adrenal medullary hyperplasia (AMH). Plasma ADM, ANP and BNP concentrations were measured in 20 patients with AMH, 35 patients with essential hypertension (EH), and 40 healthy control subjects. Following effective antihypertensive therapy, the values in AMH and EH patients were measured again and laparoscopic adrenalectomy was performed for AMH patients. At 2 weeks after surgery, the three peptides were measured again. The AMH patients had higher plasma concentrations of ADM, ANP and BNP compared with the EH and control subjects. There were significant differences in the values of ADM, ANP and BNP between adrenal vein and inferior vena cava and between AMH and contralateral adrenal vein. Plasma ADM concentration was correlated with serum epinephrine and norepinephrine and urine vanillylmandelic acid, in addition to systolic and diastolic blood pressure, left ventricular ejection fraction, left ventricular mass index and ANP and BNP values in the AMH group. Following antihypertensive treatment, ADM, ANP and BNP were significantly decreased in EH patients, but remained unchanged in AMH subjects. However, these concentrations significantly decreased following surgery. Therefore, the present results suggest that ADM, ANP and BNP may be involved in regulating adrenal medulla functions. PMID:27446289

  13. Hyponatremia in acute brain disease: the cerebral salt wasting syndrome.

    Science.gov (United States)

    Betjes, Michiel G.H.

    2002-02-01

    Hyponatremia in acute brain disease is a common occurrence, especially after an aneurysmal subarachnoid hemorrhage. Originally, excessive natriuresis, called cerebral salt wasting, and later the syndrome of inappropriate antidiuretic hormone secretion (SIADH), were considered to be the causes of hyponatremia. In recent years, it has become clear that most of these patients are volume-depleted and have a negative sodium balance, consistent with the original description of cerebral salt wasting. Elevated plasma concentrations of atrial or brain natriuretic peptide have been identified as the putative natriuretic factor. Hyponatremia and volume depletion may aggravate neurological symptoms, and timely treatment with adequate replacement of water and NaCl is essential. The use of fludrocortisone to increase sodium reabsorption by the renal tubules may be an alternative approach.

  14. Cardiac natriuretic peptide gene expression and plasma concentrations during the first 72 hours of life in piglets

    DEFF Research Database (Denmark)

    Smith, Julie; Christoffersen, Christina; Nørgaard, Linn Maiken

    2013-01-01

    Plasma measurement of cardiac natriuretic peptides constitutes promising markers of congenital heart disease. However, concentrations change rapidly and dramatically during the first days after delivery even in healthy neonates, which complicates clinical interpretation. It is unknown whether...

  15. Prognostic value of plasma brain natriuretic peptide in patients with stable chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ahmed E. Mansour

    2012-10-01

    Conclusions: Plasma BNP levels increased significantly with disease severity, progression of chronic respiratory failure, and secondary pulmonary hypertension in patients with stable COPD. These results suggest that plasma BNP can be a useful prognostic marker to monitor COPD progression and identify cases of secondary pulmonary hypertension in patients with stable COPD.

  16. Probable role of Brain Natriuretic Peptide (BNP in lung hypertension secondary to scleroderma

    Directory of Open Access Journals (Sweden)

    P. Faggioli

    2013-05-01

    Full Text Available BACKGROUND Scleroderma, when complicated with pulmonary hypertension (PHT, presents a worse prognosis; recently treatment with new drugs seems to offer good perspectives, especially in early diagnosis and treatment. The standard approach for diagnosing PHT consists in measurement of the pulmonary artery pressure (PAP by means of echodoppler. AIM OF INVESTIGATION Aim of this work is evaluating the significance of the NT-proBNP parameter, matched to echodoppler, in diagnosing scleroderma PHT. MATERIALS AND METHODS Sixty (60 patients, who came to observation for progressive systemic sclerosis underwent echodoppler in order to measure the PAP (normal values up to 30 mmHg. NT-proBNP was determined on serum sample using ECLIA method by Modular E170 (Roche Diagnostics; manufacturer reference values for age and gender were used. Forty-three (43 patients underwent a further NT-proBNP sampling 5 days later in order to assess parameter stability. RESULTS PHT and non- PHT patients showed statistically different (p < 0,001 medians (126 vs 69 pg/ml. No pathologic values of NT-proBNP were measured in the group with PAP < 30 mmHg, while 27% of cases who had PAP between 30 and 40 showed pathologic concentrations. The positivity ratio increases to 57% in patients showing PAP > 40 mmHg. No relevant correlation (r = 0,2 was found between PAP and NT-proBNP. Mean average between the two sampling groups was 31%. CONCLUSIONS In scleroderma patients, combination of NT-proBNP and PAP seems to improve the diagnosis of pulmonary hypertension, especially in presence of borderline pulmonary pressure values. We therefore propose the biochemical observation of NT-proBNP when PAP is > 30 mmHg and in monitoring the evolution of the pathology.

  17. Amino-terminal pro-brain natriuretic peptide in children with latent rheumatic heart disease

    Directory of Open Access Journals (Sweden)

    Justin P Zachariah

    2016-01-01

    Conclusion: Serum NT-proBNP did not distinguish between latent RHD cases and the controls. Sex and within-family exposures may confound this result. More investigation into biomarker-based RHD detection is warranted.

  18. Association between psychological measures and brain natriuretic peptide in heart failure patients

    DEFF Research Database (Denmark)

    Brouwers, Corline; Spindler, Helle; Larsen, Mogens Lytken

    2012-01-01

    psychological markers using a prospective study design with repeated NT-proBNP measurements. Design: The sample comprised 94 outpatients with systolic HF (80% men; mean age=62.2±9.32). The psychological markers (i.e., anxiety, depression and Type D personality), assessed with the Hospital Anxiety and Depression...... these findings and examine whether psychological risk markers are independent predictors of prognosis in HF or an artifact that may be attributed to other biological or behavioral mechanisms....

  19. Serial measurements of N-terminal pro-brain natriuretic peptide after acute ischemic stroke

    DEFF Research Database (Denmark)

    Jensen, J K; Mickley, H; Bak, S;

    2006-01-01

    consecutive patients with acute ischemic stroke. RESULTS: NT-proBNP peaked the day after onset of symptoms (p = 0.007) followed by a decrease until day 5 (p = 0.001, ANOVA). At 6-month follow-up the difference in the level of NT-proBNP was unchanged compared to day 5 (p = 0.42). NT-proBNP levels > or =615 pg...

  20. Correlation of hyponatremia with plasma renin activity, antidiuretic hormone and brain natri- uretic peptide in chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    富路

    2006-01-01

    Objective To observe the changes of plasma renin activity, antidiuretic hormone and brain natriuretic peptide in chronic heart failure (CHF) and their correlation with hyponatremia. Methods Plasma levels of PRA, ADH, and BNP were measured by radioimmunology in 76 CHF patients. Forty-one out of 76 CHF patients with hyponatremia and 35 CHF patients without hyponatremia

  1. Natriuretic peptides stimulate the cardiac sodium pump via NPR-C-coupled NOS activation

    DEFF Research Database (Denmark)

    William, M.; Hamilton, E.J.; Garcia, A.;

    2008-01-01

    ) regulates the pump. We voltage clamped rabbit ventricular myocytes and identified electrogenic Na(+)-K(+) pump current (arising from the 3:2 Na(+):K(+) exchange and normalized for membrane capacitance) as the shift in membrane current induced by 100 micromol/l ouabain. Ten nanomoles per liter ANP stimulated......Natriuretic peptides (NPs) and their receptors (NPRs) are expressed in the heart, but their effects on myocyte function are poorly understood. Because NPRs are coupled to synthesis of cGMP, an activator of the sarcolemmal Na(+)-K(+) pump, we examined whether atrial natriuretic peptide (ANP...... the Na(+)-K(+) pump when the intracellular compartment was perfused with pipette solutions containing 10 mmol/l Na(+) but had no effect when the pump was at near maximal activation with 80 mmol/l Na(+) in the pipette solution. Stimulation was abolished by inhibition of cGMP-activated protein kinase...

  2. Diurnal gene expression of lipolytic natriuretic peptide receptors in white adipose tissue

    DEFF Research Database (Denmark)

    Smith, Julie; Fahrenkrug, Jan; Jørgensen, Henrik L

    2015-01-01

    Disruption of the circadian rhythm can lead to obesity and cardiovascular disease. In white adipose tissue, activation of the natriuretic peptide receptors (NPRs) stimulates lipolysis. We have previously shown that natriuretic peptides are expressed in a circadian manner in the heart......, but the temporal expression profile of their cognate receptors has not been examined in white adipose tissue. We therefore collected peri-renal white adipose tissue and serum from WT mice. Tissue mRNA contents of NPRs - NPR-A and NPR-C, the clock genes Per1 and Bmal1, and transcripts involved in lipid metabolism...... in serum peaked in the active dark period (P=0.003). In conclusion, NPR-A and NPR-C gene expression is associated with the expression of clock genes in white adipose tissue. The reciprocal expression may thus contribute to regulate lipolysis and energy homeostasis in a diurnal manner....

  3. Clinical Applications of Natriuretic Peptides in Assessment of Valvular Heart Disease

    Directory of Open Access Journals (Sweden)

    Abhishek Sharma

    2015-01-01

    Full Text Available Biomarkers such as natriuretic peptides (NPs have evolving clinical utility beyond the scope of heart failure. The role of NPs in the management of valvular heart disease is a growing area of investigation. NPs have much potential in the assessment of asymptomatic patients with hemodynamically significant valvular lesions who have traditionally been excluded from consideration of surgical intervention. NPs also have a role in the risk stratification of these patients as well as in routine surveillance and monitoring. Together with echocardiographic data and functional status, NPs are being incorporated into the management of valvular heart disease. In this review we examine the evidence for the role of natriuretic peptides in assessment of VHD.

  4. Quantitative proteome changes in Arabidopsis thaliana suspension-cultured cells in response to plant natriuretic peptides

    KAUST Repository

    Turek, Ilona

    2015-06-30

    Proteome changes in the Arabidopsis thaliana suspension cells in response to the A. thaliana plant natriuretic peptide (PNP), AtPNP-A (At2g18660) were assessed using quantitative proteomics employing tandem mass tag (TMT) labeling and tandem mass spectrometry (LC–MS/MS). In this study, we characterized temporal responses of suspension-cultured cells to 1 nM and 10 pM AtPNP-A at 0, 10 and 30 min post-treatment. Both concentrations we found to yield a distinct differential proteome signature. The data shown in this article are associated with the article “Plant natriuretic peptides induce a specific set of proteins diagnostic for an adaptive response to abiotic stress” by Turek et al. (Front. Plant Sci. 5 (2014) 661) and have been deposited to the ProteomeXchange with identifier PXD001386.

  5. Plasma concentration of atrial natriuretic peptide in normal pregnant women and in pregnant women with preeclampsia

    DEFF Research Database (Denmark)

    Mikkelsen, A L; Schütten, G; Asping, U;

    1991-01-01

    Plasma concentration of atrial natriuretic peptide (ANP) was determined in pregnant women with preeclampsia, in normal pregnant and in nonpregnant women by a specific radioimmunoassay. Results did not show important differences between nonpregnant controls and normal pregnant women, but a signifi......Plasma concentration of atrial natriuretic peptide (ANP) was determined in pregnant women with preeclampsia, in normal pregnant and in nonpregnant women by a specific radioimmunoassay. Results did not show important differences between nonpregnant controls and normal pregnant women......, but a significant rise was seen in women with preeclampsia compared to nonpregnant controls. Marked interindividual variation was found in all three groups. The mechanism of ANP release may differ between those women with normal pregnancy and those with preeclampsia. It is unclear whether the increased level of ANP...... in preeclampsia is an effect or a cause of the disease....

  6. Cardiac natriuretic peptides in plasma increase after dietary induced weight loss in obesity

    DEFF Research Database (Denmark)

    Kistorp, Caroline Michaela Nervil; Bliddal, Henning; Gøtze, Jens P.

    2014-01-01

    BACKGROUND: Cardiac natriuretic peptides are established biomarkers in heart disease, but are also affected by body mass index (BMI). The purpose of the present study was to examine the impact of weight loss and changes in body composition following dietary intervention on plasma concentrations...... of the prohormones to A- and B-type natriuretic peptides (proANP and proBNP) and adrenomedullin (proADM). RESULTS: A total of 52 healthy obese subjects, 47 women and 5 men (BMI 36.5 ± 5.6 kg/m(2)) were randomised to either an intensive weight reduction programme using a combination of very low calorie diet (810 kcal...... pmol/L; P weight loss of 6% (P

  7. Atrial natriuretic factor inhibits mitogen-induced growth in aortic smooth muscle cells.

    Science.gov (United States)

    Baldini, P M; De Vito, P; Fraziano, M; Mattioli, P; Luly, P; Di Nardo, P

    2002-10-01

    Atrial natriuretic factor (ANF) is a polypeptide able to affect cardiovascular homeostasis exhibiting diuretic, natriuretic, and vasorelaxant activities. ANF shows antimitogenic effects in different cell types acting through R(2) receptor. Excessive proliferation of smooth muscle cells is a common phenomenon in diseases such as atherosclerosis, but the role of growth factors in the mechanism which modulate this process has yet to be clarified. The potential antimitogenic role of ANF on the cell growth induced by growth factors appears very intriguing. Aim of the present study was to investigate the possible involvement of ANF on rat aortic smooth muscle (RASM) cells proliferation induced by known mitogens and the mechanism involved. Our data show that ANF, at physiological concentration range, inhibits RASM cell proliferation induced by known mitogens such as PDGF and insulin, and the effect seems to be elicited through the modulation of phosphatidic acid (PA) production and MAP kinases involvement.

  8. Serum proatrial natriuretic peptide does not increase with higher systolic blood pressure in obese men

    DEFF Research Database (Denmark)

    Asferg, Camilla L; Andersen, Ulrik B; Linneberg, Allan;

    2017-01-01

    OBJECTIVE: Obese persons have low circulating natriuretic peptide (NP) concentrations. It has been proposed that this 'natriuretic handicap' could play a role in obesity-related hypertension. The normal physiological response of the NP system to an increase in blood pressure (BP) is an increase...... vs 149.0±7.7 mm Hg in fourth quartile, pnegatively associated with systolic ABP (ß=-0.32, p=0.004) and with diastolic ABP (ß=-0.45, p...: Contrary to known physiological BP responses, MR-proANP was negatively associated with ABP in our study. This suggests that a low amount of circulating NPs could play a role in the early stage of obesity-related hypertension....

  9. Natriuretic peptide type C induces sperm attraction for fertilization in mouse

    Science.gov (United States)

    Kong, Nana; Xu, Xiaoting; Zhang, Yu; Wang, Yakun; Hao, Xiaoqiong; Zhao, Yu; Qiao, Jie; Xia, Guoliang; Zhang, Meijia

    2017-01-01

    Mammalian spermatozoa undergo selective movement along the isthmus of the oviduct to the ampulla during ovulation, which is a prerequisite for fertilization. The factor(s) that involves in selective spermatozoa movement is still unknown. In this study, we found that the oviductal epithelium in mouse ampulla expressed high levels of natriuretic peptide type C (NPPC) in the presence of ovulated oocyte-cumulus complexes (OCCs). Spermatozoa expressed NPPC receptor natriuretic peptide receptor 2 (NPR2, a guanylyl cyclase) on the midpiece of flagellum. NPPC increased intracellular levels of cGMP and Ca2+ of spermatozoa, and induced sperm accumulation in the capillary by attraction. Importantly, spermatozoa from Npr2 mutant mice were not attracted by NPPC, preventing fertilization in vivo. Oocyte-derived paracrine factors promoted the expression of Nppc mRNA in the ampulla. Therefore, NPPC secreted by oviductal ampulla attracts spermatozoa towards oocytes, which is essential for fertilization. PMID:28054671

  10. Plasma atrial natriuretic peptide after the Fontan procedure and total cavopulmonary connexion.

    Science.gov (United States)

    Burch, M; Shinebourne, E A; Rigby, M L; Carter, N; Jeffery, S; Stanley, P; Smith, A

    1990-05-01

    Plasma atrial natriuretic peptide was measured in 10 children undergoing the Fontan procedure and 3 children undergoing total cavopulmonary connexion. There was no significant difference in pre-operative plasma levels, but post-operative levels were significantly higher 48 hours after cardiopulmonary bypass in the Fontan group. There was no significant difference in plasma arginine vasopressin levels either pre- or post-operatively. Post-operative pleural effusions occurred in only 2 of the 10 patients undergoing the Fontan procedure, but were present in all 3 of those undergoing total cavopulmonary connexion. The release of atrial natriuretic peptide is an appropriate homeostatic response to volume loading and the impairment of this response in the early post-operative period may be of clinical importance.

  11. Functional and pharmacological characterization of the natriuretic peptide-dependent lipolytic pathway in human fat cells.

    Science.gov (United States)

    Moro, Cedric; Galitzky, Jean; Sengenes, Coralie; Crampes, François; Lafontan, Max; Berlan, Michel

    2004-03-01

    A lipolytic pathway involving natriuretic peptides has recently been discovered in human fat cells. Its functional characteristics and the interactions of the atrial natriuretic peptide (ANP)-induced effects with adrenergic and insulin pathways were studied. Characterization of the action of ANP antagonists, i.e., A71915, anantin, S-28-Y (Ser-28-Tyr, a synthesized peptide), and HS-142-1 (a microbial polysaccharide), was performed. Lipolytic assays and intracellular cGMP and cAMP determinations were performed on isolated fat cells. Cell membranes were used for binding studies. At low concentrations ANP and isoproterenol [beta-adrenergic receptor (beta-AR) agonist] exerted additive lipolytic effects. The alpha(2)-AR pathway did not interfere with that of ANP. Lipolytic effects of ANP were unaltered by a 2-h pretreatment of fat cells with insulin, whereas beta-AR-induced lipolysis was reduced. Homologous desensitization occurred for ANP-dependent lipolytic pathways. Dendroapsis natriuretic peptide exhibited a similar maximal effect but a 10-fold higher lipolytic potency than ANP and mini-ANP (the shortest form of ANP). The antagonist A71915 exhibited competitive antagonistic properties with a pA(2) value of 7.51. Anantin displayed noncompetitive antagonism and exerted an inhibitory action on basal and beta-adrenergic receptor-induced lipolytic response. S-28-Y exhibited antagonist potencies toward ANP-induced lipolysis and behaved as a partial lipolytic agonist with a lower pD(2) value (7.4 +/- 0.2) than ANP (9.4 +/- 0.3). HS-142-1 exerted the weakest antagonistic effects. The results demonstrate that ANP-dependent effects do not interfere with beta- and alpha(2)-adrenergic pathways in human fat cells. They are unaffected by insulin pretreatments of fat cells but undergo desensitization. In the search of potent and specific natriuretic peptide receptor-A antagonist, in the human fat cell, A71915 was the only reliable one found.

  12. B-Type Natriuretic Peptide Modulates Ghrelin, Hunger, and Satiety in Healthy Men

    OpenAIRE

    Vila, Greisa; Grimm, Gabriele; Resl, Michael; Heinisch, Birgit; Einwallner, Elisa; Esterbauer, Harald; Dieplinger, Benjamin; Mueller, Thomas; Luger, Anton; Clodi, Martin

    2012-01-01

    Chronic heart failure is accompanied by anorexia and increased release of B-type natriuretic peptide (BNP) from ventricular cardiomyocytes. The pathophysiological mechanisms linking heart failure and appetite regulation remain unknown. In this study, we investigated the impact of intravenous BNP administration on appetite-regulating hormones and subjective ratings of hunger and satiety in 10 healthy volunteers. Participants received in a randomized, placebo-controlled, crossover, single-blind...

  13. The renal effects of atrial natriuretic peptide in man are not attenuated by (+)-sulpiride.

    OpenAIRE

    1989-01-01

    1. Human alpha atrial natriuretic peptide (ANP) was infused intravenously for 1 h in eight healthy salt-replete men on two occasions, with and without pretreatment with (+)-sulpiride. 2. ANP increased sodium excretion and urine flow rate but did not alter blood pressure or plasma renin activity. 3. (+)-sulpiride had no significant effect on baseline creatinine clearance, sodium excretion or urine flow rate and did not alter the increases in these parameters with ANP. 4. It is unlikely that th...

  14. Natriuretic peptide infusion reduces myocardial injury during acute ischemia/reperfusion

    DEFF Research Database (Denmark)

    Kousholt, Birgitte S.; Larsen, Jens Kjærgaard Rolighed; Bisgaard, Line Stattau

    2012-01-01

    in apoptotic changes in the BNP-stimulated cells. Pigs tolerated the BNP and CD-NP (a CNP analogue) infusion well, with a decrease in systemic blood pressure (~15 mmHg) and increased diuresis compared with the controls. Left ventricular pressure decreased in the pigs that received BNP infusion compared...... in the ischemic left ventricular region (Pdiuresis and vasodilation). The results suggest a role for natriuretic peptide therapy...

  15. Structure, signaling mechanism and regulation of the natriuretic peptide receptor guanylate cyclase.

    Energy Technology Data Exchange (ETDEWEB)

    Misono, K. S.; Philo, J. S.; Arakawa, T.; Ogata, C. M.; Qiu, Y.; Ogawa, H.; Young, H. S. (Biosciences Division); (Univ. of Nevada); (Alliance Protein Labs.)

    2011-06-01

    Atrial natriuretic peptide (ANP) and the homologous B-type natriuretic peptide are cardiac hormones that dilate blood vessels and stimulate natriuresis and diuresis, thereby lowering blood pressure and blood volume. ANP and B-type natriuretic peptide counterbalance the actions of the renin-angiotensin-aldosterone and neurohormonal systems, and play a central role in cardiovascular regulation. These activities are mediated by natriuretic peptide receptor-A (NPRA), a single transmembrane segment, guanylyl cyclase (GC)-linked receptor that occurs as a homodimer. Here, we present an overview of the structure, possible chloride-mediated regulation and signaling mechanism of NPRA and other receptor GCs. Earlier, we determined the crystal structures of the NPRA extracellular domain with and without bound ANP. Their structural comparison has revealed a novel ANP-induced rotation mechanism occurring in the juxtamembrane region that apparently triggers transmembrane signal transduction. More recently, the crystal structures of the dimerized catalytic domain of green algae GC Cyg12 and that of cyanobacterium GC Cya2 have been reported. These structures closely resemble that of the adenylyl cyclase catalytic domain, consisting of a C1 and C2 subdomain heterodimer. Adenylyl cyclase is activated by binding of G{sub s}{alpha} to C2 and the ensuing 7{sup o} rotation of C1 around an axis parallel to the central cleft, thereby inducing the heterodimer to adopt a catalytically active conformation. We speculate that, in NPRA, the ANP-induced rotation of the juxtamembrane domains, transmitted across the transmembrane helices, may induce a similar rotation in each of the dimerized GC catalytic domains, leading to the stimulation of the GC catalytic activity.

  16. Natriuretic peptide infusion reduces myocardial injury during acute ischemia/reperfusion

    DEFF Research Database (Denmark)

    Kousholt, Birgitte S.; Larsen, Jens Kjærgaard Rolighed; Bisgaard, Line Stattau

    2012-01-01

    in apoptotic changes in the BNP-stimulated cells. Pigs tolerated the BNP and CD-NP (a CNP analogue) infusion well, with a decrease in systemic blood pressure (∼15 mmHg) and increased diuresis compared with the controls. Left ventricular pressure decreased in the pigs that received BNP infusion compared...... in the ischemic left ventricular region (Pdiuresis and vasodilation). The results suggest a role for natriuretic peptide therapy...

  17. Effect of atrial natriuretic peptide on gonadotropin release in superfused rat pituitary cells.

    OpenAIRE

    Horvath, J; Ertl, T.; Schally, A V

    1986-01-01

    Cardiac atrial muscle cells produce a polypeptide hormone that plays a role in the control of water and electrolyte balance and blood pressure. The circulating form of this hormone is the atrial natriuretic peptide (ANP), which contains 28 amino acids. Various immunohistochemical studies have shown that ANP is present in many areas of the central nervous system, including the median eminence. In our studies, we investigated the effect of ANP in a superfused rat pituitary cell system. When ANP...

  18. Cardiac resynchronization therapy and B-type natriuretic peptide in heart failure

    Institute of Scientific and Technical Information of China (English)

    HUANG De-jia

    2009-01-01

    @@ Cardiac resynchronization therapy (CRT) improves left ventricular function, symptom status, quality of life and reduces hospitalization and mortality in patients with New York Heart Association (NYHA) Class Ⅲ or IV heart failure and intraventricular conduction delay despite optimal medical management.1 B-type natriuretic peptide (BNP) and its amino terminal cleavage equivalent (NT-pro BNP) levels correlate with the severity of heart failure and predict prognosis of heart failure patients.2

  19. Novel mutations in natriuretic peptide receptor-2 gene underlie acromesomelic dysplasia, type maroteaux

    Directory of Open Access Journals (Sweden)

    Khan Saadullah

    2012-06-01

    Full Text Available Abstract Background Natriuretic peptides (NPs are peptide hormones that exert their biological actions by binding to three types of cell surface natriuretic peptide receptors (NPRs. The receptor NPR-B binding C-type natriuretic peptide (CNP acts locally as a paracrine and/or autocrine regulator in a wide variety of tissues. Mutations in the gene NPR2 have been shown to cause acromesomelic dysplasia-type Maroteaux (AMDM, an autosomal recessive skeletal disproportionate dwarfism disorder in humans. Methods In the study, presented here, genotyping of six consanguineous families of Pakistani origin with AMDM was carried out using polymorphic microsatellite markers, which are closely linked to the gene NPR2 on chromosome 9p21-p12. To screen for mutations in the gene NPR2, all of its coding exons and splice junction sites were PCR amplified from genomic DNA of affected and unaffected individuals of the families and sequenced. Results Sequence analysis of the gene NPR2 identified a novel missence mutation (p.T907M in five families, and a splice donor site mutation c.2986 + 2 T > G in the other family. Conclusion We have described two novel mutations in the gene NPR2. The presence of the same mutation (p.T907M and haplotype in five families (A, B, C, D, E is suggestive of a founder effect.

  20. Reduced ability of C-type natriuretic peptide (CNP) to activate natriuretic peptide receptor B (NPR-B) causes dwarfism in lbab−/− mice

    Science.gov (United States)

    Yoder, Andrea R.; Kruse, Andrew C.; Earhart, Cathleen A.; Ohlendorf, Douglas H.; Potter, Lincoln R.

    2015-01-01

    C-type natriuretic peptide (CNP) stimulates endochondrial ossification by activating the transmembrane guanylyl cyclase, natriuretic peptide receptor-B (NPR-B). Recently, a spontaneous autosomal recessive mutation that causes severe dwarfism in mice was identified. The mutant, called long bone abnormality (lbab), contains a single point mutation that converts an arginine to a glycine in a conserved coding region of the CNP gene, but how this mutation affects CNP activity has not been reported. Here, we determined that thirty to greater than one hundred-fold more CNPlbab was required to activate NPR-B as compared to wild-type CNP in whole cell cGMP elevation and membrane guanylyl cyclase assays. The reduced ability of CNPlbab to activate NPR-B was explained, at least in part, by decreased binding since ten-fold more CNPlbab than wild-type CNP was required to compete with [125I][Tyr0]CNP for receptor binding. Molecular modeling suggested that the conserved arginine is critical for binding to an equally conserved acidic pocket in NPR-B. These results indicate that reduced binding to and activation of NPR-B causes dwarfism in lbab−/− mice. PMID:18554750

  1. Urinary responses to acute moxonidine are inhibited by natriuretic peptide receptor antagonist.

    Science.gov (United States)

    El-Ayoubi, Rouwayda; Menaouar, Ahmed; Gutkowska, Jolanta; Mukaddam-Daher, Suhayla

    2005-05-01

    We have previously shown that acute intravenous injections of moxonidine and clonidine increase plasma atrial natriuretic peptide (ANP), a vasodilator, diuretic and natriuretic hormone. We hypothesized that moxonidine stimulates the release of ANP, which would act on its renal receptors to cause diuresis and natriuresis, and these effects may be altered in hypertension. Moxonidine (0, 10, 50, 100 or 150 microg in 300 microl saline) and clonidine (0, 1, 5 or 10 microg in 300 microl saline) injected intravenously in conscious normally hydrated normotensive Sprague-Dawley rats (SD, approximately 200 g) and 12-14-week-old Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR) dose-dependently stimulated diuresis, natriuresis, kaliuresis and cGMP excretion, with these effects being more pronounced during the first hour post-injection. The actions of 5 microg clonidine and 50 microg moxonidine were inhibited by yohimbine, an alpha2-adrenoceptor antagonist, and efaroxan, an imidazoline I1-receptor antagonist. Moxonidine (100 microg) stimulated (P<0.01) diuresis in SHR (0.21+/-0.04 vs 1.16+/-0.06 ml h(-1) 100 g(-1)), SD (0.42+/-0.06 vs 1.56+/-0.19 ml h(-1) 100 g(-1)) and WKY (0.12+/-0.04 vs 1.44+/-0.21 ml h(-1) 100 g(-1)). Moxonidine-stimulated urine output was lower in SHR than in SD and WKY. Moxonidine-stimulated sodium and potassium excretions were lower in SHR than in SD, but not WKY, demonstrating an influence of strain but not of pressure. Pretreatment with the natriuretic peptide antagonist anantin (5 or 10 microg) resulted in dose-dependent inhibition of moxonidine-stimulated urinary actions. Anantin (10 microg) inhibited (P<0.01) urine output to 0.38+/-0.06, 0.12+/-0.01, and 0.16+/-0.04 ml h(-1) 100 g(-1) in SD, WKY, and SHR, respectively. Moxonidine increased (P<0.01) plasma ANP in SD (417+/-58 vs 1021+/-112 pg ml(-1)) and WKY (309+/-59 vs 1433+/-187 pg ml(-1)), and in SHR (853+/-96 vs 1879+/-229 pg ml(-1)). These results demonstrate that natriuretic

  2. The effects of exercise training and caloric restriction on the cardiac oxytocin natriuretic peptide system in the diabetic mouse

    Science.gov (United States)

    Broderick, Tom L; Jankowski, Marek; Gutkowska, Jolanta

    2017-01-01

    Background Regular exercise training (ET) and caloric restriction (CR) are the frontline strategies in the treatment of type 2 diabetes mellitus with the aim at reducing cardiometabolic risk. ET and CR improve body weight and glycemic control, and experimental studies indicate that these paradigms afford cardioprotection. In this study, the effects of combined ET and CR on the cardioprotective oxytocin (OT)–natriuretic peptide (NP) system were determined in the db/db mouse, a model of type 2 diabetes associated with insulin resistance, hyperglycemia, and obesity. Methods Five-week-old male db/db mice were assigned to the following groups: sedentary, ET, and ET + CR. Nonobese heterozygote littermates served as controls. ET was performed on a treadmill at moderate intensity, and CR was induced by reducing food intake by 30% of that consumed by sedentary db/db mice for a period of 8 weeks. Results After 8 weeks, only ET + CR, but not ET, slightly improved body weight compared to sedentary db/db mice. Regardless of the treatment, db/db mice remained hyperglycemic. Hearts from db/db mice demonstrated reduced expression of genes linked to the cardiac OT–NP system. In fact, compared to control mice, mRNA expression of GATA binding protein 4 (GATA4), OT receptor, OT, brain NP, NP receptor type C, and endothelial nitric oxide synthase (eNOS) was decreased in hearts from sedentary db/db mice. Both ET alone and ET + CR increased the mRNA expression of GATA4 compared to sedentary db/db mice. Only ET combined with CR produced increased eNOS mRNA and protein expression. Conclusion Our data indicate that enhancement of eNOS by combined ET and CR may improve coronary endothelial vasodilator dysfunction in type 2 diabetes but did not prevent the downregulation of cardiac expression in the OT–NP system, possibly resulting from the sustained hyperglycemia and obesity in diabetic mice. PMID:28138261

  3. Evaluation of B-type Natriuretic Peptide for validation of a heart failure register in primary care

    Directory of Open Access Journals (Sweden)

    Hughes Elizabeth A

    2007-07-01

    Full Text Available Abstract Background Diagnosing heart failure and left ventricular systolic dysfunction is difficult on clinical grounds alone. We sought to determine the accuracy of a heart failure register in a single primary care practice, and to examine the usefulness of b-type (or brain natriuretic peptide (BNP assay for this purpose. Methods A register validation audit in a single general practice in the UK was carried out. Of 217 patients on the heart failure register, 56 of 61 patients who had not been previously investigated underwent 12-lead electrocardiography and echocardiography within the practice site. Plasma was obtained for BNP assay from 45 subjects, and its performance in identifying echocardiographic abnormalities consistent with heart failure was assessed by analysing area under receiver operator characteristic (ROC curves. Results 30/217 were found to have no evidence to suggest heart failure on notes review and were probably incorrectly coded. 70/112 who were previously investigated were confirmed to have heart failure. Of those not previously investigated, 24/56 (42.9% who attended for the study had echocardiographic left ventricular systolic dysfunction. A further 8 (14.3% had normal systolic function, but had left ventricular hypertrophy or significant valve disease. Overall, echocardiographic features consistent with heart failure were found in only 102/203 (50.2%. BNP was poor at discriminating those with and without systolic dysfunction (area under ROC curve 0.612, and those with and without any significant echocardiographic abnormality (area under ROC curve 0.723. Conclusion In this practice, half of the registered patients did not have significant cardiac dysfunction. On-site echocardiography identifies patients who can be removed from the heart failure register. The use of BNP assay to determine which patients require echocardiography is not supported by these data.

  4. Differential response of the natriuretic peptide system to weight loss and exercise in overweight or obese patients.

    Science.gov (United States)

    Haufe, Sven; Kaminski, Jana; Utz, Wolfgang; Haas, Verena; Mähler, Anja; Daniels, Martin A; Birkenfeld, Andreas L; Lichtinghagen, Ralf; Luft, Friedrich C; Schulz-Menger, Jeanette; Engeli, Stefan; Jordan, Jens

    2015-07-01

    Relative atrial natriuretic peptide (ANP) deficiency has been implicated in the pathogenesis of obesity-associated cardiovascular and metabolic disease. We tested the hypothesis that more than 5% body weight reduction through 6 months hypocaloric dieting alters ANP release at rest and more so during exercise in overweight or obese patients. Venous mid-regional pro-ANP concentration was assessed at rest and after incremental exhaustive exercise testing before and after weight reduction. We also measured natriuretic peptide receptor A and C mRNA expression in subcutaneous adipose tissue to gauge both ANP responsiveness and clearance mechanisms. The average weight reduction of 9.1 ± 3.8  kg was associated with reductions in visceral and subcutaneous abdominal fat mass, liver fat content, insulin resistance, and ambulatory blood pressure. However, mid-regional pro-ANP plasma concentrations were unchanged with weight loss (51 ± 24 vs. 53 ± 24  pmol/l). Exercise elicited similar acute mid-regional pro-ANP increases before and after weight loss. Adipose tissue natriuretic peptide receptor type A mRNA expression remained unchanged, whereas natriuretic peptide receptor type C mRNA decreased with weight loss. We conclude that physical exercise acutely increases ANP release in obese patients, whereas modest diet-induced weight loss primarily affects ANP clearance mechanisms. Interventions combining weight loss and regular physical exercise may be particularly efficacious in reversing obesity-associated relative natriuretic peptide deficiency.

  5. Thirty years of the heart as an endocrine organ: physiological role and clinical utility of cardiac natriuretic hormones.

    Science.gov (United States)

    Clerico, Aldo; Giannoni, Alberto; Vittorini, Simona; Passino, Claudio

    2011-07-01

    Thirty years ago, De Bold et al. (20) reported that atrial extracts contain some biologically active peptides, which promote a rapid and massive diuresis and natriuresis when injected in rats. It is now clear that the heart also exerts an endocrine function and in this way plays a key role in the regulation of cardiovascular and renal systems. The aim of this review is to discuss some recent insights and still-debated findings regarding the cardiac natriuretic hormones (CNHs) produced and secreted by cardiomyocytes (i.e., atrial natriuretic peptide and B-type natriuretic peptide). The functional status of the CNH system depends not only on the production/secretion of CNHs by cardiomyocytes but also on both the peripheral activation of circulating inactive precursor of natriuretic hormones and the transduction of the hormone signal by specific receptors. In this review, we will discuss the data supporting the hypothesis that the production and secretion of CNHs is the result of a complex integration among mechanical, chemical, hemodynamic, humoral, ischemic, and inflammatory inputs. The cross talk among endocrine function, adipose tissue, and sex steroid hormones will be discussed more in detail, considering the clinically relevant relationships linking together cardiovascular risk, sex, and body fat development and distribution. Finally, we will review the pathophysiological role and the clinical relevance of both peripheral maturation of the precursor of B-type natriuretic peptides and hormone signal transduction.

  6. Pro-A-type natriuretic peptide, proadrenomedullin, and N-terminal pro-B-type natriuretic peptide used in a multimarker strategy in primary health care in risk assessment of patients with symptoms of heart failure

    DEFF Research Database (Denmark)

    Alehagen, Urban; Dahlström, Ulf; Rehfeld, Jens F;

    2013-01-01

    Use of new biomarkers in the handling of heart failure patients has been advocated in the literature, but most often in hospital-based populations. Therefore, we wanted to evaluate whether plasma measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP), midregional pro-A-type natriure......Use of new biomarkers in the handling of heart failure patients has been advocated in the literature, but most often in hospital-based populations. Therefore, we wanted to evaluate whether plasma measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP), midregional pro......-A-type natriuretic peptide (MR-proANP), and midregional proadrenomedullin (MR-proADM), individually or combined, gives prognostic information regarding cardiovascular and all-cause mortality that could motivate use in elderly patients presenting with symptoms suggestive of heart failure in primary health care....

  7. Heart specific up-regulation of genes for B-type and C-type natriuretic peptide receptors in diabetic mice

    DEFF Research Database (Denmark)

    Christoffersen, Christina; Bartels, E D; Nielsen, L B

    2006-01-01

    Diabetes may cause cardiomyopathy characterized by cardiac fibrosis. Recent studies of genetically modified mice have elucidated a role of the natriuretic peptides (NP), type-A and type-B (ANP and BNP), and their common receptor [natriuretic peptide receptor (NPR), type-A] in development of cardi...

  8. An activating mutation in the kinase homology domain of the natriuretic peptide receptor-2 causes extremely tall stature without skeletal deformities

    NARCIS (Netherlands)

    S.E. Hannema (Sabine); H.A. van Duyvenvoorde (Hermine); P. Thomas (Premsler); R.-B. Yang (Ruey-Bing); T.D. Mueller (Thomas); I.J. Gassner (Ingrid); H. Oberwinkler (Heike); F. Roelfsema (Ferdinand); G.W.E. Santen (Gijs); T. Prickett (Timothy); S.G. Kant (Sarina); A. Verkerk; A.G. Uitterlinden (André); E. Espiner (Eric); C.A. Ruivenkamp (Claudia); W. Oostdijk (Wilma); A.M. Pereira (Alberto); M. Losekoot (Monique); M. Kuhn (Michael); J.M. Wit (Jan)

    2013-01-01

    textabstractBackground: C-type natriuretic peptide (CNP)/natriuretic peptide receptor 2 (NPR2) signaling is essential for long bone growth. Enhanced CNP production caused by chromosomal translocations results in tall stature, a Marfanoid phenotype, and skeletal abnormalities.Asimilar phenotype was d

  9. Prognostic value of N-terminal pro C-type natriuretic peptide in heart failure patients with preserved and reduced ejection fraction

    NARCIS (Netherlands)

    Lok, Dirk J.; Klip, IJsbrand T.; Voors, Adriaan A.; Lok, Sjoukje I.; de la Porte, Pieta W. Bruggink-Andre; Hillege, Hans L.; Jaarsma, Tiny; van Veldhuisen, Dirk J.; van der Meer, Peter

    2014-01-01

    AimsA-type and B-type natriuretic peptides are established markers in chronic heart failure (HF). C-type natriuretic peptide (CNP) belongs to the same peptide family, but is predominantly localized in the endothelium. The prognostic role of CNP in heart failure has not been established. The aim of t

  10. Relationship between the actions of atrial natriuretic peptide (ANP, guanylin and uroguanylin on the isolated kidney

    Directory of Open Access Journals (Sweden)

    M.S. Santos-Neto

    1999-08-01

    Full Text Available Guanylin and uroguanylin are peptides that bind to and activate guanylate cyclase C and control salt and water transport in many epithelia in vertebrates, mimicking the action of several heat-stable bacteria enterotoxins. In the kidney, both of them have well-documented natriuretic and kaliuretic effects. Since atrial natriuretic peptide (ANP also has a natriuretic effect mediated by cGMP, experiments were designed in the isolated perfused rat kidney to identify possible synergisms between ANP, guanylin and uroguanylin. Inulin was added to the perfusate and glomerular filtration rate (GFR was determined at 10-min intervals. Sodium was also determined. Electrolyte dynamics were measured by the clearance formula. Guanylin (0.5 µg/ml, N = 12 or uroguanylin (0.5 µg/ml, N = 9 was added to the system after 30 min of perfusion with ANP (0.1 ng/ml. The data were compared at 30-min intervals to a control (N = 12 perfused with modified Krebs-Hanseleit solution and to experiments using guanylin and uroguanylin at the same dose (0.5 µg/ml. After previous introduction of ANP in the system, guanylin promoted a reduction in fractional sodium transport (%TNa+, P<0.05 (from 78.46 ± 0.86 to 64.62 ± 1.92, 120 min. In contrast, ANP blocked uroguanylin-induced increase in urine flow (from 0.21 ± 0.01 to 0.15 ± 0.007 ml g-1 min-1, 120 min, P<0.05 and the reduction in fractional sodium transport (from 72.04 ± 0.86 to 85.19 ± 1.48, %TNa+, at 120 min of perfusion, P<0.05. Thus, the synergism between ANP + guanylin and the antagonism between ANP + uroguanylin indicate the existence of different subtypes of receptors mediating the renal actions of guanylins.

  11. Cardiac mechanics and ventricular twist by three-dimensional strain analysis in relation to B-type natriuretic peptide as a clinical prognosticator for heart failure patients.

    Directory of Open Access Journals (Sweden)

    Sheng-Nan Chang

    Full Text Available BACKGROUND: Three dimensional (3D echocardiography-derived measurements of myocardial deformation and twist have recently advanced as novel clinical tools. However, with the exception of left ventricular ejection fraction and mass quantifications in hypertension and heart failure populations, the prognostic value of such imaging techniques remains largely unexplored. METHODS: We studied 200 subjects (mean age: 60.2±16 years, 54% female, female n = 107 with known hypertension (n = 51, diastolic heart failure (n = 61, or systolic heart failure (n = 30, recruited from heart failure outpatient clinics. Fifty-eight healthy volunteers were used as a control group. All participants underwent 3D-based myocardial deformation and twist analysis (Artida, Toshiba Medical Systems, Tokyo, Japan. We further investigated associations between these measures and brain natriuretic peptide levels and clinical outcomes. RESULTS: The global 3D strain measurements of the healthy, hypertension, diastolic heart failure, and systolic heart failure groups were 28.03%, 24.43%, 19.70%, and 11.95%, respectively (all p<0.001. Global twist measurements were estimated to be 9.49°, 9.77°, 8.32°, and 4.56°, respectively. We observed significant differences regarding 3D-derived longitudinal, radial, and global 3D strains between the different disease categories (p<0.05, even when age, gender, BMI and heart rate were matched. In addition, 3D-derived longitudinal, circumferential, and 3D strains were all highly correlated with brain natriuretic peptide levels (p<0.001. At a mean 567.7 days follow-up (25th-75th IQR: 197-909 days, poorer 3D-derived longitudinal, radial, and global 3D strain measurements remained independently associated with a higher risk of cardiovascular related death or hospitalization due to heart failure, after adjusting for age, gender, and left ventricular ejection fraction (all p<0.05. CONCLUSIONS: 3D-based strain analysis may be a

  12. Immunohistochemical localization of atrial natriuretic factor (ANF) in the excretory system of the rabbit parotid gland.

    Science.gov (United States)

    Valentino, B; Farina Lipari, E; Carini, F; Valenza, V

    1999-01-01

    The immunohistochemical localization of atrial natriuretic factor (ANF) in the rabbit parotid gland was performed using an antibody against rabbit ANF and avidin-biotin or streptoavidin as detector. Results showed positivity in cuboidal and columnar cells of intralobular ducts and in basal cells of extralobular and main excretory duct. These data support the hypothesis that ANF produced by intralobular ducts could act through a paracrine mechanism; ANF produced by extralobular and main ducts may play a role in the regulation of salivary composition.

  13. Splanchnic removal of human alpha-atrial natriuretic peptide in humans: enhancement after food intake

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Bendtsen, Flemming; Gerbes, A L

    1990-01-01

    In order to assess the effect of food ingestion on splanchnic disposal of human alpha-atrial natriuretic peptide (ANF), hepatic-intestinal removal of ANF was determined before and after a test meal. Hepatic venous and arterial plasma samples were obtained from six subjects, most of whom had only...... disorders of minor degree. Hepatic blood flow (HBF) increased significantly after meal ingestion (1.10 +/- 0.17 [SEM] to 1.51 +/- 0.26 L/min, P less than .01). Baseline arterial ANF (10.9 +/- 3.1 pmol/L) did not change significantly. In contrast, hepatic venous ANF increased after meal intake (5.7 +/- 2...

  14. Plasma pro-atrial natriuretic peptide to indicate fluid balance during cystectomy

    DEFF Research Database (Denmark)

    Rasmussen, Kirsten C; Højskov, Michael; Ruhnau, Birgitte

    2016-01-01

    : One university/tertiary centre. PARTICIPANTS: The study included patients who underwent radical cystectomy. Plasma for determination of proANP was obtained before surgery, after resection of the bladder, and at the end of surgery for 20 robotic-assisted radical cystectomy (RARC) and 20 open radical......OBJECTIVES: During surgery the volume of administered fluid is debated. Pro-atrial natriuretic peptide (proANP) is released by atrial distension, and we evaluated the relationship between changes in proANP associated with perioperative fluid balance. DESIGN: Prospective observational study. SETTING...

  15. ANP (Atrial Natriuretic Peptide presence in the heart of a tunicate, Ciona intestinalis.

    Directory of Open Access Journals (Sweden)

    Aldo Gerbino

    2010-06-01

    Full Text Available Atrial natriuretic peptide was found in the heart of vertebrates, we studied the ANP presence in the heart of Ciona intestinalis. This is animal is very important because of the its evolutionary position between invertebrates and vertebrates. ANP presence was only revealed in myoepithelial cells of the myocardium. Results suggest the hypothesis that ANP is present not only in the vertebrates but also in the invertebrates and in Ciona heart ANP might play a similar role like in the heart of vertebrates.

  16. Splanchnic removal of human alpha-atrial natriuretic peptide in humans: enhancement after food intake

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Bendtsen, F; Gerbes, A L

    1990-01-01

    In order to assess the effect of food ingestion on splanchnic disposal of human alpha-atrial natriuretic peptide (ANF), hepatic-intestinal removal of ANF was determined before and after a test meal. Hepatic venous and arterial plasma samples were obtained from six subjects, most of whom had only...... .05). Splanchnic removal of ANF was 3.0 +/- 0.5 pmol/min before and increased to a maximum value (7.1 +/- 2.2 pmol/min, P less than .05) 35 minutes after ingestion of the meal. Our results showed enhanced splanchnic removal of ANF after food intake. This is due to increased hepatic...

  17. Discriminating between cardiac and pulmonary dysfunction in the general population with dyspnea by plasma pro-B-type natriuretic peptide

    DEFF Research Database (Denmark)

    Mogelvang, R; Goetze, JP; Schnohr, P;

    2007-01-01

    OBJECTIVES: This study was designed to determine whether measurement of plasma pro-B-type natriuretic peptide (proBNP) could be used in discriminating between cardiac and pulmonary dyspnea in the general population. BACKGROUND: Natriuretic peptides are useful markers in ruling out acute cardiac...... the expected concentration of plasma proBNP based on age and gender was established for dyspneic subjects: an actual plasma proBNP concentration below half of the expected value ruled out left ventricular systolic and diastolic dysfunction (sensitivity 100%, 95% CI 100% to 100%; specificity 15%, 95% CI 12...

  18. Discriminating between cardiac and pulmonary dysfunction in the general population with dyspnea by plasma pro-B-type natriuretic peptide

    DEFF Research Database (Denmark)

    Mogelvang, R; Goetze, JP; Schnohr, P

    2007-01-01

    OBJECTIVES: This study was designed to determine whether measurement of plasma pro-B-type natriuretic peptide (proBNP) could be used in discriminating between cardiac and pulmonary dyspnea in the general population. BACKGROUND: Natriuretic peptides are useful markers in ruling out acute cardiac...... with dyspnea, left ventricular hypertrophy and/or systolic dysfunction was associated with a 2.6-fold increase in plasma proBNP concentration (p ...% to 17%). CONCLUSIONS: In the general population with dyspnea, plasma proBNP concentrations are increased in left ventricular dilatation, hypertrophy, systolic dysfunction, or diastolic dysfunction, but are unaffected by pulmonary dysfunction....

  19. 血浆N末端脑钠肽前体联合全球急性冠状动脉事件注册评分建立非ST段抬高型急性冠状动脉综合征临床风险预测模型的研究%Addition of N-terminal pro-brain natriuretic peptide to the Global Registry of Acute Coronary Events risk stratification to predict outcome in non-ST-segment elevation acute coronary syndrome

    Institute of Scientific and Technical Information of China (English)

    张宁; 刘文娴

    2014-01-01

    Objective To build a composite score based on the Global Registry of Acute Coronary Events (GRACE) score and N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations to predict outcome in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods Patients with NSTE-ACS in Beijing Anzhen Hospital affiliated to capital medical university, a composite score including the GRACE score and NT-proBNP concentrations was first randomly developed in a retrospective cohort of 409 patients with NSTE-ACS and then validated in a prediction model of other 231 patients. The mean follow- up time in a retrospective cohort were (774±217) days, and in a prediction model were (706±231)days. The primary end point was the composite of MACE, defined as cardiogenic deaths, myocardial infarction, readmission for heart failure. Results The patients were reclassified by the composite score, 105 patients were in low risk group, 209 patients were in medium risk group, and 95 patients were in high risk group. End points were reached in 26 patients (6.6%). The lgNT-proBNP in patients with NSTE-ACS had positive correlation with their GRACE risk score (r=0.507, P170 was high risk group. 10 patients would be reclassified at high risk using the composite score despite being classified at low risk using the GRACE score alone. Alternatively, 7 patients would be reclassified at medium risk, while being classified high risk with the GRACE score alone. 8 patients would be reclassified at low risk using the composite score despite being classified at high risk using the GRACE score alone. Finally, 2 patients while being classified medium risk of reached the end points, that was would be reclassified at high risk. 6.5% of the population in prediction model reached the end points. The use of the composite score increased the accuracy of the GRACE score, with an increase in the under-ROC curve area from 0.748 to 0.762. Conclusion Both NT-proBNP concentration and GRACE

  20. Plant natriuretic peptides: Systemic regulators of plant homeostasis and defense that can affect cardiomyoblasts

    KAUST Repository

    Gehring, Christoph A.

    2010-09-01

    Immunologic evidence has suggested the presence of biologically active natriuretic peptide (NPs) hormones in plants because antiatrial NP antibodies affinity purify biologically active plant NPs (PNP). In the model plant, an Arabidopsis thaliana PNP (AtPNP-A) has been identified and characterized. AtPNP-A belongs to a novel class of molecules that share some similarity with the cell wall loosening expansins but do not contain the carbohydrate-binding wall anchor thus suggesting that PNPs and atrial natriuretic peptides are heterologs. AtPNP-A acts systemically, and this is consistent with its localization in the apoplastic extracellular space and the conductive tissue. Furthermore, AtPNP-A signals via the second messenger cyclic guanosine 3′,5′-monophosphate and modulates ion and water transport and homeostasis. It also plays a critical role in host defense against pathogens. AtPNP-A can be classified as novel paracrine plant hormone because it is secreted into the apoplastic space in response to stress and can enhance its own expression. Interestingly, purified recombinant PNP induces apo-ptosis in a dose-dependent manner and was most effective on cardiac myoblast cell lines. Because PNP is mimicking the effect of ANP in some instances, PNP may prove to provide useful leads for development of novel therapeutic NPs. Copyright © 2013 by The American Federation for Medical Research.

  1. B and C types natriuretic peptides modify norepinephrine uptake and release in the rat adrenal medulla.

    Science.gov (United States)

    Vatta, M S; Presas, M F; Bianciotti, L G; Rodriguez-Fermepin, M; Ambros, R; Fernandez, B E

    1997-01-01

    We have previously reported that atrial natriuretic factor (ANF) modulates adrenomedullar norepinephrine (NE) metabolism. On this basis, the aim of the present work was to study the effects of B and C types natriuretic peptides (BNP and CNP) on the uptake, intracellular distribution and release of 3H-NE. Experiments were carried out in rat adrenal medulla slices incubated "in vitro." Results showed that 100 nM of both, CNP and BNP, enhanced total and neuronal NE uptake. Both peptides (100 nM) caused a rapid increase in NE uptake during the first minute, which was sustained for 60 min. NE intracellular distribution was only modified by CNP (100 nM), which increased the granular fraction and decreased the cytosolic pool. On the other hand, spontaneous as well as evoked (KCl) NE release, was decreased by BNP and CNP (50 and 100 nM for spontaneous release and 1, 10, 50 and 100 nM for evoked output). The present results suggest that BNP and CNP may regulate catecholamine secretion and modulate adrenomedullary biological actions mediated by catecholamines, such as blood arterial pressure, smooth muscle tone, and metabolic activities.

  2. Plasma levels of atrial natriuretic peptide (ANP) during mineralocorticoid escape in normal man.

    Science.gov (United States)

    Wambach, G; Götz, S; Suckau, G; Kaufmann, W

    1986-01-01

    A natriuretic factor has long been postulated to play a role in renal mineralocorticoid escape. We therefore investigated changes in plasma levels of atrial natriuretic peptide (ANP) during chronic treatment with 9 alpha-fluorohydrocortisone. Five normal subjects were studied on a constant diet (300 meq Na+ and 72 meq K+ per day) and received 0.8 mg 9 alpha-fluorohydrocortisone for up to 14 days. Sodium balance became positive and body weight increased between 1.0-4.5 kg maximally. Serum aldosterone was suppressed and plasma levels of ANP were stimulated up to 10-fold. Increment in plasma ANP was positively correlated with the gain in body weight (r = 0.666, p less than 0.001). Renormalization of sodium balance was seen in two subjects, however the maximum in plasma ANP did not occur during the time of renal escape. ANP-secretion is stimulated during sodium retention induced by mineralocorticoids, however ANP does not seem to trigger the escape mechanism.

  3. A liver metalloendopeptidase which degrades the circulating hypotensive peptide hormones bradykinin and atrial natriuretic peptide

    Directory of Open Access Journals (Sweden)

    Carvalho K.M.

    1999-01-01

    Full Text Available A new metalloendopeptidase was purified to apparent homogeneity from a homogenate of normal human liver using successive steps of chromatography on DEAE-cellulose, hydroxyapatite and Sephacryl S-200. The purified enzyme hydrolyzed the Pro7-Phe8 bond of bradykinin and the Ser25-Tyr26 bond of atrial natriuretic peptide. No cleavage was produced in other peptide hormones such as vasopressin, oxytocin or Met- and Leu-enkephalin. This enzyme activity was inhibited by 1 mM divalent cation chelators such as EDTA, EGTA and o-phenanthroline and was insensitive to 1 µM phosphoramidon and captopril, specific inhibitors of neutral endopeptidase (EC 3.4.24.11 and angiotensin-converting enzyme (EC 3.4.15.1, respectively. With Mr 85 kDa, the enzyme exhibits optimal activity at pH 7.5. The high affinity of this endopeptidase for bradykinin (Km = 10 µM and for atrial natriuretic peptide (Km = 5 µM suggests that it may play a physiological role in the inactivation of these circulating hypotensive peptide hormones.

  4. Associates of an Elevated Natriuretic Peptide Level in Stable Heart Failure Patients: Implications for Targeted Management

    Directory of Open Access Journals (Sweden)

    Aftab Jan

    2013-01-01

    Full Text Available Background. Persistently elevated natriuretic peptide (NP levels in heart failure (HF patients are associated with impaired prognosis. Recent work suggests that NP-guided therapy can improve outcome, but the mechanisms behind an elevated BNP remain unclear. Among the potential stimuli for NP in clinically stable patients are persistent occult fluid overload, wall stress, inflammation, fibrosis, and ischemia. The purpose of this study was to identify associates of B-type natriuretic peptide (BNP in a stable HF population. Methods. In a prospective observational study of 179 stable HF patients, the association between BNP and markers of collagen metabolism, inflammation, and Doppler-echocardiographic parameters including left ventricular ejection fraction (LVEF, left atrial volume index (LAVI, and E/e prime (E/e′ was measured. Results. Univariable associates of elevated BNP were age, LVEF, LAVI, E/e′, creatinine, and markers of collagen turnover. In a multiple linear regression model, age, creatinine, and LVEF remained significant associates of BNP. E/e′ and markers of collagen turnover had a persistent impact on BNP independent of these covariates. Conclusion. Multiple variables are associated with persistently elevated BNP levels in stable HF patients. Clarification of the relative importance of NP stimuli may help refine NP-guided therapy, potentially improving outcome for this at-risk population.

  5. Natriuretic Peptides as Predictors of Atrial Fibrillation Recurrences Following Electrical Cardioversion.

    Science.gov (United States)

    Zografos, Theodoros A; Katritsis, Demosthenes G

    2013-11-01

    Electrical cardioversion (ECV) can be effective in restoring sinus rhythm (SR) in the majority of patients with atrial fibrillation (AF). Several factors that predispose to AF recurrences, such as age, AF duration and left atrial size have been used to guide a decision for cardioversion, but increasing evidence suggests that they may be rather poor markers of left atrial structural remodeling that determines the long-term success of a rhythm control strategy. In this context, the use of easily obtainable biomarkers, such as the levels of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP), to predict AF recurrences may be preferable. Since ANP production is associated with the extent of functional atrial myocardium, and both ANP and BNP reflect atrial pressure and mechanical stretching, these peptides are good candidate biomarkers to assess predisposition to AF recurrences. In this review we focus on the pathophysiological mechanisms and the available clinical evidence regarding the prediction of AF recurrences following successful ECV from pre-procedural ANP and BNP levels.

  6. Role of C-type natriuretic peptide in the function of normal human sperm

    Directory of Open Access Journals (Sweden)

    Hui Xia

    2016-01-01

    Full Text Available C-type natriuretic peptide (CNP is a newly discovered type of local regulatory factor that mediates its biological effects through the specific, membrane-bound natriuretic peptide receptor-B (NPR-B. Recent studies have established that CNP is closely related to male reproductive function. The aims of this study were to determine the distribution of CNP/NPR-B in human ejaculated spermatozoa through different methods (such as immunolocalization, real time polymerase chain reaction and Western Blot, and then to evaluate the influence of CNP on sperm function i n vitro, such as motility and acrosome reaction. Human semen samples were collected from consenting donors who met the criteria of the World Health Organization for normozoospermia. Our results show that the specific receptor NPR-B of CNP is localized in the acrosomal region of the head and the membrane of the front-end tail of the sperm, and there is no signal of CNP in human sperm. Compared with the control, CNP can induce a significant dose-dependent increase in spermatozoa motility and acrosome reaction. In summary, CNP/NPR-B can affect sperm motility and acrosome reaction, thus regulating the reproductive function of males. CNP may be a new key factor in regulating sperm function.

  7. Phorbol ester and atrial natriuretic peptide receptor response on vascular smooth muscle.

    Science.gov (United States)

    Yasunari, K; Kohno, M; Murakawa, K; Yokokawa, K; Horio, T; Takeda, T

    1992-04-01

    At least two types of receptors for natriuretic peptides have been reported: biologically active receptors coupled with guanylate cyclase (atrial natriuretic peptide [ANP]-B receptors) and clearance receptors (ANP-C receptors). To elucidate the role of protein kinase C (PKC) in the regulation of ANP-B receptors, vascular smooth muscle cells in culture were treated with phorbol ester. Incubation with receptor agonists and phorbol ester led to the desensitization of receptor-mediated cyclic guanosine monophosphate (ANP-B receptor response) in rat vascular smooth muscle cells. Although a PKC inhibitor and downregulation of PKC by long-term incubation of cells with phorbol esters blocked the phorbol ester-induced desensitization of the ANP-B receptor response, they did not block the ANP-induced desensitization of the ANP-B receptor response. In addition, when desensitization by phorbol esters was observed, ANP was still capable of desensitization. These observations suggest that the mechanism for regulating ANP-B receptor sensitivity may be both PKC-dependent and PKC-independent and mediated by phorbol esters and ANP, respectively.

  8. 利钠肽系统与高血压的研究进展%Advance in Research of Natriuretic Peptide System and Hypertension

    Institute of Scientific and Technical Information of China (English)

    林军华

    2011-01-01

    The natriuretic peptide system consists of ANP, BNP, CNP and their receptors NPRA, NPRB,NPRC ;the natriuretic peptides play the physiological role of lowering blood pressure as natriuretic, diuretic,and vasorelaxing through binding to the receptors. Recent studies found that changes in any component of the natriuretic peptide or natriuretic peptide receptors would increase or decrease blood pressure on different levels. Injection natriuretic peptide can lower blood pressure. Natriuretic peptide system may play an important role in the diagnosis and treatment of hypertension.%利钠肽系统主要包括ANP、BNP、CNP及其受体NPRA、NPRB、NPRC,利钠肽通过与其受体结合从而发挥一系列生理作用如利钠、利尿、扩张血管而起降压作用.近年来研究发现,改变某一利钠肽或利钠肽受体成分表达,血压将出现不同程度改变(升高或下降);注射利钠肽可使血压下降.利钠肽系统在高血压诊治方面有可能在临床上受到日益重视.

  9. Atrial natriuretic peptide in patients with heart failure and chronic atrial fibrillation : Role of duration of at atrial fibrillation

    NARCIS (Netherlands)

    Van Den Berg, MP; Crijns, HJGM; Van Veldhuisen, DJ; Van Gelder, IC; De Kam, PJ; Lie, KI

    1998-01-01

    The purpose of this study was to analyze the determinants of atrial natriuretic peptide level in patients with congestive heart failure and atrial fibrillation. In particular, the duration of atrial fibrillation was analyzed because atrial fibrillation per se might have a specific effect on atrial n

  10. Vascular effects and electrolyte homeostasis of the natriuretic peptide isolated from Crotalus oreganus abyssus (North American Grand Canyon rattlesnake) venom

    NARCIS (Netherlands)

    Da Silva, S.L.; Dias-Junior, C.A.; Baldasso, P.A.; Damico, D.C.; Carvalho, B.M.; Garanto, A.; Acosta, G.; Oliveira, E.; Albericio, F.; Soares, A.M.; Marangoni, S.; Resende, R.R.

    2012-01-01

    Crotalus oreganus abyssus is a rattlesnake that is usually found in the Grand Canyon, United States of America. Knowledge regarding the composition of C. o. abyssus venom is scarce. New natriuretic peptides (NPs) have been isolated and characterized from the venoms of members of the Crotalinae famil

  11. Hepatic-intestinal disposal of endogenous human alpha atrial natriuretic factor99-126 in patients with cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Bendtsen, Flemming; Schütten, H J

    1990-01-01

    Hepatic-intestinal disposal of endogenous human alpha atrial natriuretic factor99-126 (ANF) was assessed in 13 patients with cirrhosis (six Child-Turcotte class A, five class B, and two class C) and eight control subjects. The Fick principle was applied during hepatic vein catheterization. Arterial...

  12. Atrial natriuretic peptide (ANP) as a neuropeptide: Interaction with angiotensin II on volume control and renal sodium handling

    OpenAIRE

    Unger, Th.; Badoer, E.; Gareis, C.; Girchev, R.; Kotrba, M.; Qadri, F; Rettig, R.; Rohmeiss, P

    1990-01-01

    1 Angiotensin II (ANG II) and atrial natriuretic peptide (ANP) are functionally antagonistic circulating hormones involved in blood pressure and body fluid regulation. An inappropriate atrial secretion of ANP has been implicated in the pathogenesis of hypertension, but clinical and experimental results on the role of ANP in hypertension are still conflicting.

  13. Will sacubitril-valsartan diminish the clinical utility of B-type natriuretic peptide testing in acute cardiac care?

    DEFF Research Database (Denmark)

    Mair, Johannes; Lindahl, Bertil; Giannitsis, Evangelos;

    2016-01-01

    Since the approval of sacubitril-valsartan for the treatment of chronic heart failure with reduced ejection fraction, a commonly raised suspicion is that a wider clinical use of this new drug may diminish the clinical utility of B-type natriuretic peptide testing as sacubitril may interfere with B...

  14. Vascular effects and electrolyte homeostasis of the natriuretic peptide isolated from Crotalus oreganus abyssus (North American Grand Canyon rattlesnake) venom

    NARCIS (Netherlands)

    Da Silva, S.L.; Dias-Junior, C.A.; Baldasso, P.A.; Damico, D.C.; Carvalho, B.M.; Garanto, A.; Acosta, G.; Oliveira, E.; Albericio, F.; Soares, A.M.; Marangoni, S.; Resende, R.R.

    2012-01-01

    Crotalus oreganus abyssus is a rattlesnake that is usually found in the Grand Canyon, United States of America. Knowledge regarding the composition of C. o. abyssus venom is scarce. New natriuretic peptides (NPs) have been isolated and characterized from the venoms of members of the Crotalinae famil

  15. Cardiac effects of 3 months treatment of acromegaly evaluated by magnetic resonance imaging and B-type natriuretic peptides

    DEFF Research Database (Denmark)

    Andreassen, Mikkel; Faber, Jens Oscar; Kjær, Andreas;

    2010-01-01

    Long-term treatment of acromegaly prevents aggravation and reverses associated heart disease. A previous study has shown a temporary increase in serum levels of the N-terminal fraction of pro B-type natriuretic peptide (NT-proBNP) suggesting an initial decline in cardiac function when treatment...

  16. Hepatic-intestinal disposal of endogenous human alpha atrial natriuretic factor99-126 in patients with cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Bendtsen, F; Schütten, H J

    1990-01-01

    Hepatic-intestinal disposal of endogenous human alpha atrial natriuretic factor99-126 (ANF) was assessed in 13 patients with cirrhosis (six Child-Turcotte class A, five class B, and two class C) and eight control subjects. The Fick principle was applied during hepatic vein catheterization. Arterial...

  17. Prognostic Value of Serum B-Type Natriuretic Peptide in Early Mortality and Morbidity of Children with Congenital Heart Disease after Open Heart Surgery

    Directory of Open Access Journals (Sweden)

    Nozar Givtaj

    2009-06-01

    Full Text Available Background: Brain type natriuretic peptide (BNP is a cardiac hormone that is secreted mainly by the ventricles in response to volume expansion and pressure load. It can predict post-operative complications after heart surgery in adults. We sought to investigate the prognostic value of BNP in children after heart surgery. Methods: We measured the BNP serum levels in 96 children with congenital heart diseases before, immediately after, and 12 hours after open heart surgery. We studied the ability of the post-operative BNP serum level variations to predict mortality and morbidity in children. Results: In total, 96 patients, comprising 40 (41.7% females and 56 (58.3% males with a mean age of 4.1 years (range: 1 month to 17 years, with various congenital heart diseases were studied. The rise in the serum BNP level 12 hours post surgery was directly related to mortality before discharge from hospital (P value=0.004, congestive heart failure after surgery (P value<0.001 , patients' cyanosis (P value=0.045, duration of ICU stay (r=0.342, P value=0.004, and post-operative need for inotropic drugs (P value<0.001. Conclusion: The rise in the BNP serum level 12 hours after heart surgery is a good marker for predicting mortality, morbidity, and early diagnosis of heart failure in children.

  18. What is the most cost-effective strategy to screen for left ventricular systolic dysfunction: natriuretic peptides, the electrocardiogram, hand-held echocardiography, traditional echocardiography, or their combination?

    Science.gov (United States)

    Galasko, Gavin I W; Barnes, Sophie C; Collinson, Paul; Lahiri, Avijit; Senior, Roxy

    2006-01-01

    To assess the screening characteristics and cost-effectiveness of screening for left ventricular systolic dysfunction (LVSD) in community subjects. A total of 1392 members of the general public and 928 higher risk subjects were randomly selected from seven community practices. Attending subjects underwent an ECG, N-terminal pro-brain natriuretic peptide (NTproBNP) serum levels, and traditional echocardiography (TE). A total of 533 consecutive subjects underwent hand-held echocardiography (HE). The screening characteristics and cost-effectiveness (cost per case of LVSD diagnosed) of eight strategies to predict LVSD (LVSD cost-effective, screening low-risk subjects least cost-effective. TE screening was the least cost-effective strategy. NTproBNP screening gave similar cost savings to ECG screening; HE screening greater cost-savings, and HE screening following NTproBNP or ECG pre-screening the greatest cost-savings, costing approximately 650 Euros per case of LVSD diagnosed in high-risk subjects (63% cost-savings vs.TE). Thus several different modalities allow cost-effective community-based screening for LVSD, especially in high-risk subjects. Such programmes would be cost-effective and miss few cases of LVSD in the community.

  19. Changes in plasma cardiac natriuretic peptides concentrations during 1 year treatment with angiotensin-converting enzyme inhibitor in elderly hypertensive patients with left ventricular hypertrophy.

    Science.gov (United States)

    Kohno, M; Yokokawa, K; Yasunari, K; Kano, H; Minami, M; Hanehira, T; Yoshikawa, J

    1997-01-01

    Plasma concentrations of atrial and brain natriuretic peptides (ANP and BNP) are high in patients with hypertension and congestive heart failure. The present study examined changes in plasma ANP and BNP concentrations during 1 year of monotherapy with enalapril in elderly hypertensive patients with left ventricular (LV) hypertrophy. Eight elderly hypertensive patients with LV hypertrophy were treated with enalapril for 1 year, during which time serial changes were recorded in LV mass index, LV systolic function, and plasma concentrations of ANP and BNP. Enalapril maintained systolic and diastolic blood pressure in the normal range for over 1 year. Treatment significantly reduced posterior wall thickness at 6 months, and more so at 1 year, and tended to reduce septal wall thickness and LV mass index at 1 year. LV ejection fraction was slightly but significantly increased at 1 year. Plasma ANP and BNP, which were markedly elevated at study entry, both decreased after 1 year of enalapril. These results suggest that 1 year of treatment with enalapril caused both a modest regression of LV hypertrophy and a modest improvement in LV systolic function in our selected group of elderly hypertensive patients. The drug reduced elevated plasma ANP and BNP levels but did not alter BUN and serum creatinine levels. Enalapril appears to be useful for the treatment of elderly hypertensive patients with LV hypertrophy.

  20. Application of shock waves to rat skin decreases calcitonin gene-related peptide immunoreactivity in dorsal root ganglion neurons.

    Science.gov (United States)

    Takahashi, Norimasa; Wada, Yuichi; Ohtori, Seiji; Saisu, Takashi; Moriya, Hideshige

    2003-09-30

    There have been several reports on the use of extracorporeal shock waves in the treatment of pseudarthrosis, calcifying tendinitis, and tendinopathies of the elbow. However, the pathomechanism of pain relief has not been clarified. To investigate the analgesic properties of shock wave application, we analyzed changes in calcitonin gene-related peptide (CGRP)-immunoreactive (ir) dorsal root ganglion (DRG) neurons. In the nontreated group, fluorogold-labeled dorsal root ganglion neurons innervating the most middle foot pad of hind paw were distributed in the L4 and L5 dorsal root ganglia. Of these neurons, 61% were CGRP-ir. However, in the shock wave-treated group, the percentage of FG-labeled CGRP-ir DRG neurons decreased to 18%. These data show that relief of clinical pain after shock wave application may result from reduced CGRP expression in DRG neurons.

  1. Distribution of adrenomedullin and proadrenomedullin N-terminal 20 peptide immunoreactivity in the pituitary gland of the frog Rana perezi.

    Science.gov (United States)

    Collantes, M; Bodegas, M E; Sesma, M P; Villaro, A C

    2003-08-01

    Adrenomedullin (AM) and proadrenomedullin N-terminal 20 peptide (PAMP) are two multifunctional peptides processed from a common precursor which have been described in numerous mammalian organs, including the pituitary gland. Previous studies have found AM immunoreactivity in neurohypophysis nerve fibers of amphibian pituitary. In the present study, immunocytochemical and Western blot analysis in the pituitary gland of the amphibian Rana perezi demonstrated in the adenohypophysis both AM and PAMP. AM-like immunoreactivity was found in a moderate number of endocrine cells of the pars distalis. In the neurohypophysis, AM was observed not only in nerve fibers of pars nervosa and axonal projections innervating the pars intermedia, but also in the outer zone of the median eminence. PAMP staining was observed in numerous endocrine cells scattered all over the pars distalis and in some cells of the pars tuberalis, but not in the neurohypophysis. In order to compare the quantity of AM and PAMP immunoreactivity between pars distalis of female and male specimens, an image analysis study was done. Significant differences for AM immunoreactivity (p<0.001) between sexes was found, the males showing higher immunostained area percentage. Differences of PAMP immunoreactivity were not significant (p=0.599). Western blot analysis detected bands presumably corresponding to precursor and/or intermediate species in the propeptide processing.

  2. Brain Basics

    Medline Plus

    Full Text Available ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  3. Brain Basics

    Science.gov (United States)

    ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  4. Brain Basics

    Medline Plus

    Full Text Available ... Events About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  5. Brain Basics

    Medline Plus

    Full Text Available ... Brain Research Glossary Brain Basics (PDF, 10 pages) Introduction Watch the Brain Basics video Welcome. Brain Basics ... brain may play a role in disorders like schizophrenia or attention deficit hyperactivity disorder (ADHD) . Glutamate —the ...

  6. Immunoreactive atrial natriuretic factor is increased in ovine model of endotoxemia

    Energy Technology Data Exchange (ETDEWEB)

    Lubbesmeyer, H.J.; Woodson, L.; Traber, L.D.; Flynn, J.T.; Herndon, D.N.; Traber, D.L. (Univ. of Texas Medical Branch, Galveston (USA) Thomas Jefferson Medical College, Philadelphia, PA (USA) Westfaelian Wilhelms Univ., Muenster (West Germany))

    1988-04-01

    A bolus of Escherichia coli endotoxin (1.5 {mu}g/kg) was administered to chronically instrumented sheep. Immunoreactive atrial natriuretic factor (IR-ANF) was measured in extracted plasma by radioimmunoassay. There was a thirteenfold increase in IR-ANF 2 h after endotoxin administration, and IR-ANF levels remained significantly elevated during the first 6 h. A marked diuresis and natriuresis occurred between 4 and 6 h. ANF not only affects renal function but is also associated with decreased cardiac output, increased peripheral resistance (in sheep), and decreased capillary absorption (in rats). These renal and hemodynamic changes are also characteristic of the early (first 6 h) response to endotoxin. Therefore ANF should be considered as a potential mediator of renal and hemodynamic changes induced by sepsis. It is difficult to determine if ANF elevation is an epiphenomenon or a causative factor, because no antagonist of ANF is currently available.

  7. Does bioimpedance analysis or measurement of natriuretic peptides aid volume assessment in peritoneal dialysis patients?

    Science.gov (United States)

    Davenport, Andrew

    2013-01-01

    Cardiovascular mortality remains the commonest cause of death for peritoneal dialysis patients. As such, preventing persistent hypervolemia is important. On the other hand, hypovolemia may potentially risk episodes of acute kidney injury and loss of residual renal function, a major determinant of peritoneal dialysis technique survival. Bioimpedance has developed from a single-frequency research tool to a multi-frequency bioelectrical impedance analysis readily available in the clinic and capable of measuring extracellular, intracellular, and total body water. Similarly, natriuretic peptides released from the heart because of myocardial stretch and increased intracardiac volume have also been variously reported to be helpful in assessing volume status in peritoneal dialysis patients. The question then arises whether these newer technologies and biomarkers have supplanted the time-honored clinical assessment of hydration status or whether they are merely adjuncts that aid the experienced clinician.

  8. Atrial natriuretic peptide, copeptin and adrenomedullin levels in polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Frøssing, Signe; Nylander, Malin; Aziz, Mubeena;

    2016-01-01

    BACKGROUND: Polycystic ovary syndrome (PCOS) defined by the Rotterdam criteria does not take into account the unhealthy metabolic profile of the syndrome with increased insulin resistance (IR) and overweight favoring development of type 2 diabetes, hypertension and cardiovascular disease (CVD). We...... assess three vasoactive peptides associated with CVD in women with PCOS. METHOD: Plasma levels of mid-regional pro-atrial natriuretic peptide (MR-proANP), copeptin and mid-regional pro-adrenomedullin (MR-proADM) were measured in 98 PCOS patients and 46 age- and BMI-matched healthy women. RESULTS: We...... found no difference in levels of MR-proANP, copeptin and MR-proADM between the PCOS and control group. Multiple regression analyses on a combined group of PCOS and control subjects demonstrated an inverse correlation between MR-proANP and IR (measured by fasting C-peptide) and a positive correlations...

  9. Effects of angiotensin, vasopressin and atrial natriuretic peptide on intraocular pressure in anesthetized rats

    Science.gov (United States)

    Palm, D. E.; Shue, S. G.; Keil, L. C.; Balaban, C. D.; Severs, W. B.

    1995-01-01

    The effects of atrial natriuretic peptide (ANP), vasopressin (AVP) and angiotensin (ANG) on blood and intraocular pressures of pentobarbital anesthetized rats were evaluated following intravenous, intracerebroventricular or anterior chamber routes of administration. Central injections did not affect intraocular pressure. Equipressor intravenous infusions of ANG raised, whereas AVP decreased, intraocular pressure. Direct infusions of a balanced salt solution (0.175 microliter/min) raised intraocular pressure between 30 and 60 min. Adding ANG or ANP slightly reduced this solvent effect but AVP was markedly inhibitory. An AVP-V1 receptor antagonist reversed the blunting of the solvent-induced rise by the peptide, indicating receptor specificity. Acetazolamide pretreatment lowered intraocular pressure, but the solvent-induced rise in intraocular pressure and inhibition by AVP still occurred without altering the temporal pattern. Thus, these effects appear unrelated to aqueous humor synthesis rate. The data support the possibility of intraocular pressure regulation by peptides acting from the blood and aqueous humor.

  10. Impact of hemoglobin on plasma pro-B-type natriuretic peptide concentrations in the general population

    DEFF Research Database (Denmark)

    Nybo, Mads; Benn, Marianne; Mogelvang, Rasmus

    2007-01-01

    BACKGROUND: Age, sex, and renal function contribute to variations in plasma concentrations of B-type natriuretic peptide (BNP) and its molecular precursor (proBNP). Recent studies indicate that anemia may also affect proBNP concentrations in patients with heart failure or stroke. However...... the proBNP plasma concentration. RESULTS: The mean proBNP concentration was increased 1.7-fold in the group with anemia vs the nonanemic group [mean (SD) 42 (45) pmol/L vs 25 (29) pmol/L, P ... was modest. CONCLUSIONS: Because moderate anemia is associated with a 1.7-fold increase in proBNP concentrations, hemoglobin concentrations should be taken into consideration in patients with nonspecific symptoms of heart disease and increased proBNP concentrations....

  11. Dexamethasone stimulates expression of C-type Natriuretic Peptide in chondrocytes

    Directory of Open Access Journals (Sweden)

    Beier Frank

    2006-11-01

    Full Text Available Abstract Background Growth of endochondral bones is regulated through the activity of cartilaginous growth plates. Disruption of the physiological patterns of chondrocyte proliferation and differentiation – such as in endocrine disorders or in many different genetic diseases (e.g. chondrodysplasias – generally results in dwarfism and skeletal defects. For example, glucocorticoid administration in children inhibits endochondral bone growth, but the molecular targets of these hormones in chondrocytes remain largely unknown. In contrast, recent studies have shown that C-type Natriuretic Peptide (CNP is an important anabolic regulator of cartilage growth, and loss-of-function mutations in the human CNP receptor gene cause dwarfism. We asked whether glucocorticoids could exert their activities by interfering with the expression of CNP or its downstream signaling components. Methods Primary mouse chondrocytes in monolayer where incubated with the synthetic glucocorticoid Dexamethasone (DEX for 12 to 72 hours. Cell numbers were determined by counting, and real-time PCR was performed to examine regulation of genes in the CNP signaling pathway by DEX. Results We show that DEX does influence expression of key genes in the CNP pathway. Most importantly, DEX significantly increases RNA expression of the gene encoding CNP itself (Nppc. In addition, DEX stimulates expression of Prkg2 (encoding cGMP-dependent protein kinase II and Npr3 (natriuretic peptide decoy receptor genes. Conversely, DEX was found to down-regulate the expression of the gene encoding its receptor, Nr3c1 (glucocorticoid receptor, as well as the Npr2 gene (encoding the CNP receptor. Conclusion Our data suggest that the growth-suppressive activities of DEX are not due to blockade of CNP signaling. This study reveals a novel, unanticipated relationship between glucocorticoid and CNP signaling and provides the first evidence that CNP expression in chondrocytes is regulated by endocrine

  12. Sex Differences of the Natriuretic Peptide Polymorphism Associated With Angiographic Coronary Atherosclerosis

    Science.gov (United States)

    Li, Terry Y.; Tse, M. Yat; Pang, Stephen C.; McLellan, Catherine S.; King, Will D.; Johri, Amer M.

    2017-01-01

    Background Polymorphisms within natriuretic peptide (NP) genes have been associated with clinical outcomes for cardiovascular disease (CVD), but no previous study has compared the effect of these polymorphisms between men and women. This study aimed to investigate the association between single nucleotide polymorphisms (SNPs) in key genes of the NP system and coronary angiographic outcomes, with the focus on the sexual dimorphism in the effects of these SNPs. Methods Patients undergoing clinically indicated coronary angiography (n = 513, 328 men and 185 women) were consented and genotyped for NPPA rs5065, NPPB rs198389 and NPR2 rs10758325. Patients were stratified into having normal coronaries, non-obstructive coronary artery disease (CAD) or obstructive CAD, based on the highest stenosis in any epicardial artery. Average luminal narrowing across all four arteries was derived to represent the overall atherosclerotic burden. Results The frequency of NPPB rs198389 AA genotype was significantly higher in women with obstructive CAD (P = 0.014). The same association was not observed in males. With respect to atherosclerotic burden, an association was found between the AA genotype and average luminal narrowing in women (P = 0.005), but not in men. Conclusions The current study identified an association between an SNP of the NPPB gene and coronary atherosclerotic burden through angiographic evidence in women but not in men. These results suggest that B-type natriuretic peptide (BNP) may have more important involvement in the development of CAD in women compared to men, and as such, genotyping of the NPPB gene may serve as a potential biomarker to identify women with high risk for CAD. PMID:28275418

  13. The plant natriuretic peptide receptor is a guanylyl cyclase and enables cGMP-dependent signaling

    KAUST Repository

    Turek, Ilona

    2016-03-05

    The functional homologues of vertebrate natriuretic peptides (NPs), the plant natriuretic peptides (PNPs), are a novel class of peptidic hormones that signal via guanosine 3′,5′-cyclic monophosphate (cGMP) and systemically affect plant salt and water balance and responses to biotrophic plant pathogens. Although there is increasing understanding of the complex roles of PNPs in plant responses at the systems level, little is known about the underlying signaling mechanisms. Here we report isolation and identification of a novel Leucine-Rich Repeat (LRR) protein that directly interacts with A. thaliana PNP, AtPNP-A. In vitro binding studies revealed that the Arabidopsis AtPNP-A binds specifically to the LRR protein, termed AtPNP-R1, and the active region of AtPNP-A is sufficient for the interaction to occur. Importantly, the cytosolic part of the AtPNP-R1, much like in some vertebrate NP receptors, harbors a catalytic center diagnostic for guanylyl cyclases and the recombinant AtPNP-R1 is capable of catalyzing the conversion of guanosine triphosphate to cGMP. In addition, we show that AtPNP-A causes rapid increases of cGMP levels in wild type (WT) leaf tissue while this response is significantly reduced in the atpnp-r1 mutants. AtPNP-A also causes cGMP-dependent net water uptake into WT protoplasts, and hence volume increases, whereas responses of the protoplasts from the receptor mutant are impaired. Taken together, our results suggest that the identified LRR protein is an AtPNP-A receptor essential for the PNP-dependent regulation of ion and water homeostasis in plants and that PNP- and vertebrate NP-receptors and their signaling mechanisms share surprising similarities. © 2016 Springer Science+Business Media Dordrecht

  14. Characterization of atrial natriuretic peptide degradation by cell-surface peptidase activity on endothelial cells

    Science.gov (United States)

    Frost, S. J.; Whitson, P. A.

    1993-01-01

    Atrial natriuretic peptide (ANP) is a fluid-regulating peptide hormone that promotes vasorelaxation, natriuresis, and diuresis. The mechanisms for the release of ANP and for its clearance from the circulation play important roles in modulating its biological effects. Recently, we have reported that the cell surface of an endothelial cell line, CPA47, could degrade 125I-ANP in the presence of EDTA. In this study, we have characterized this degradation of 125I-ANP. The kinetics of ANP degradation by the surface of CPA47 cells were first order, with a Km of 320 +/- 60 nM and Vmax of 35 +/- 14 pmol of ANP degraded/10 min/10(5) cells at pH 7.4. ANP is degraded by the surface of CPA47 cells over a broad pH range from 7.0-8.5. Potato carboxypeptidase inhibitor and bestatin inhibited 125I-ANP degradation, suggesting that this degradative activity on the surface of CPA47 cells has exopeptidase characteristics. The selectivity of CPA47 cell-surface degradation of ANP was demonstrated when 125I-ANP degradation was inhibited in the presence of neuropeptide Y and angiotensin I and II but not bradykinin, bombesin, endothelin-1, or substance P. The C-terminal amino acids phe26 and tyr28 were deduced to be important for ANP interaction with the cell-surface peptidase(s) based on comparison of the IC50 of various ANP analogues and other natriuretic peptides for the inhibition of ANP degradation. These data suggest that a newly characterized divalent cation-independent exopeptidase(s) that selectively recognizes ANP and some other vasoactive peptides exists on the surface of endothelial cells.

  15. Influence of storage conditions on in vitro stability of atrial natriuretic peptide and of anesthesia on plasma atrial natriuretic peptide concentration in cats.

    Science.gov (United States)

    Heishima, Yasuhiro; Hori, Yasutomo; Chikazawa, Seishiro; Kanai, Kazutaka; Hoshi, Fumio; Itoh, Naoyuki

    2016-08-01

    OBJECTIVE To investigate the in vitro stability of atrial natriuretic peptide (ANP) in plasma samples under various storage conditions and the influence of anesthesia on plasma ANP concentration in cats. ANIMALS 1 cat with congestive heart failure and 5 healthy adult mixed-breed cats. PROCEDURES A plasma sample from the cat with heart failure was serially diluted, and dilutional parallelism of ANP concentration was evaluated. Plasma samples containing aprotinin or serum samples from the 5 healthy cats were kept at room temperature (27°C) for ≤ 12 hours. Plasma samples from the same healthy cats were stored at -70°, -20°, or 4°C for ≤ 14 days. Plasma samples were obtained from the healthy cats before and during isoflurane anesthesia. Plasma ANP concentrations were measured at a commercial laboratory by use of a human ANP chemiluminescence assay. RESULTS Intra- and interassay coefficients of variation were 1.5% and 2.5%, respectively, and dilutional parallelism was established. Although ANP concentration decreased by 82.4 ± 13.6% (mean ± SD) after sample storage for 12 hours at room temperature, this decrease was prevented by aprotinin. Plasma ANP concentrations were stable for 7 days at -20°C and for 14 days at -70°C. However, concentrations decreased markedly to 57.6 ± 6.9% at -20°C and to 18.0 ± 3.0% at 4°C after 14 days. Plasma ANP concentration decreased significantly in cats during anesthesia and was correlated with blood pressure. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that aprotinin should be added routinely in preparation of plasma samples from cats for measurement of ANP concentration, and those samples, if stored, should be frozen immediately at ≤ -20°C. General anesthesia or systemic blood pressure may affect plasma ANP concentration in cats.

  16. Brain herniation

    Science.gov (United States)

    ... herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain ... Brain herniation occurs when something inside the skull produces pressure that moves brain tissues. This is most ...

  17. Interplay Between Adiponectin and Pro-Atrial Natriuretic Peptide and Prognosis in Patients With ST-Segment Elevation Myocardial Infarction

    DEFF Research Database (Denmark)

    Lindberg, Søren; Jensen, Jan S; Hoffmann, Søren

    2015-01-01

    Natriuretic peptides (NPs) may regulate adipocyte metabolism including adiponectin. Infusion of atrial natriuretic peptide (ANP) increases plasma adiponectin in patients with heart failure. However, this relation has not been examined in a clinical setting or in myocardial infarction (MI......). Accordingly, we investigated the interplay between proANP and adiponectin and the prognostic implications in patients with MI. We prospectively included 680 patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention from September 2006 to December...... 2008. Blood samples were drawn immediately before percutaneous coronary intervention. Additionally, we included 40 patients with 4 obtained blood samples during STEMI. Adiponectin and proANP were measured in all plasma samples. All patients were followed for 5 years. End points were all-cause mortality...

  18. Cardiac effects of 3 months treatment of acromegaly evaluated by magnetic resonance imaging and B-type natriuretic peptides

    DEFF Research Database (Denmark)

    Andreassen, Mikkel; Faber, Jens; Kjær, Andreas;

    2010-01-01

    of acromegaly is initiated. This was a three months prospective study investigating short-term cardiac effects of treatment in acromegalic patients. Cardiac function was evaluated by the gold standard method cardiac magnetic resonance imaging (CMRI) and circulating levels of B-type natriuretic peptides (BNP......Long-term treatment of acromegaly prevents aggravation and reverses associated heart disease. A previous study has shown a temporary increase in serum levels of the N-terminal fraction of pro B-type natriuretic peptide (NT-proBNP) suggesting an initial decline in cardiac function when treatment...... and NT-proBNP). CMRI was performed at baseline and after 3 months of treatment. Levels of IGF-I, BNP and NT-proBNP were measured after 0, 1, 2 and 3 months. Eight patients (5 males and 3 females, mean age 53 ± 12 years (range 30-70)) and 8 matched healthy control subjects were included. Median IGF-I Z...

  19. Invasive and noninvasive correlations of B-type natriuretic peptide in patients with heart failure due to Chagas cardiomyopathy.

    Science.gov (United States)

    Vilas-Boas, Fábio; Feitosa, Gilson Soares; Soares, Milena B P; Pinho-Filho, Joel Alves; Nascimento, Thais; Barojas, Marcos M; Andrade, Marcus V S; Ribeiro-Dos-Santos, Ricardo; Bocchi, Edimar

    2008-01-01

    Heart failure due to Chagas cardiomyopathy (HFCC) differs from failure with other etiologies because of the occurrence of intense inflammatory infiltrate and right ventricle compromise. This article investigates correlations of B-type natriuretic peptide (BNP) levels with parameters of severity in HFCC. Twenty-eight patients and 8 normal controls underwent heart catheterization and clinical and laboratory analyses. BNP levels were higher in patients with HFCC (PHFCC, irrespective of NYHA class, and that the occurrence of HFCC correlates with severity of disease.

  20. Plasmatic levels of N-terminal pro-atrial natriuretic peptide in preeclamptic patients and healthy normotensive pregnant women.

    Science.gov (United States)

    Reyna-Villasmil, Eduardo; Mejia-Montilla, Jorly; Reyna-Villasmil, Nadia; Mayner-Tresol, Gabriel; Herrera-Moya, Pedro; Fernández-Ramírez, Andreina; Rondón-Tapía, Marta

    2017-08-31

    To compare plasma N-terminal pro-atrial natriuretic peptide concentrations in preeclamptic patients and healthy normotensive pregnant women. A cases-controls study was done with 180 patients at Hospital Central Dr. Urquinaona, Maracaibo, Venezuela, that included 90 preeclamptic patients (group A; cases) and 90 healthy normotensive pregnant women selected with the same age and body mass index similar to group A (group B; controls). Blood samples were collected one hour after admission and prior to administration of any medication in group A to determine plasma N-terminal pro-atrial natriuretic peptide and other laboratory parameters. Plasma N-terminal pro-atrial natriuretic peptide concentrations in group A (mean 1.01 [0.26] pg/mL) showed a significant difference when compared with patients in group B (mean 0.55 [0.07] pg/mL; P<.001]. There was no significant correlation with systolic and diastolic blood pressure values in preeclamptic patients (P=ns). A cut-off value of 0.66ng/mL had an area under the curve of 0.93, sensitivity of 87.8%, specificity of 83.3%, a positive predictive value of 84.0% and a negative predictive value of 87.2%, with a diagnostic accuracy of 85.6%. Preeclamptic patients have significantly higher concentrations of plasma N-terminal pro-atrial natriuretic peptide compared with healthy normotensive pregnant women, with high predictive values for diagnosis. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  1. Pro-A-type natriuretic peptide and pro-adrenomedullin predict progression of chronic kidney disease: the MMKD Study.

    Science.gov (United States)

    Dieplinger, Benjamin; Mueller, Thomas; Kollerits, Barbara; Struck, Joachim; Ritz, Eberhard; von Eckardstein, Arnold; Haltmayer, Meinhard; Kronenberg, Florian

    2009-02-01

    A-type natriuretic peptide (ANP) and adrenomedullin (ADM) are potent hypotensive, diuretic, and natriuretic peptides involved in maintaining cardiovascular and renal homeostasis. We conducted a prospective 7-year study of 177 nondiabetic patients with primary chronic kidney disease to see if ANP and ADM plasma concentrations predict the progression of their disease, using novel sandwich immunoassays covering the midregional epitopes of the stable prohormones (MRproANP and MR-proADM). Progression of chronic kidney disease was defined as doubling of baseline serum creatinine and/or terminal renal failure, which occurred in 65 patients. Analysis of the receiver operating characteristic curve for the prediction of renal endpoints showed similar areas under the curve for the glomerular filtration rate (GFR) (0.838), MR-proANP (0.810), and MRproADM (0.876), respectively, as did the Kaplan-Meier curve analyses of the patients stratified according to the median of the respective markers. In separate multiple Cox-proportional hazard regression analyses, increased plasma concentrations of both peptides were each strongly predictive of the progression of chronic kidney disease after adjustments for age, gender, GFR, proteinuria and amino-terminal pro-B-type natriuretic peptide. Our study suggests that MR-proANP and MR-proADM are useful new markers of progression of primary nondiabetic chronic kidney disease.

  2. Physiological levels of A-, B- and C-type natriuretic peptide shed the endothelial glycocalyx and enhance vascular permeability.

    Science.gov (United States)

    Jacob, Matthias; Saller, Thomas; Chappell, Daniel; Rehm, Markus; Welsch, Ulrich; Becker, Bernhard F

    2013-05-01

    Atrial natriuretic peptide (ANP) is a peptide hormone released from the cardiac atria during hypervolemia. Though named for its well-known renal effect, ANP has been demonstrated to acutely increase vascular permeability in vivo. Experimentally, this phenomenon was associated with a marked shedding of the endothelial glycocalyx, at least for supraphysiological intravascular concentrations. This study investigates the impact and mechanism of action of physiological doses of ANP and related peptides on the vascular barrier. In isolated guinea pig hearts, prepared and perfused in a modified Langendorff mode with and without the intravascular presence of the colloid hydroxyethyl starch (HES), we measured functional changes in vascular permeability and glycocalyx shedding related to intracoronary infusion of physiological concentrations of A-, B- and C-type natriuretic peptide (ANP, BNP and CNP). Significant coronary venous washout of glycocalyx constituents (syndecan-1 and heparan sulfate) was observed. As tested for ANP, this effect was positively related to the intracoronary concentration. Intravascular shedding of the glycocalyx was morphologically confirmed by electron microscopy. Also, functional vascular barrier competence decreased, as indicated by significant increases in transudate formation and HES extravasation. Ortho-phenanthroline, a non-specific inhibitor of matrix metalloproteases, was able to reduce ANP-induced glycocalyx shedding. These findings suggest participation of natriuretic peptides in pathophysiological processes like heart failure, inflammation or sepsis. Inhibition of metalloproteases might serve as a basis for future therapeutical options.

  3. Atrial natriuretic peptide regulates lipid mobilization and oxygen consumption in human adipocytes by activating AMPK

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Sandra C. [Translational Sciences - Translational Medicine, Novartis Institutes for Biomedical Research, Inc., 220 Massachusetts Avenue, Cambridge, MA 02139 (United States); Chau, Mary D.L.; Yang, Qing [Cardiovascular and Metabolism Disease Area, Novartis Institutes for Biomedical Research, Inc., 100 Technology Square, Cambridge, MA 02139 (United States); Gauthier, Marie-Soleil [Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA 02140 (United States); Clairmont, Kevin B.; Wu, Zhidan; Gromada, Jesper [Cardiovascular and Metabolism Disease Area, Novartis Institutes for Biomedical Research, Inc., 100 Technology Square, Cambridge, MA 02139 (United States); Dole, William P., E-mail: bill.dole@novartis.com [Translational Sciences - Translational Medicine, Novartis Institutes for Biomedical Research, Inc., 220 Massachusetts Avenue, Cambridge, MA 02139 (United States)

    2011-07-08

    Highlights: {yields} Treatment of differentiated human adipocytes with atrial natriuretic peptide (ANP) increased lipolysis and oxygen consumption by activating AMP-activated protein kinase (AMPK). {yields} ANP stimulated lipid mobilization by selective activation of the alpha2 subunit of AMPK and increased energy utilization through activation of both the alpha1 and alpha2 subunits of AMPK. {yields} ANP enhanced adipocyte mitochondrial oxidative capacity as evidenced by induction of oxidative mitochondrial genes and increase in oxygen consumption. {yields} Exposure of human adipocytes to fatty acids and (TNF{alpha}) induced insulin resistance and decreased expression of mitochondrial genes which was restored to normal by ANP. -- Abstract: Atrial natriuretic peptide (ANP) has been shown to regulate lipid and carbohydrate metabolism providing a possible link between cardiovascular function and metabolism by mediating the switch from carbohydrate to lipid mobilization and oxidation. ANP exerts a potent lipolytic effect via cGMP-dependent protein kinase (cGK)-I mediated-stimulation of AMP-activated protein kinase (AMPK). Activation of the ANP/cGK signaling cascade also promotes muscle mitochondrial biogenesis and fat oxidation. Here we demonstrate that ANP regulates lipid metabolism and oxygen utilization in differentiated human adipocytes by activating the alpha2 subunit of AMPK. ANP treatment increased lipolysis by seven fold and oxygen consumption by two fold, both of which were attenuated by inhibition of AMPK activity. ANP-induced lipolysis was shown to be mediated by the alpha2 subunit of AMPK as introduction of dominant-negative alpha2 subunit of AMPK attenuated ANP effects on lipolysis. ANP-induced activation of AMPK enhanced mitochondrial oxidative capacity as evidenced by a two fold increase in oxygen consumption and induction of mitochondrial genes, including carnitine palmitoyltransferase 1A (CPT1a) by 1.4-fold, cytochrome C (CytC) by 1.3-fold, and

  4. Natriuretic peptide-dependent lipolysis in fat cells is a primate specificity.

    Science.gov (United States)

    Sengenès, Coralie; Zakaroff-Girard, Alexia; Moulin, Agnès; Berlan, Michel; Bouloumié, Anne; Lafontan, Max; Galitzky, Jean

    2002-07-01

    We have recently demonstrated that natriuretic peptides (NPs), which are known for regulation of blood pressure via membrane guanylyl cyclase (GC) receptors, are lipolytic in human adipose tissue. In this study, we compared the NP control of lipolysis in adipocytes from humans, nonhuman primates (macaques), rodents (rats, mice, hamsters), and nonrodent mammals (rabbits, dogs). Isolated adipocytes from these species were exposed to increasing concentrations of atrial NP (ANP) or isoproterenol (beta-adrenergic agonist). Although isoproterenol was lipolytic in all of the species, ANP only enhanced lipolysis in human and macaque adipocytes. In primate fat cells, NP-induced lipolysis involved a cGMP-dependent pathway. Binding studies and real-time quantitative PCR assays revealed that rat adipocytes expressed a higher density of NP receptors compared with humans but with a different subtype pattern of expression; type-A GC receptors predominate in human fat cells. This was also confirmed by the weak GC-activity stimulation and the reduced cGMP formation under ANP exposure in rat adipocytes compared with human fat cells. In conclusion, NP-induced lipolysis is a primate specificity, and adipocytes from ANP-nonresponsive species present a predominance of "clearance" receptors and very low expression of "biologically active" receptors.

  5. Atrial natriuretic peptide stimulates lipid mobilization during repeated bouts of endurance exercise.

    Science.gov (United States)

    Moro, Cédric; Polak, Jan; Hejnova, Jindra; Klimcakova, Eva; Crampes, François; Stich, Vladimir; Lafontan, Max; Berlan, Michel

    2006-05-01

    Atrial natriuretic peptide (ANP) controls lipolysis in human adipocytes. Lipid mobilization is increased during repeated bouts of exercise, but the underlying mechanisms involved in this process have not yet been delineated. The relative involvement of catecholamine- and ANP-dependent pathways in the control of lipid mobilization during repeated bouts of exercise was thus investigated in subcutaneous adipose tissue (SCAT) by microdialysis. The study was performed in healthy males. Subjects performed two 45-min exercise bouts (E1 and E2) at 50% of their maximal oxygen uptake separated by a 60-min rest period. Extracellular glycerol concentration (EGC), reflecting SCAT lipolysis, was measured in a control probe perfused with Ringer solution and in two other probes perfused with either Ringer plus phentolamine (alpha(1/2)-AR antagonist) or Ringer plus both phentolamine and propranolol (beta-AR antagonist). Plasma epinephrine, plasma glycerol, and EGC were 1.7-, 1.6-, and 1.2-fold higher in E2 than in E1, respectively. Phentolamine potentiated exercise-induced EGC increase during E2 only. Propranolol reduced the lipolytic rate during both E1 and E2 compared with the probe with phentolamine. Plasma ANP concentration increased more during E2 than during E1 and was correlated with the increase in EGC in the probe containing phentolamine plus propranolol. The results suggest that ANP is involved in the control of lipolysis during exercise and that it contributes to stimulation of lipolysis during repeated bouts of exercise.

  6. [Physiological and pathophysiological features of the control of lipolysis and lipid mobilization by natriuretic peptides].

    Science.gov (United States)

    Moro, Cédric; Berlan, Michel; Lafontan, Max

    2006-01-01

    We have demonstrated a potent and specific lipolytic effect of natriuretic peptides (NP) in human and primates' fat cells. The lipolytic effect of NP is mediated through intracellular production of cGMP and activation of the cGMP-dependent kinase 1alpha. Local infusion of atrial-NP (ANP), directly within the subcutaneous adipose tissue through a microdialysis catheter, increases lipolysis and stimulates blood flow through its vasodilating effect in lean healthy men. This effect is blunted in overweight men and can be recovered by endurance training. Intravenous infusion of physiological doses of ANP induces lipid mobilization. Higher concentrations of ANP that are encountered during heart failure also stimulate lipid oxidation. ANP activates lipolysis and free fatty acids release from adipose tissue during endurance exercise. This effect is paradoxically amplified when exercise is performed under beta-blockade treatment, because of an enhanced cardiac release of ANP. No gender differences in ANP-induced lipid mobilization during exercise have been found. Heart failure is associated with high circulating levels of NP that could participate to the progression toward cachexia. On contrary, a negative correlation between NP levels and body mass index is found in obese persons. The molecular basis of this inverse correlation is not yet demonstrated from a functional standpoint. Further studies are needed to clearly define the pathophysiological role of NP in obesity and heart failure.

  7. Atrial natriuretic peptide contributes to physiological control of lipid mobilization in humans.

    Science.gov (United States)

    Moro, Cedric; Crampes, Francois; Sengenes, Coralie; De Glisezinski, Isabelle; Galitzky, Jean; Thalamas, Claire; Lafontan, Max; Berlan, Michel

    2004-05-01

    In humans, lipid mobilization is considered to depend mainly on sympathetic nervous system activation and catecholamine action. A contribution of ANP was hypothesized because we have previously shown that atrial natriuretic peptide (ANP) is a lipolytic agent on isolated human fat cells. Control of lipid-mobilizing mechanisms was investigated using in situ microdialysis in subcutaneous adipose tissue (SCAT) in healthy young men during two successive exercise bouts performed at 35% and 60% peak oxygen consumption (VO2max) after placebo or acute oral tertatolol (nonselective beta-antagonist) treatment. In placebo-treated subjects, infusion of propranolol in the probe (100 micromol/l) only partially reduced (40%) the increment in extracellular glycerol concentration (EGC) promoted by exercise. Moreover, oral beta-adrenergic receptor blockade did not prevent exercise-induced lipid mobilization in SCAT while exerting fat cell beta-adrenergic receptor blockade. Exercise-induced increase in plasma ANP was potently amplified by oral tertatolol. A positive correlation was found between EGC and plasma ANP levels but also between extracellular cGMP (i.e., index of ANP-mediated lipolysis) and EGC. Thus, we demonstrate that exercise-induced lipid mobilization resistant to local propranolol and lipid-mobilizing action observed under oral beta-blockade is related to the action of ANP. Oral beta-adrenergic receptor blockade, which potentiates exercise-induced ANP release by the heart, may contribute to lipid mobilization in SCAT. The potential relevance of an ANP-related lipid-mobilizing pathway is discussed.

  8. B-type natriuretic peptide to predict ductus intervention in infants <28 weeks.

    Science.gov (United States)

    Czernik, Christoph; Lemmer, Julia; Metze, Boris; Koehne, Petra S; Mueller, Christian; Obladen, Michael

    2008-09-01

    Patent ductus arteriosus (PDA) is frequent in neonates with gestational age of less than 28 wk. Clinical and echocardiographic signs define hemodynamic significance of PDA, but do not reveal the need for PDA intervention in the first days of life. B-type natriuretic peptide (BNP) has been proposed as a screening tool for PDA in preterm infants. To determine whether BNP can predict the need for PDA intervention, plasma BNP was measured by chemiluminescence immunoassay in 67 preterm infants <28 wk (median 26) on the second day of life in a prospective blinded study. PDA intervention was based on specified clinical and echocardiographic findings. Twenty-four patients (intervention group) received treatment for PDA and 43 patients (controls) remained without intervention. BNP concentrations were higher in the intervention (median 1069 pg/mL) than in the control group (247 pg/mL, p < 0.001). BNP correlated positively with ductal size (R = 0.46, p < 0.001) and atrial/aortic root ratio (R = 0.54, p < 0.001). In conclusion, plasma BNP proved to be a good predictor for ductus intervention (area under the curve: 0.86) with the best cutoff at 550 pg/mL on the second day of life in ventilated infants less than 28 wk gestation (sensitivity: 83%; specificity: 86%).

  9. Circulating natriuretic peptide concentrations reflect changes in insulin sensitivity over time in the Diabetes Prevention Program.

    Science.gov (United States)

    Walford, Geoffrey A; Ma, Yong; Christophi, Costas A; Goldberg, Ronald B; Jarolim, Petr; Horton, Edward; Mather, Kieren J; Barrett-Connor, Elizabeth; Davis, Jaclyn; Florez, Jose C; Wang, Thomas J

    2014-05-01

    We aimed to study the relationship between measures of adiposity, insulin sensitivity and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the Diabetes Prevention Program (DPP). The DPP is a completed clinical trial. Using stored samples from this resource, we measured BMI, waist circumference (WC), an insulin sensitivity index (ISI; [1/HOMA-IR]) and NT-proBNP at baseline and at 2 years of follow-up in participants randomised to placebo (n = 692), intensive lifestyle intervention (n = 832) or metformin (n = 887). At baseline, log NT-proBNP did not differ between treatment arms and was correlated with baseline log ISI (p  0.05 for both). In regression models, the change in log NT-proBNP was positively associated with the change in log ISI (p < 0.005) in all three study groups after adjusting for changes in BMI and WC, but was not associated with the change in BMI or WC after adjusting for changes in log ISI. Circulating NT-proBNP was associated with a measure of insulin sensitivity before and during preventive interventions for type 2 diabetes in the DPP. This relationship persisted after adjustment for measures of adiposity and was consistent regardless of whether a participant was treated with placebo, intensive lifestyle intervention or metformin.

  10. Differential changes in atrial natriuretic peptide and vasopressin receptor bindings in kidney of spontaneously hypertensive rat

    Energy Technology Data Exchange (ETDEWEB)

    Ogura, T.; Mitsui, T.; Yamamoto, I.; Katayama, E.; Ota, Z.; Ogawa, N.

    1987-01-19

    To elucidate the role of atrial natriuretic peptide (ANP) and vasopressin (VP) in a hypertensive state, ANP and VP receptor bindings in spontaneously hypertensive rat (SHR) kidney were analyzed using the radiolabeled receptor assay (RRA) technique. Systolic blood pressure of SHR aged 12 weeks was statistically higher than that of age-matched Wistar Kyoto (WKY) rats. Maximum binding capacity (Bmax) of (/sup 125/I)-ANP binding to the SHR kidney membrane preparations was statistically lower than that of WKY rats, but dissociation constant (Kd) was not significantly different. On the other hand, Bmax of (/sup 3/H)-VP binding to the SHR kidney membrane preparations was statistically higher than that of WKY rats, but Kd were similar. Since the physiological action of ANP is natriuresis and VP is the most important antidiuretic hormone in mammalia, these opposite changes of ANP and VP receptor bindings in SHR kidney suggested that these peptides may play an important role in the pathophysiology of the hypertensive state, although it has not been confirmed as yet.

  11. The role of atrial natriuretic peptide (ANP) in cold-induced diuresis (CID)

    Energy Technology Data Exchange (ETDEWEB)

    Agnew, J.W.; Freund, B.J.; DuBose, D.A.; McKay, J.M.; Hashiro, G.M. (Army Research Inst. of Environmental Medicine, Natick, MA (United States) Tripler Army Medical Center, Honolulu, HI (United States))

    1991-03-11

    The hormonal control of cold-induced diuresis (CID) remains unresolved. This study investigated the role of ANP, plasma vasopressin (AVP), and aldosterone (ALDO) on CID. Four semi-nude men participated in a 210 min exposure to 15C and 29C air, on separate days. These subjects drank 300 mL of water and had an intravenous saline drip throughout both exposures to replace blood and insensible fluid losses. CID was observed in 15C but not in the 29C experiment, as indicated by a greater urine output. In 15C, atrial natriuretic peptide (ANP) increased after 90 min by 41% and remained elevated for 2 h relative to 29C. No differences were observed in AVP between 15C and 29C. In the 15C versus the 29C experiment, ALDO was approximately 37% lower at the pre, 15 and 90 min time periods. Mean arterial blood pressure was generally greater but only significant at 60 min during the 15C versus the 29C experiment. Urinary NA{sup +} excretion was elevated in 15C relative to 29C while no difference in K{sup +} excretion was observed. Although pressure effects may contribute, the observed natriuresis in the absence of a kaliuresis in the cold suggests a physiological role of ANP in CID.

  12. Circulating atrial natriuretic peptide (ANP) and central blood volume (CBV) in cirrhosis

    DEFF Research Database (Denmark)

    Schütten, H J; Henriksen, Jens Henrik Sahl; Bendtsen, F

    1986-01-01

    , P less than 0.02) and inversely correlated with portal pressure (r = 0.42, P less than 0.05), whereas total plasma volume was somewhat increased (3.51 +/- 0.2 vs. 3.19 +/- 0.2, 0.05 less than P less than 0.1). A high arterio-venous extraction of ANP was found in the splanchnic system (extraction......Endogenous alpha-atrial natriuretic peptide (ANP) in plasma is elevated in various hypervolaemic conditions. Possible relationships between circulating immunoreactive ANP and cardiovascular and splanchnic haemodynamics were therefore studied in patients with cirrhosis (n = 16) and controls (n = 12......). Arterial plasma concentration of ANP in supine patients was (mean +/- SEM) 33 +/- 4 vs 41 +/- 10 pg/ml (9.9 +/- 1.2 vs 12.3 +/- 3.0 fmol/l) in controls (n.s.), and there was a weak direct correlation with right atrial pressure (r = 0.36, P = 0.05). There was no relationship with the presence of ascites...

  13. Constitutively active form of natriuretic peptide receptor 2 ameliorates experimental pulmonary arterial hypertension.

    Science.gov (United States)

    Nawa, Nobutoshi; Ishida, Hidekazu; Katsuragi, Shinichi; Baden, Hiroki; Takahashi, Kunihiko; Higeno, Ryota; Torigoe, Fumiko; Mihara, Seiko; Narita, Jun; Miura, Kohji; Nakamura, Kazufumi; Kogaki, Shigetoyo; Ozono, Keiichi

    2016-01-01

    We recently found a constitutively active mutant of natriuretic peptide receptor 2 (caNPR2; V883M), which synthesizes larger amounts of cyclic guanosine monophosphate (cGMP) intracellularly without any ligand stimulation than existing drugs. The aim of this study was to investigate the therapeutic effects of gene transduction using caNPR2 for pulmonary arterial hypertension (PAH). In vitro gene transduction into human pulmonary arterial smooth muscle cells using Sendai virus (SeV) vectors carrying caNPR2 induced 10,000-fold increases in the synthesis of cGMP without ligand stimulation, and the proliferation of caNPR2-expressing cells was significantly attenuated. The PAH model rats generated by hypoxia and the administration of SU5416 were then treated with SeV vectors through a direct injection into the left pulmonary artery. Right ventricular systolic pressure was significantly decreased 2 weeks after the treatment, while systemic blood pressure remained unchanged. Histological analyses revealed that the medial wall thickness and occlusion rate of pulmonary arterioles were significantly improved in caNPR2-treated lungs. Neither the systemic integration of virus vectors nor side effects were observed. The massive stimulation of cGMP synthesis by gene therapy with caNPR2 was safe and effective in a PAH rat model and, thus, has potential as a novel therapy for patients with severe progressive PAH.

  14. Receptor binding sites for atrial natriuretic factor are expressed by brown adipose tissue

    Energy Technology Data Exchange (ETDEWEB)

    Bacay, A.C.; Mantyh, C.R.; Vigna, S.R.; Mantyh, P.W. (Wadsworth VA Medical Center, Los Angeles, CA (USA))

    1988-09-01

    To explore the possibility that atrial natriuretic factor (ANF) is involved in thermoregulation we used quantitative receptor autoradiography and homogenate receptor binding assays to identify ANF bindings sites in neonatal rat and sheep brown adipose tissue, respectively. Using quantitative receptor autoradiography were were able to localize high levels of specific binding sites for {sup 125}I-rat ANF in neonatal rat brown adipose tissue. Homogenate binding assays on sheep brown fat demonstrated that the radioligand was binding to the membrane fraction and that the specific binding was not due to a lipophilic interaction between {sup 125}I-rat ANF and brown fat. Specific binding of {sup 125}I-rat ANF to the membranes of brown fat cells was inhibited by unlabeled rat ANF with a Ki of 8.0 x 10(-9) M, but not by unrelated peptides. These studies demonstrate that brown fat cells express high levels of ANF receptor binding sites in neonatal rat and sheep and suggest that ANF may play a role in thermoregulation.

  15. Response of atrial natriuretic factor to acute extracellular fluid volume in patients with pheochromocytoma.

    Science.gov (United States)

    Paniagua, R; Rodríguez, E; Amato, D; Sánchez, G; Ron, O; Rodríguez, F; Herrera-Acosta, J

    2000-01-01

    Patients with pheochromocytoma have been reported to show high plasmatic atrial natriuretic factor (ANF) levels. Its source may not be the atrium because blood volume, the most important physiological stimulus for ANF release, is usually reduced in these patients. To evaluate ANF secretion functional integrity, we studied three patients with pheochromocytoma before and after surgical removal of the tumor. Extracellular fluid (ECF) volume, plasmatic ANF levels, and plasmatic renin activity (PRA) were measured. ANF was measured before and after an acute saline load of 1.5L in 90 min. Before surgery, ECF volume was normal or reduced, and PRA was normal but decreased after the saline load. By contrast, ANF was elevated and did not change after the saline load. After surgery ANF decreased, ECF volume rose, and the saline load induced a significant increase of plasma ANF and reduction of PRA. ANF was present in significant amounts in tumoral tissue homogenates. These data suggest that the tumor was the source of ANF in these patients with pheochromocytoma because high levels of ANF, despite reduced or normal ECF volume, as well as unresponsiveness to acute saline infusion, were found before surgery with subsequent normalization after tumor removal.

  16. Urinary C-type natriuretic peptide: an emerging biomarker for heart failure and renal remodeling.

    Science.gov (United States)

    Zakeri, Rosita; Burnett, John C; Sangaralingham, S Jeson

    2015-03-30

    The public health and economic burden of heart failure (HF) is staggering and the need for relevant pathophysiologic and clinical biomarkers to advance the field and improve HF therapy remains high. Renal dysfunction is common among HF patients and is associated with increased HF hospitalization and mortality. It is widely recognized that mechanisms contributing to HF pathogenesis include a complex bidirectional interaction between the kidney and heart, encompassed by the term cardiorenal syndrome (CRS). Among a new wave of urinary biomarkers germane to CRS, C-type natriuretic peptide (CNP) has emerged as an innovative biomarker of renal structural and functional impairment in HF and chronic renal disease states. CNP is a hormone, synthesized in the kidney, and is an important regulator of cell proliferation and organ fibrosis. Hypoxia, cytokines and fibrotic growth factors, which are inherent to both cardiac and renal remodeling processes, are among the recognized stimuli for CNP production and release. In this review we aim to highlight current knowledge regarding the biology and pathophysiological correlates of urinary CNP, and its potential clinical utility as a diagnostic and prognostic biomarker in HF and renal disease states.

  17. Atrial natriuretic factor: radioimmunoassay and effects on adrenal and pituitary glands

    Energy Technology Data Exchange (ETDEWEB)

    Gutkowska, J.; Horky, K.; Schiffrin, E.L.; Thibault, G.; Garcia, R.; De Lean, A.; Hamet, P.; Tremblay, J.; Anand-Srivastava, M.B.; Januszewicz, P.

    1986-06-01

    A simple and sensitive radioimmunoassay was developed for measurement of immunoreactive atrial natriuretic factor (IR-ANF) in rat and human plasma and in rat atria. The two atria contain about 20 ..mu..g ANF per rat. The right atrium contained 2.5 times more ANF than did the left. Ether anesthesia and morphine markedly increased IR-ANF in rat plasma. The concentration of IR-ANF in plasma of clinically normal human subjects was 65.3 +/- 2.5 pg/ml. Paroxysmal tachycardia and rapid atrial pacing significantly increased IR-ANF in human plasma. Two- to seven-fold higher concentrations were found in coronary sinus blood than in the peripheral circulation. In the plasma of rats and humans, circulating ANF is probably a small-molecular-weight peptide. ANF acts on the adrenal and the pituitary. ANF inhibits aldosterone secretion from rat zona glomerulosa and steroid secretion by bovine adrenal zona glomerulosa and fasciculata. ANF stimulated the basal secretion of arginine vasopressin (AVP) in vitro and inhibited KCl-stimulated release of AVP.

  18. Effectiveness of natriuretic peptide-guided treatment of chronic heart failure. Meta-analysis.

    Science.gov (United States)

    Gamiño-Arroyo, Ana-Estela; Prado-Galbarro, Francisco-Javier; García-Pérez, Sonia; Sánchez-Piedra, Carlos

    2017-04-10

    Evaluate the efficacy of natriuretic peptide (NP)-guided therapy compared to clinically-guided therapy reducing mortality and hospitalization in chronic heart failure (HF) patients. Randomized clinical trials (RCT) were selected through a systematic review. Four meta-analyses were conducted for the outcomes of overall mortality, HF-related mortality, overall hospitalization, and HF-related hospitalization. Heterogeneity between studies and publication bias were assessed. Nine RCTs were found with a total of 1914 patients. NP-guided therapy reduced significantly overall mortality and HF-related hospitalization. No significant results were found for HF-related mortality and overall hospitalization. Some clinical heterogeneity regarding interventions performed was found between studies. Publication bias was found for HF-related and overall hospitalizations. NP-guided therapy seems to improve outcomes compare to clinically-guided therapy. However, heterogeneity found between interventions might reduce generalizability of these results. Specific interventions of the clinical trials should be examined when making recommendations regarding NP-guided therapy. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  19. PI 3-kinase pathway is responsible for antiapoptotic effects of atrial natriuretic peptidein rat liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Uwe Grutzner; Melanie Keller; Michael Bach; Alexandra K Kiemer; Herbert Meissner; Manfred Bilzer; Stefan Zahler; Alexander L Gerbes; Angelika M Vollmar

    2006-01-01

    AIM: To investigate the in vivo effect of atrial natriuretic peptide (ANP) and its signaling pathway during orthotopic rat liver transplantation.METHODS: Rats were infused with NaCl, ANP (5 μg/kg), wortmannin (WM, 16 μg/kg), or a combination of both for 20 min. Livers were stored in UW solution (4°C) for 24 h, transplanted and reperfused. Apoptosis was examined by caspase-3 activity and TUNEL staining.Phosphorylation of Akt and Bad was visualized by Western blotting and phospho-Akt-localization by confocai microscopy.RESULTS: ANP-pretreatment decreased caspase-3activity and TUNEL-positive cells after cold ischemia,indicating antiapoptotic effects of ANP in vivo. The antiapoptotic signaling of ANP was most likely caused by phosphorylation of Akt and Bad, since pretreatment with PI 3-kinase inhibitor WM abrogated the ANP-induced reduction of caspase-3 activity. Interestingly, analysis of liver tissue by confocal microscopy showed translocation of phosphorylated Akt to the plasma membrane of hepatocytes evoked by ANP.CONCLUSION: ANP activates the PI-3-kinase pathway in the liver in vivo leading to phosphorylation of Bad,an event triggering antiapoptotic signaling cascade in ischemic liver.

  20. Natriuretic Peptide System Activation in Acute Heart Failure Patients with Diabetes

    Directory of Open Access Journals (Sweden)

    Filipe M. Cunha

    2017-01-01

    Full Text Available Background. Elevated B-type natriuretic peptide (BNP is a hallmark in heart failure (HF. Diabetic patients with chronic HF seem to have higher BNP than nondiabetics. We studied, in acute HF, if BNP levels are different between diabetics and nondiabetics. Methods. From a prospectively recruited population of acute HF patients, we selected a convenience sample. In pair-matched analysis, each diabetic patient was matched with a nondiabetic of the same age (±1 year, gender, and according to left ventricular systolic dysfunction. Diabetics and nondiabetics were compared. Cox-regression analysis was used to analyse the prognostic impact of diabetes. Results. We studied 328 patients, mean age: 78 years, 44.5% male. Diabetics were more often hypertensive and had ischemic HF; they had higher body mass index, lower haemoglobin, and worse renal function. Diabetics were more often discharged on ACE inhibitors/ARB, antiplatelet therapy, and statins. Neither admission nor discharge BNP values differed between diabetics and pair-matched nondiabetics. One-year mortality was also nondifferent between pairs of diabetics and nondiabetics: 44 (26.8% and 46 (28.0%, respectively. HR for 1-year mortality in diabetics was 1.00 (95% CI: 0.82–1.24 compared with nondiabetics. Conclusions. HF patients with diabetes have similar neurohumoral activation when compared with nondiabetics. One-year mortality is also nondifferent after matching for age, gender, and systolic function.

  1. Atrial natriuretic peptide secretion during development of the rat supraoptic nucleus

    Directory of Open Access Journals (Sweden)

    E Farina Lipari

    2009-06-01

    Full Text Available Since a relationship between atrial natriuretic peptide and oxytocin was recently demonstrated in the heart (Gutkowska et al., 1997, the aim of this study was to determine whether a relationship between the two peptides is present also in the rat hypothalamus. For this purpose, we measured ANPontogeny in the rat hypothalamus immunohistochemically and compared it with oxytocin-ontogeny which we previously studied. The results showed that the ANP-peptide and mRNA-ANP start at the 18th day of the fetal life. Our earlier data for oxytocin in the rat hypothalamus showed that only mRNA-oxytocin appeared the 18th day of foetal life (Farina Lipari et al., 2001; thus, at the 18th day of foetal life, mRNA-ANP, ANP-peptide and mRNA-oxytocin are present.We conclude that in the hypothalamus, differently from that in the heart, ANP might play a role on the synthesis of the oxytocin since ANP and its mRNA appear earlier than oxytocin.

  2. Atrial natriuretic peptide receptor heterogeneity and effects on cyclic GMP accumulation

    Energy Technology Data Exchange (ETDEWEB)

    Leitman, D.C.

    1988-01-01

    The effects of atrial natriuretic peptide (ANP), oxytocin (OT) and vasopressin (AVP) on guanylate cyclase activity and cyclic GMP accumulation were examined, since these hormones appear to be intimately associated with blood pressure and intravascular volume homeostasis. ANP was found to increase cyclic GMP accumulation in ten cell culture systems, which were derived from blood vessels, adrenal cortex, kidney, lung, testes and mammary gland. ANP receptors were characterized in intact cultured cells using {sup 125}I-ANP{sub 8-33}. Specific {sup 125}I-ANP binding was saturable and of high affinity. Scratchard analysis of the binding data for all cell types exhibited a straight line, indicating that these cells possessed a single class of binding sites. Despite the presence of linear Scatchard plots, these studies demonstrated that cultured cells possess two functionally and physically distinct ANP-binding sites. Most of the ANP-binding sites in cultured cells have a molecular size of 66,000 daltons under reducing conditions. The identification of cultured cell types in which hormones (ANP and oxytocin) regulate guanylate cyclase activity and increase cyclic GMP synthesis will provide valuable systems to determine the mechanisms of hormone-receptor coupling to guanylate cyclase and the cellular processes regulated by cyclic GMP.

  3. Stimulation of p38 MAPK by hormal preconditioning with atrial natriuretic peptide

    Institute of Scientific and Technical Information of China (English)

    Alexandra K. Kiemer; Stefanie Kulhanek-Heinze; Tobias Gerwig; Alexander L. Gerbes; Angelika M. Vollmar

    2002-01-01

    AIM: Stress-activated signaling pathways responsiblefor hepatic ischemia reperfusion injury and theirmodulation by protective interventions are widelyunknown. Preconditioning of rat livers with AtrialNatriuretic Peptide (ANP) attenuates ischemiareperfusion injury (Gerbes et al. Hepatology 1998, 28:1309-1317). Since ANP has recently been shown to bea regulator of the p38 MAPK pathway in endothelialcells (Kiemer et al. Circ Res 2002, 90:874-881), aim ofthis study was to investigate activities of MAPK duringischemia and reperfusion and effects of ANP on MAPK.METHODS: Rat livers were perfused with KH-buffer inthe presence or absence of ANP for 20 min, kept in coldUW solution for 24 h, and reperfused for up to 120 min.Activities of p38 MAPK and JNK was determined by invitro phosphorylation assays using MBP and c-jun assubstrates. After SDS/PAGE electrophoresis, gels werequantified by phosphorimaging.RESULTS: Activity of p38 MAPK in control organsdecreased in the course of ischemia and reperfusionby 85%, whereas ANP increased p38 activity by up to30-fold. JNK activation of control livers increased in thecourse of ischemia and reperfusion by up to three-fold.This increase in JNK activity was slightly elevated inANP preconditioned organs.CONCLUSION: This work represents a systematicinvestigation of MAPK activation during liver ischemiaand reperfusion. Employing ANP, for the first time apharmacological approach to modulate these centralsignal transduction molecules is presented.

  4. The Role of Natriuretic Peptides for the Diagnosis of Left Ventricular Dysfunction

    Directory of Open Access Journals (Sweden)

    Alberto Palazzuoli

    2013-01-01

    Full Text Available Natriuretic peptides (NPs are entered in current guidelines for heart failure (HF diagnosis and management because of their high specificity and sensibility in screening patients with acute dyspnea. Due to their availability and relatively low cost, they became the first step examinations in HF patients evaluation at hospital admission together with clinical and chest radiography examination. NPs are released following any cardiac haemodynamic stress due to volume or pressure overload and should be considered as a mirror of cardiac condition helping in recognizing patients with poor outcome. Moreover, the exact role of NPs in early HF stages, in isolated diastolic dysfunction, and in general population is questioned. Several promising reports described their potential role; however, the wide cut-off definition, inclusion criteria, and intrinsic measurement biases do not actually consent to their clinical application in these settings. A multimodality strategy including both NPs and imaging studies appears to be the best strategy to define the cardiac dysfunction etiology and its severity as well as to identify patients with higher risk. In this review, we describe the current and potential role of NPs in patients with asymptomatic cardiac insufficiency, evaluating the requirement to obtain a better standardization for imaging as for laboratory criteria.

  5. The impact of atrial natriuretic peptide on anxiety, stress and craving in patients with alcohol dependence.

    Science.gov (United States)

    Koopmann, Anne; Leménager, Tagrid; Wolf, Nadine Donata; Reinhard, Iris; Hermann, Derik; Koch, Jan; Wiedemann, Klaus; Kiefer, Falk

    2014-01-01

    Atrial natriuretic peptide (ANP) is well known to modulate fluid and electrolyte homeostasis but also to counter-regulate hypothalamic-pituitary-adrenal (HPA) axis activity. Correspondingly, recent studies suggest an important role of ANP in the neurobiology of anxiety. Preclinical and clinical data now provide evidence for an involvement of ANP in the pathophysiology of addictive behavior. The present study aims to elucidate the effects of ANP on alcohol-dependent patients' anxiety, perceived stress and craving during alcohol withdrawal. A sample of 59 alcohol-dependent inpatients was included in the analysis. A blood sample was taken at day 14 of detoxification in order to assess the concentrations of ANP and cortisol in plasma. In parallel, we assessed patients' alcohol craving, using the Obsessive Compulsive Drinking Scale, as well as anxiety (State-Trait Anxiety Inventory). Patients' stress levels were assessed using the Perceived Stress Scale. We found a significant negative association between patients' ANP plasma concentrations and anxiety, craving for alcohol and perceived stress. Regression analyses suggest that ANP is a significant predictor both for patients' perceived stress and for the severity of anxiety during early abstinence. The association of patients' ANP plasma levels and craving is suggested to be mediated by perceived stress. Our results suggest that the association of patients' ANP plasma levels and craving is mediated by their perceived stress. For this reason, intranasal application of ANP may prove to be a new avenue for the treatment of alcohol dependence in patients exhibiting high levels of perceived stress.

  6. N-terminal pro brain natriuretic peptide in arterial hypertension--a marker for left ventricular dimensions and prognosis

    DEFF Research Database (Denmark)

    Hildebrandt, Per; Boesen, Mikael; Olsen, Michael

    2004-01-01

    and preserved LV function demonstrated that NT-proBNP was a very strong prognostic marker, especially combined with a history of cardiovascular disease. Patients with high NT-proBNP and known cardiovascular disease had a seven-fold increase in CV events compared to patients with low NT-proBNP and no CV disease...... is present in arterial hypertension, risk factor evaluation would be easier. In 36 patients with arterial hypertension, electrocardiographic LV hypertrophy and preserved left ventricular function, NT-proBNP was eight-fold higher than in healthy subjects. The log NT-proBNP correlated with LV mass index (R=0...

  7. High Serum Levels of Pro-Brain Natriuretic Peptide (pro BNP Identify Cardioembolic Origin in Undetermined Stroke

    Directory of Open Access Journals (Sweden)

    Manuel Rodríguez-Yáñez

    2009-01-01

    Full Text Available Background: Stroke subtype diagnosis leads to specific therapies to reduce recurrences. Because nearly one third of patients remain with unknown etiology after a complete screening workup, we aim to investigate whether molecular markers of myocardial damage were associated with cardioembolic stroke and if they were useful to reclassify strokes of undetermined etiology.

  8. Adding serial N-terminal pro brain natriuretic peptide measurements to optimal clinical management in outpatients with systolic heart failure

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Videbaek, Lars

    2013-01-01

    AIMS: This study was designed to evaluate a new NT-proBNP monitoring concept in outpatients with systolic heart failure (HF). METHODS AND RESULTS: This was a multicentre, prospective randomized open-label blinded endpoint study. A total of 407 systolic HF patients were allocated to either clinical...... management (n = 208) or clinical management + NT-proBNP monitoring (n = 199) and followed for 2.5 years. If NT-proBNP increased >30%, a clinical checklist was completed and treatment initiated. The patients were matched at randomization and were 73 years old, 25% were females, 85% were NYHA class I-II, LVEF...... was 30%, and NT-proBNP 1955 pg/mL. NT-proBNP monitoring did not improve outcome, the hazard ratio for the primary composite endpoint (death or a cardiovascular admission) being 0.96 [95% confidence interval (CI) 0.71-1.29, P = 0.766]. NT-proBNP monitoring did not induce a significant change...

  9. N-terminal pro brain natriuretic peptide in arterial hypertension--a marker for left ventricular dimensions and prognosis

    DEFF Research Database (Denmark)

    Hildebrandt, Per; Boesen, Mikael; Olsen, Michael

    2004-01-01

    In arterial hypertension risk factor evaluation, including LV mass measurements, and risk stratification using risk charts or programs, is generally recommended. In heart failure NT-proBNP has been shown to be a marker of LV dimensions and of prognosis. If the same diagnostic and prognostic value...... is present in arterial hypertension, risk factor evaluation would be easier. In 36 patients with arterial hypertension, electrocardiographic LV hypertrophy and preserved left ventricular function, NT-proBNP was eight-fold higher than in healthy subjects. The log NT-proBNP correlated with LV mass index (R=0...... and preserved LV function demonstrated that NT-proBNP was a very strong prognostic marker, especially combined with a history of cardiovascular disease. Patients with high NT-proBNP and known cardiovascular disease had a seven-fold increase in CV events compared to patients with low NT-proBNP and no CV disease...

  10. Chamber-dependent expression of brain natriuretic peptide and its mRNA in normal and diabetic pig heart

    DEFF Research Database (Denmark)

    Christoffersen, Christina; Goetze, Jens P; Bartels, Emil D;

    2002-01-01

    -induced diabetes doubled the expression of BNP mRNA in porcine atrial myocardium (P=0.03), but was without effect on BNP mRNA in the ventricular myocardium. The data suggest that BNP mRNA processing and proBNP storage differ between the atrial and ventricular myocardium. The results also imply that diabetes...

  11. Brain Fingerprinting

    Directory of Open Access Journals (Sweden)

    Ravi Kumar

    2012-12-01

    Full Text Available Brain Fingerprinting is a scientific technique to determine whether or not specific information is stored in an individual's brain by measuring a electrical brain wave response to Word, phrases, or picture that are presented on computer screen. Brain Fingerprinting is a controversial forensic science technique that uses electroencephalography (EEG to determine whether specific information is stored in a subject's brain.

  12. Brain Fingerprinting

    Directory of Open Access Journals (Sweden)

    ravi kumar

    2012-12-01

    Full Text Available Brain Fingerprinting is a scientific technique to determine whether or not specific information is stored in an individual's brain by measuring a electrical brain wave response to Word, phrases, or picture that are presented on computer screen. Brain Fingerprinting is a controversial forensic science technique that uses electroencephalograph y (EEG to determine whether specific information is stored in a subject's brain

  13. Brain Basics

    Medline Plus

    Full Text Available ... Basics will introduce you to some of this science, such as: How the brain develops How genes and the environment affect the brain The basic structure of the brain How different parts of the brain communicate and work with each other How changes in the brain ...

  14. Brain Tumors

    Science.gov (United States)

    A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, ... cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are ...

  15. Brain Basics

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    Full Text Available ... science, such as: How the brain develops How genes and the environment affect the brain The basic ... that with brain development in people mental disorders. Genes and environmental cues both help to direct this ...

  16. Brain Basics

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    Full Text Available ... can lead to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits ... tailored treatments, and possibly prevention of such illnesses. The Working Brain Neurotransmitters Everything we do relies on ...

  17. Brain Basics

    Medline Plus

    Full Text Available ... brain's structure, studies show that brain growth in children with autism appears to peak early. And as ... grow there are differences in brain development in children who develop bipolar disorder than children who do ...

  18. Brain Basics

    Medline Plus

    Full Text Available ... science, such as: How the brain develops How genes and the environment affect the brain The basic ... that with brain development in people mental disorders. Genes and environmental cues both help to direct this ...

  19. Brain Basics

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    Full Text Available ... lead to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons ... affects the Brain Meet Sarah Sarah is a middle-aged woman who seemed to have it all. ...

  20. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery -