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Sample records for natriuretic peptides bnp

  1. 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...

  2. 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...

  3. Obesity and natriuretic peptides, BNP and NT-proBNP: mechanisms and diagnostic implications for heart failure.

    Science.gov (United States)

    Madamanchi, Chaitanya; Alhosaini, Hassan; Sumida, Arihiro; Runge, Marschall S

    2014-10-20

    Many advances have been made in the diagnosis and management of heart failure (HF) in recent years. Cardiac biomarkers are an essential tool for clinicians: point of care B-type natriuretic peptide (BNP) and its N-terminal counterpart (NT-proBNP) levels help distinguish cardiac from non-cardiac causes of dyspnea and are also useful in the prognosis and monitoring of the efficacy of therapy. One of the major limitations of HF biomarkers is in obese patients where the relationship between BNP and NT-proBNP levels and myocardial stiffness is complex. Recent data suggest an inverse relationship between BNP and NT-proBNP levels and body mass index. Given the ever-increasing prevalence of obesity world-wide, it is important to understand the benefits and limitations of HF biomarkers in this population. This review will explore the biology, physiology, and pathophysiology of these peptides and the cardiac endocrine paradox in HF. We also examine the clinical evidence, mechanisms, and plausible biological explanations for the discord between BNP levels and HF in obese patients.

  4. 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.

  5. 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.

  6. 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...

  7. B-type natriuretic peptide (BNP serum levels in rats after forced repeated swimming stress

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    Almira Hadžovic-Džuvo

    2011-02-01

    Full Text Available Aim To estimate the effects of forced repeated swimming stress on BNP serum levels in rats. Methods Adult male Wistar rats weighting between 280-330 g were divided into two groups: control group (n =8 and stress group (n =8. Rats in the stress group were exposed to forced swimming stress daily, for 7 days. The rats were forced to swim in plastic tanks (90 cm wide, 120 cm deep containing tap water (temperature ca. 25°C. The depth of water was 40 cm. Duration of each swimming session progressively increased from 10 minutes on the irst day to 40 minutes on days 6 and 7. Rats were sacriiced and blood was drawn from abdominal aorta for BNP analysis immediately after the last swimming session. B-type natriuretic serum level was determined by ELISA method using RAT BNP-32 kit (Phoenix Pharmaceutical Inc.. Results There was no statistically signiicant difference between mean BNP serum level in the stress group after the swimming period (0.81±0.14 ng/ml as compared to the unstressed group of rats (0.8 ±0.08ng/ml. After the swimming period mean body weight slightly decreased in the stress group in comparison with values before stress period (296.3 g vs.272.8 g, but this difference was not statistically signiicant. The stress period had no inluence on food intake in the stress rat group. Conclusion The workload consisting of 40-minutes long swimming session is not suficient to provoke BNP release from myocardium in rats.

  8. Relationship between renalase and N-terminal pro-B-type Natriuretic Peptide (NT pro-BNP in haemodialysis patients

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    Marcin Dziedzic

    2014-03-01

    Full Text Available Introduction. Our knowledge in the field of cause of deaths in dialysis patients is rapidly expanding, yet we still do not fully understand how renalase regulates the processes of cardiovascular disease developing in end-stage renal disease. Increased sympathetic nerve activity observed in chronic kidney diseases due to raised catecholamines in plasma results from the absence of renalase. Renalase synthesized and secreted by the kidneys participate in the regulation of sympathetic tone and blood pressure. A family of natriuretic peptides has been identified – NT pro-BNP – which seems to be the best predictor of clinical outcome and marker of extracellular fluid overload, as well as predicting mortality, irrespective of renal function. Objective. The aim of the presented study was to investigate renalase concentration and investigate associations between NT-proBNP, as well as analyzed parameters in haemodialysis patients. Materials and method. The study was conducted among residents of the municipality and neighbouring villages in the province of Lublin, central-eastern Poland. 49 male subjects on haemodialysis, aged 65.3 ± 14.2 years, median time on haemodialysis: 37.5 months, were included. All study subjects underwent haemodialysis 3 times a week. The mean concentration of renalase in the entire study population was 126.59 ± 32.63 ng/mL. The circulating levels of NT-proBNP was 813.64 ± 706.96 pg/mL. A significant inverse correlation was found between NT-proBNP and renalase plasma levels (R = –0.3, P = 0.03. Conclusions. Inverse correlation between NT-proBNP and renalase plasma levels in haemodialysis patients were due to impaired kidney function, accompanied by increased sympathetic nerve activity, which have an impact on the development of hypertension and cardiovascular complications.

  9. N-terminal fragment of B-type natriuretic peptide (NT-proBNP, a marker of cardiac safety during antipsychotic treatment

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    Schneider Udo

    2005-05-01

    Full Text Available Abstract Background The potential cardiotoxicity of antipsychotic drugs is well known. The N-terminal fragment of B-type natriuretic peptide (NT-proBNP is considered to be a possible biomarker in clinical practice for the diagnosis and prognosis in patients with suspected heart failure. This pilot evaluation tests the influence of antipsychotic drugs on NT-proBNP concentration in view of the hypothesis that NT-proBNP could be used as marker for the tolerability and safety of antipsychotic medications. Methods On a routine basis, patient's blood samples were examined for NT-proBNP on days 0, 7 and 21 after initiation of a new antipsychotic monotherapy. All plasma samples were analysed for NT-proBNP using an electrochemiluminiscence immunoassay "ECLIA" (proBNP kit, Roche Diagnostics, Mannheim, Germany on an Elecsys 2010 analyser. Results A difference was found in NT-proBNP values at day 0 between patients younger versus older than 40 years. Also women had comparatively lower NTproBNP on days 7 and 21. Smokers' levels of NT-proBNP values decreased more from day 0 to day 7. Conclusion Our results suggest that antipsychotic medication influences the plasma concentration of NT-proBNP, suggesting a possible method to identify high-risk-patients for cardiovascular adverse effects due to antipsychotic medication. Larger studies should further test this hypothesis.

  10. N-terminal pro b-type natriuretic peptide (NT-pro-BNP) -based score can predict in-hospital mortality in patients with heart failure.

    Science.gov (United States)

    Huang, Ya-Ting; Tseng, Yuan-Teng; Chu, Tung-Wei; Chen, John; Lai, Min-Yu; Tang, Woung-Ru; Shiao, Chih-Chung

    2016-07-14

    Serum N-terminal pro b-type natriuretic peptide (NT-pro-BNP) testing is recommended in the patients with heart failure (HF). We hypothesized that NT-pro-BNP, in combination with other clinical factors in terms of a novel NT-pro BNP-based score, may provide even better predictive power for in-hospital mortality among patients with HF. A retrospective study enrolled adult patients with hospitalization-requiring HF who fulfilled the predefined criteria during the period from January 2011 to December 2013. We proposed a novel scoring system consisting of several independent predictors including NT-pro-BNP for predicting in-hospital mortality, and then compared the prognosis-predictive power of the novel NT-pro BNP-based score with other prognosis-predictive scores. A total of 269 patients were enrolled in the current study. Factors such as "serum NT-pro-BNP level above 8100 mg/dl," "age above 79 years," "without taking angiotensin converting enzyme inhibitors/angiotensin receptor blocker," "without taking beta-blocker," "without taking loop diuretics," "with mechanical ventilator support," "with non-invasive ventilator support," "with vasopressors use," and "experience of cardio-pulmonary resuscitation" were found as independent predictors. A novel NT-pro BNP-based score composed of these risk factors was proposed with excellent predictability for in-hospital mortality. The proposed novel NT-pro BNP-based score was extremely effective in predicting in-hospital mortality in HF patients.

  11. Probable role of Brain Natriuretic Peptide (BNP in lung hypertension secondary to scleroderma

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    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.

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

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    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.

  13. 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.

  14. Is N-terminal pro B-type natriuretic peptide (NT-proBNP) a useful screening test for angiographic findings in patients with stable coronary disease?

    DEFF Research Database (Denmark)

    Kragelund, Charlotte; Grønning, Bjørn; Omland, Torbjørn;

    2006-01-01

    BACKGROUND: Whether N-terminal pro B-type natriuretic peptide (NT-proBNP) is a useful screening tool for angiographic coronary artery disease in patients with angina is not known. Therefore, the purpose of this study was to assess the diagnostic test performance of NT-proBNP in detecting coronary......). The ability of NT-proBNP in detecting clinically significant coronary disease at angiography was modest, however, with sensitivity of 0.61, specificity 0.60, accuracy 61 (95% CI 58-64), positive likelihood ratio 1.5 (95% CI 1.3-1.8), negative likelihood ratio 0.7 (95% CI 0.6-0.8), and area under the ROC curve...... atherosclerotic lesions, as assessed by coronary angiography. METHODS: We examined 1034 patients referred for diagnostic angiography because of symptoms or signs of coronary artery disease. The diagnostic value of NT-proBNP in predicting clinically significant coronary disease was assessed. RESULTS: In a multiple...

  15. 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.

  16. 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. .

  17. 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....

  18. 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\

  19. 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...

  20. B-type natriuretic peptide secretion following scuba diving

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    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....

  1. 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...

  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. 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

  4. Chamber-dependent circadian expression of cardiac natriuretic peptides

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    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...

  5. 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.

  6. 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

  7. N‐terminal fragment of the type‐B natriuretic peptide (NT‐proBNP) contributes to a simple new frailty score in patients with newly diagnosed multiple myeloma

    Science.gov (United States)

    Milani, Paolo; Vincent Rajkumar, S.; Merlini, Giampaolo; Kumar, Shaji; Gertz, Morie A.; Palladini, Giovanni; Lacy, Martha Q.; Buadi, Francis K.; Hayman, Suzanne R.; Leung, Nelson; Dingli, David; Lust, John A.; Lin, Yi; Kapoor, Prashant; Go, Ronald S.; Hwa, Yi L.; Gonsalves, Wilson I.; Zeldenrust, Steven R.; Kyle, Robert A.

    2016-01-01

    Multiple myeloma (MM) patient frailty has been delineated primarily by age and ECOG performance score (PS) and recently by the IMWG frailty score based on functional status [Activity of Daily Living (ADL) and Instrumental‐ADL scores], comorbidities [Charlson‐comorbidity‐index (CCI)] and age. It was hypothesized that N‐terminal natriuretic peptide type B (NT‐proBNP) might be both a more convenient measure of frailty and a predictor of overall survival (OS). Three‐hundred and fifty‐one consecutive symptomatic MM patients who were seen at Mayo Clinic within 30 days of diagnosis and who had blood stored were eligible. Data from the first visit was abstracted and used to calculate an ADL, CCI, and measure the NT‐proBNP level. The best cutoff of NT‐proBNP predicting OS was 300 ng/L. Variables predictive for OS were ECOG‐PS, age, CCI, ADL, ISS, revised‐ISS, and NT‐proBNP. On multivariate analysis age ≥70, PS ≥2, and NT‐proBNP ≥300 were independent predictors of survival. Patients were assigned a score of 1 for each of these variables, creating stages I–IV with scores of 0–3 points, respectively. The median OS from diagnosis was not reached, 58, 28, and 18 months (P could be added to the panel of laboratory tests of newly diagnosed MM patients and serve as a simple and objective tool of determining frailty in clinical practice. Am. J. Hematol. 91:1129–1134, 2016. © 2016 Wiley Periodicals, Inc. PMID:27508522

  8. 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...

  9. 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...

  10. 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.

  11. 血清脑利钠肽(BNP)在正常孕妇及子痫前期患者中的研究%Study on B -type natriuretic peptide in normal pregnant women and patients with preeclampsia

    Institute of Scientific and Technical Information of China (English)

    任秀聪; 任立新

    2011-01-01

    Objective: To explore the changes of B -type natriuretic peptide (BNP) levels in normal pregnant women during different gestational periods and its relationship with the onset of preeclampsia. Methods; The serum levels of BNP were detected among 199 pregnant women from the first trimester of pregnancy to antepartum period, the difference of median of BNP level in peripheral blood between pregnant women with preeclampsia and normal pregnant women during different gestational periods was analyzed retrospectively. Results; In normal pregnant women, the medians of serum BNP levels maintained stable (17. 3 pg/ml, 16. 9 pg/ml, 15. 8 pg/ml and 18. 6 pg/ml, respectively) ; the averages levels of BNP in normal pregnant women, pregnant women with mild preeclampsia and pregnant women with severe preeclampsia were 17. 1 pg/ml, 22. 7 pg/ml and 118 pg/ml, respectively; there was significant difference in the averages level of BNP between pregnant women with severe preeclampsia and normal pregnant women, pregnant women with mild preeclampsia (P <0. 001) . Conclusion; In normal pregnant women, serum BNP levels maintain stable during different gestational periods; the serum BNP level of pregnant women with preeclampsia is significantly higher than that in normal pregnant women at the same gestational period, there is a correlation between BNP and onset of preeclampsia.%目的:探讨正常孕妇各孕期血清脑利钠肽(BNP)值的变化及其与子痫前期发病的关系.方法:共检测199例从孕早期至分娩前期孕妇血清BNP值,统计分析子痫前期孕妇与正常孕妇各孕期外周血清BNP值中位数的差异.结果:正常孕妇各孕期血清BNP中位数保持相对稳定,分别为17.3 pg/mL、16.9 pg/mL、15.8 pg/mL和18.6 pg/mL,正常孕妇,轻度子痫前期和重度子痫前期孕妇血清BNP值为17.1 pg/mL、22.7 pg/mL和118 pg/mL,重度子痫前期患者血清BNP值与正常孕妇及轻度子痫前期孕妇血清BNP差异有统计学意义(P<0.001).

  12. 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...

  13. Aminoterminal Pro B-Type Natriuretic Peptide (NT-proBNP Levels for Monitoring Interventions in Paediatric Cardiac Patients with Stenotic Lesions

    Directory of Open Access Journals (Sweden)

    Eva Welisch

    2009-01-01

    Full Text Available Background. Serum concentration of NT-proBNP correlates well with the severity of cardiac disease in adults. Few studies have been performed on the applicability of NT-proBNP for monitoring children with congenital heart disease. Objective. To assess the potential of NT-proBNP for monitoring the success of interventions in children with stenotic cardiac lesions. Methods. NT-proBNP was measured in 42 children aged 1 day to 17 years (y before and 6 to 12 weeks after surgical or interventional correction of obstructive lesions of the heart. Comparison is made with the clinical status and echocardiographic data of the child. Results. NT-proBNP levels (median 280, range 10–263,000 pg/mL were above the reference value in all but 6 patients (pts prior to the intervention. Higher levels were found in more compromised patients. The 35 children with clinical improvement after the procedure showed a decline of their NT-proBNP level in all but 4 patients, whose levels remained unchanged. Five patients with unchanged gradients despite a therapeutic intervention also demonstrated unchanged NT-proBNP levels after the intervention. Thus, the success rate of the procedure correlated well to clinical and echocardiographic findings. Conclusion. NT-proBNP can be used to assess the efficiency of an intervention.

  14. 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

  15. 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

  16. Effect of Professional Exercises on Brain Natriuretic Peptide

    Directory of Open Access Journals (Sweden)

    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.

  17. Serum levels of N-terminal fragment of precursor protein brain-type natriuretic peptide (NT-proBNP) in twin pregnancy.

    Science.gov (United States)

    Yamada, Takashi; Koyama, Takahiro; Furuta, Itsuko; Takeda, Masamitsu; Nishida, Ryutaro; Yamada, Takahiro; Morikawa, Mamoru; Minakami, Hisanori

    2013-01-16

    Twin pregnancy differs considerably from singleton pregnancy in many aspects and it is unknown how serum NT-proBNP level behaves in women with twin pregnancies. Serum NT-proBNP levels were determined longitudinally at gestational weeks (GW) 24 and 35 in normotensive women with 13 twin and 99 singleton pregnancies. The effects of maternal demographic characteristics on NT-proBNP levels were also analyzed. The serum NT-proBNP levels (pg/ml) in twin pregnancies, which were not different from those in singleton pregnancies at 24 GW (26±15 vs. 40±27, respectively, P=0.0718), increased significantly (P=0.0038) and were significantly higher than those in singleton pregnancies at 35 GW (72±49 vs. 34±24, Ptwin pregnancy were likely to exhibit an increase in serum NT-proBNP levels in the late stage of pregnancy, especially in lean and nulliparous women. The relative greater blood volume expansion occurring in twin than in singleton pregnancies was considered to be responsible for this phenomenon.

  18. 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

  19. 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...

  20. 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...

  1. Polymorphisms in the B-type natriuretic peptide (BNP) gene are associated with NT-proBNP levels but not with diabetic nephropathy or mortality in type 1 diabetic patients

    DEFF Research Database (Denmark)

    Lajer, Maria Stenkil; Tarnow, Lise; Jorsal, Anders

    2007-01-01

    of diabetes 28 +/- 8.0 years, glomerular filtration rate 67 +/- 28 ml/min/1.73 m2}, and a matched control group of 183 patients with longstanding type 1 diabetes and persistent normoalbuminuria (111 men, age 43 +/- 10.0 years, duration of diabetes 27 +/- 8.3 years) were followed for 12.6 (0.0-12.9) years....../A of the BNP gene, plasma NT-proBNP levels and mortality prognosis in 380 type 1 diabetic patients with and without diabetic nephropathy. METHODS: In a prospective observational follow-up study, 197 type 1 diabetic patients with diabetic nephropathy {121 men, age [mean (SD)] 41 +/- 9.5 years, duration....... Plasma NT-proBNP concentration was determined by immunoassay at baseline. The BNP genotypes were determined by TaqMan chemistry based assays. RESULTS: The two polymorphisms were in almost complete linkage disequilibrium (r2 = 0.883) and thus only the results of the -381T/C promoter polymorphism are shown...

  2. 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.

  3. 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....

  4. Porcine brain natriuretic peptide receptor in bovine adrenal cortex

    Energy Technology Data Exchange (ETDEWEB)

    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).

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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....

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

    Science.gov (United States)

    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.

  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. The role of B-type natriuretic peptide in the diagnosis and treatment of decompensated heart failure

    Institute of Scientific and Technical Information of China (English)

    Michael J. Gallagher; Peter A. McCullough

    2004-01-01

    Heart failure (HF) is a common disease associated with increasing age. B-type natriuretic peptide (BNP), is a cardiac neurohormone, and is released as prepro BNP and then enzyrnatically cleaved to the Ntenninal-proBNP (NT-proBNP) and BNP upon ventricular myocyte stretch. Blood measurements of BNP have been used to identify patients with I-IF. The BNP assay is currently used as a diagnostic and prognostic aid in HF. In general, a BNP level below 100 pg/mL excludes acutely decompensated HF and levels > 500 pg/ml indicate decompensation. Recombinant human BNP (hBNP, nesiritide) is an approved intravenous treatment for acute,decompensated -HF. Nesiritide given in supraphysiologic doses causes vasodilation, natriuresis, diuresis, and improved symptoms over the course of a 48-hour infusion. This paper will sort out the literature concerning the use of this peptide both as a diagnostic test and as an intravenous therapy.

  14. 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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  16. 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.

  17. 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.

  18. 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。

  19. 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...

  20. 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...

  1. 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....

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

    Science.gov (United States)

    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.

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  5. 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...

  6. 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....

  7. 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

  8. 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

  9. 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...

  10. 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...

  11. 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

  12. 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.

  13. 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...

  14. 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....

  15. 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...

  16. 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

  17. 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

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

    Science.gov (United States)

    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.

  19. 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.

  20. 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...

  1. Incremental value of natriuretic peptide measurement in acute decompensated heart failure (ADHF): a systematic review.

    Science.gov (United States)

    Santaguida, Pasqualina L; Don-Wauchope, Andrew C; Ali, Usman; Oremus, Mark; Brown, Judy A; Bustamam, Amy; Hill, Stephen A; Booth, Ronald A; Sohel, Nazmul; McKelvie, Robert; Balion, Cynthia; Raina, Parminder

    2014-08-01

    The aim of this systematic review was to determine whether B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) independently add incremental value for predicting mortality and morbidity in patients with acute decompensated heart failure (ADHF). Medline(®), Embase™, AMED, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL were searched from 1989 to June 2012. We also searched reference lists of included articles, systematic reviews, and the gray literature. Studies were screened for eligibility criteria and assessed for risk of bias. Data were extracted on study design, population demographics, assay cutpoints, prognostic risk prediction model covariates, statistical methods, outcomes, and results. From 183 citations, only seven studies (5 BNP and 2 NT-proBNP) considered incremental value in ADHF subjects admitted to acute care centers. Admission assay levels and length of follow-up varied for BNP studies (31 days to 12 months) and for NT-proBNP studies (25-82 months). All studies presented at least one estimate of incremental value of BNP/NT-proBNP relative to the base prognostic model. Using discrimination or likelihood statistics, these studies consistently showed that BNP or NT-proBNP increased model performance. Three studies used reclassification and model validation computations to establish incremental value; these studies showed less consistency with respect to added value. In conclusion, the literature assessing incremental value of BNP/NT-proBNP in ADHF populations is limited to seven studies evaluating only mortality outcomes and at moderate risk of bias. Although there were differences in the base risk prediction models, assay cutpoints, and lengths of follow-up, there was consistency in BNP/NT-proBNP adding incremental value in prediction models in ADHF patients.

  2. 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...

  3. 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...

  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. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  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. 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.

  12. 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.

  13. 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.

  14. 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...

  15. 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...

  16. [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.

  17. [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.

  18. BNP and NT-proBNP, Predictors of 1-Year Mortality in Nursing Home Residents

    NARCIS (Netherlands)

    Barents, Maaike; Hillege, Hans H. L.; van der Horst, Iwan C. C.; de Boer, Rudolph A.; Koster, J.; Muskiet, Frits A. J.; de Jongste, Mike J. L.

    2008-01-01

    Objectives: To investigate 1-year mortality prediction of B type natriuretic peptide (BNP) and N terminal-proBNP (NT-proBNP) in institutionalized elderly with multiple morbidities. Design: Prospective cross-sectional study. Setting: One nursing home. Participants: Ninety-three residents (mean age 81

  19. 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...

  20. Effect of beta-blockade and ACE inhibition on B-type natriuretic peptides in stable patients with systolic heart failure

    DEFF Research Database (Denmark)

    Rosenberg, J.; Gustafsson, F.; Remme, W.J.;

    2008-01-01

    treatment allocation: Carvedilol, enalapril or carvedilol+enalapril. Changes in BNP and NT-proBNP from baseline to 6 months maintenance visit were evaluated in each treatment arm. Furthermore, the prognostic value of BNP and NT-proBNP during monotherapy with carvedilol was assessed with univariate Cox...... (1.005-1.032), BNP 1.171 (1.088-1.260)). Conclusion Treatment of HF patients with carvedilol alone does not reduce levels of natriuretic peptides, but treatment with enalapril does. Both BNP and NT-proBNP predict death and hospitalisation in HF patients treated with carvedilol for six months....... The clinical implication of our results is that NT-proBNP and BNP can be used as risk markers of death and cardiovascular hospitalisations in systolic HF patients receiving carvedilol without ACE inhibition Udgivelsesdato: 2008/8...

  1. 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.

  2. Diagnostic and prognostic value of brain natriuretic peptide (BNP) concentrations in very elderly heart disease patients: specific geriatric cut-off and impacts of age, gender, renal dysfunction, and nutritional status.

    Science.gov (United States)

    Blondé-Cynober, F; Morineau, G; Estrugo, B; Fillie, E; Aussel, C; Vincent, J-P

    2011-01-01

    Confirming the presence of heart failure (HF) in geriatric patients is made difficult by the overlapping symptoms with other diseases and by limited access to investigative techniques such as echography, and the clinical signs are either non-constant or difficult to interpret. In this context, BNP measurement could prove highly useful. We determined a cut-off value of BNP for diagnosing HF in geriatric patients and gauged its predictive power in terms of cardiovascular events, dependence and death within a 6-month timeframe. This clinical and biological study was performed in patients, 44 women and 20 men, age>65 years with suspected HF hospitalized in the geriatric unit at Emile-Roux hospital. Echography was performed at baseline examination. BNP concentrations were determined at baseline examination and at 2 and 6 months later. Renal function was assessed via the Cockroft-Gault formula. Nutritional status was assessed using the geriatric nutritional risk index (GNRI). Final reference diagnosis was established by both cardiologist and geriatrician. The diagnostic value of BNP was assessed by area under the ROC curve. The average age of the 64 patients was 84.3±7.4 years. The final diagnosis was HF in 26 patients (41%). A BNPvalue of 90% (accuracy 80%) for excluding the diagnosis of HF. BNP values were predictive of cardiovascular events over a 2-month timeframe in patients with HF and over a 6-month timeframe in the global population. BNP values were not predictive of mortality in patients with or without HF. BNP testing should help to differentiate pulmonary from cardiac etiologies of dyspnea, but a specific cut-off point has to be used in geriatric settings, mainly for patients presenting nutritional and renal dysfunctions.

  3. 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...

  4. 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.

  5. 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....

  6. 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.

  7. 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

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

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    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.

  9. Reference Intervals for N-Terminal Pro-B-Type Natriuretic Peptide in Amniotic Fluid between 10 and 34 Weeks of Gestation

    OpenAIRE

    Merz, Waltraut M.; Christina Leufgen; Rolf Fimmers; Birgit Stoffel-Wagner; Ulrich Gembruch

    2014-01-01

    BACKGROUND: In adult and pediatric cardiology, n-terminal pro-B-type natriuretic peptide (nt-proBNP) serves as biomarker in the diagnosis and management of cardiovascular dysfunction. Elevated levels of circulating nt-proBNP are present in fetal conditions associated with myocardial pressure or volume load. Compared to fetal blood sampling, amniocentesis is technically easier and can be performed from early pregnancy onwards. We aimed to investigate amniotic fluid (AF) nt-proBNP concentration...

  10. 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.

  11. 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.

  12. 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.

  13. 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...

  14. 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.

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

    Science.gov (United States)

    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.

  16. 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.

  17. 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....

  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 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...

  19. Borderline values of troponin-T (TnT and high sensitivity C-reactive Protein (CRP did not predict 2-year mortality in TnT positive chest pain patients, whereas Brain Natriuretic Peptide (BNP did

    Directory of Open Access Journals (Sweden)

    Dennis WT Nilsen

    2015-04-01

    Full Text Available Background: Troponin-T (TnT, hsCRP and BNP have been shown to be independent prognostic indicators of total and cardiac death during short- and long-term follow-up.Methods: We investigated prospectively the prognostic value of admission samples of TnT, hsCRP and BNP in 871 chest-pain patients from South-Western Norway and 982 patients from Northern Argentina, based on a similar protocol and database setup. Follow-up was 2 years for the pooled population. The prognostic value of the selected biomarkers was investigated in quartiles of 239 patients with TnT values greater than 0.01 and up to and including 0.1 ng/mL, with continuous TnT as a potential confounder.Results: After 24 months, 69 patients had died, of whom 38 died from cardiac causes. In the selected range of TnT, this biomarker was not significantly different between patients that died and survived (mean 0.0452 and 0.0457, p = 0.887. The BNP levels were significantly higher among patients dying than in long-term survivors (340 (142 - 656 versus 157 (58 - 367 pq/mL [median, 25 and 75% percentiles], p < 0.001. In a multivariable Cox regression model for death within 2 years, the hazard ratio (HR for BNP in the highest quartile (Q4 as compared to the lowest (Q1 was significantly related to total mortality [HR 2.84 (95% confidence interval (CI, 1.13 - 7.17], p = 0.027, in addition to age (p ≤ 0.001 and hypercholesterolemia (p = 0.043. For cardiac death the HR for BNP was 5.18 (95% CI 1.06 - 25.3, p = 0.042. Several other variables (age, congestive heart failure, ST elevation myocardial infarction (STEMI and study country were also significantly related to cardiac death. In a multivariable Cox regression model hsCRP rendered no significant prognostic information for all-cause mortality (p = 0.089 or for cardiac mortality (p = 0.52.Conclusion: In patients with borderline troponin-T values (greater than 0.01 and up to and including 0.1 ng/mL, this biomarker as well as hsCRP did not render p

  20. 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...

  1. Anaemia and renal dysfunction are independently associated with BNP and NT-proBNP levels in patients with heart failure

    NARCIS (Netherlands)

    Hogenhuis, Jochern; Voors, Adriaan A.; Jaarsma, Tiny; Hoes, Arno W.; Hillege, Hans L.; Kragten, Johannes A.; van Veldhuisen, Dirk J.

    2007-01-01

    Background: Anaemia may affect 13-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) levels, but this has not been well described in heart failure (1417) patients without the exclusion of patients with renal dysfunction. Aims: To study the influence of both anaemia and renal function o

  2. Negative interference by rheumatoid factor of plasma B-type natriuretic peptide in chemiluminescent microparticle immunoassays.

    Directory of Open Access Journals (Sweden)

    Wen Fan

    Full Text Available BACKGROUND: The chemiluminescent microparticle immunoassay (CMIA is widely used for the quantitative determination of B-type natriuretic peptide (BNP in human ethylenediaminetetraacetic acid plasma. Rheumatoid factor (RF is usually thought to result in a positive interference in immunoassays, but it is not clear whether its presence in plasma can lead to interferences in the CMIA of BNP. METHODS: The estimation of BNP recovery was carried out by diluting high-concentration BNP samples with RF-positive or RF-negative plasma at a ratio of 1:9. The diluted samples were then tested using the ARCHITECT i2000 System and ARCHITECT BNP Reagent Kits and the recovery was then calculated. RESULTS: When the RF level ranged from 48 to 1420 IU/mL, the average recovery of BNP was 79.29% and 91.61% in the RF-positive and RF-negative plasma samples, respectively, and was thus significantly lower in the group of RF-positive plasma samples than in the group of RF-negative plasma samples. At a dilution of 1:16, the measured BNP level increased by >36% in six of the seven RF-positive plasma samples. The recovery of BNP increased significantly in the RF-positive plasma samples after pretreatment with IgG-sensitive latex particles. In addition, The BNP recovery was not significantly related to the plasma RF at concentrations ranging from 48 to 2720 IU/mL. CONCLUSIONS: Measurement of BNP by CMIA is susceptible to interference from RF leading to predominantly (but not exclusively lower results. Pretreatment of samples with blocking reagents is advisable prior to the initiation of denying patient's necessary treatment.

  3. Negative interference by rheumatoid factor of plasma B-type natriuretic peptide in chemiluminescent microparticle immunoassays.

    Science.gov (United States)

    Fan, Wen; Xu, Lei; Xie, Liangcai; Yang, Decai; Liu, Xuezheng; Zhang, Jiajun; Li, Yirong; Yi, Cunjian

    2014-01-01

    The chemiluminescent microparticle immunoassay (CMIA) is widely used for the quantitative determination of B-type natriuretic peptide (BNP) in human ethylenediaminetetraacetic acid plasma. Rheumatoid factor (RF) is usually thought to result in a positive interference in immunoassays, but it is not clear whether its presence in plasma can lead to interferences in the CMIA of BNP. The estimation of BNP recovery was carried out by diluting high-concentration BNP samples with RF-positive or RF-negative plasma at a ratio of 1:9. The diluted samples were then tested using the ARCHITECT i2000 System and ARCHITECT BNP Reagent Kits and the recovery was then calculated. When the RF level ranged from 48 to 1420 IU/mL, the average recovery of BNP was 79.29% and 91.61% in the RF-positive and RF-negative plasma samples, respectively, and was thus significantly lower in the group of RF-positive plasma samples than in the group of RF-negative plasma samples. At a dilution of 1:16, the measured BNP level increased by >36% in six of the seven RF-positive plasma samples. The recovery of BNP increased significantly in the RF-positive plasma samples after pretreatment with IgG-sensitive latex particles. In addition, The BNP recovery was not significantly related to the plasma RF at concentrations ranging from 48 to 2720 IU/mL. Measurement of BNP by CMIA is susceptible to interference from RF leading to predominantly (but not exclusively) lower results. Pretreatment of samples with blocking reagents is advisable prior to the initiation of denying patient's necessary treatment.

  4. Attenuation of monocyte chemotaxis--a novel anti-inflammatory mechanism of action for the cardio-protective hormone B-type natriuretic peptide.

    Science.gov (United States)

    Glezeva, Nadezhda; Collier, Patrick; Voon, Victor; Ledwidge, Mark; McDonald, Kenneth; Watson, Chris; Baugh, John

    2013-08-01

    B-type natriuretic peptide (BNP) is a prognostic and diagnostic marker for heart failure (HF). An anti-inflammatory, cardio-protective role for BNP was proposed. In cardiovascular diseases including pressure overload-induced HF, perivascular inflammation and cardiac fibrosis are, in part, mediated by monocyte chemoattractant protein (MCP)1-driven monocyte migration. We aimed to determine the role of BNP in monocyte motility to MCP1. A functional BNP receptor, natriuretic peptide receptor-A (NPRA) was identified in human monocytes. BNP treatment inhibited MCP1-induced THP1 (monocytic leukemia cells) and primary monocyte chemotaxis (70 and 50 %, respectively). BNP did not interfere with MCP1 receptor expression or with calcium. BNP inhibited activation of the cytoskeletal protein RhoA in MCP1-stimulated THP1 (70 %). Finally, BNP failed to inhibit MCP1-directed motility of monocytes from patients with hypertension (n = 10) and HF (n = 6) suggesting attenuation of this anti-inflammatory mechanism in chronic heart disease. We provide novel evidence for a direct role of BNP/NPRA in opposing human monocyte migration and support a role for BNP as a cardio-protective hormone up-regulated as part of an adaptive compensatory response to combat excess inflammation.

  5. Prognostic value of B-type natriuretic peptide in surgical palliation of children with single-ventricle congenital heart disease.

    Science.gov (United States)

    Berry, J G; Askovich, B; Shaddy, R E; Hawkins, J A; Cowley, C G

    2008-01-01

    The objective of this prospective study was to assess the prognostic role of perioperative B-type natriuretic peptide (BNP) levels in infants and children with single-ventricle congenital heart disease undergoing Norwood, bidirectional cavopulmonary anastomosis (BCPA), or Fontan operation. BNP levels were measured at baseline, after cardiopulmonary bypass, 6 to 12 hours after surgery, and then daily until indwelling vascular catheters were removed. Outcome measures included length of mechanical ventilation, inotropic support, and hospital stay. Twenty subjects underwent 23 surgical procedures (13 Norwood, 5 BCPA, and 5 Fontan). BNP levels were significantly higher in patients undergoing a Norwood procedure compared with a BCPA or Fontan procedure (p extubation was observed in 92% of patients undergoing a Norwood procedure. Early postoperative BNP levels correlate significantly with the ensuing duration of inotropic support and length of hospitalization. An increase in BNP after extubation may be reflective of the degree of underlying cardiopulmonary instability. Further investigation is necessary to define this important relation.

  6. 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...

  7. 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.

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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

  11. 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%).

  12. 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.

  13. Clinical Value of Natriuretic Peptides in Predicting Time to Dialysis in Stage 4 and 5 Chronic Kidney Disease Patients

    Science.gov (United States)

    Sundqvist, Sofia; Larson, Thomas; Cauliez, Bruno; Bauer, Fabrice; Dumont, Audrey; Le Roy, Frank; Hanoy, Mélanie; Fréguin-Bouilland, Caroline; Godin, Michel

    2016-01-01

    Background Anticipating the time to renal replacement therapy (RRT) in chronic kidney disease (CKD) patients is an important but challenging issue. Natriuretic peptides are biomarkers of ventricular dysfunction related to poor outcome in CKD. We comparatively investigated the value of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) as prognostic markers for the risk of RRT in stage 4 and 5 CKD patients, and in foretelling all-cause mortality and major cardiovascular events within a 5-year follow-up period. Methods Baseline plasma BNP (Triage, Biosite) and NT-proBNP (Elecsys, Roche) were measured at inclusion. Forty-three patients were followed-up during 5 years. Kaplan-Meier analysis, with log-rank testing and hazard ratios (HR), were calculated to evaluate survival without RRT, cardiovascular events or mortality. The independent prognostic value of the biomarkers was estimated in separate Cox multivariate analysis, including estimated glomerular filtration rate (eGFR), creatininemia and comorbidities. Results During the first 12-month follow-up period, 16 patients started RRT. NT-proBNP concentration was higher in patients who reached endpoint (3221 ng/L vs 777 ng/L, p = 0.02). NT-proBNP concentration > 1345 ng/L proved significant predictive value on survival analysis for cardiovascular events (p = 0.04) and dialysis within 60 months follow-up (p = 0.008). BNP concentration > 140 ng/L was an independent predictor of RRT after 12 months follow-up (p<0.005), and of significant predictive value for initiation of dialysis within 60 months follow-up. Conclusions Our results indicate a prognostic value for BNP and NT-proBNP in predicting RRT in stage 4 and 5 CKD patients, regarding both short- and long-term periods. NT-proBNP also proved a value in predicting cardiovascular events. Natriuretic peptides could be useful predictive biomarkers for therapeutic guidance in CKD. PMID:27548064

  14. 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....

  15. Predictors of Left Ventricle Remodeling: Combined Plasma B-type Natriuretic Peptide Decreasing Ratio and Peak Creatine Kinase-MB.

    Science.gov (United States)

    Hsu, Jen-Te; Chung, Chang-Min; Chu, Chi-Ming; Lin, Yu-Shen; Pan, Kuo-Li; Chang, Jung-Jung; Wang, Po-Chang; Chang, Shih-Tai; Yang, Teng-Yao; Jang, Shih-Jung; Yang, Tsung-Han; Hsiao, Ju-Feng

    2017-01-01

    Background: Previous studies reported that patients who had an acute myocardial infarction (AMI) have found that measuring B-type natriuretic peptide (BNP) during the subacute phase of left ventricular (LV) remodeling can predict the possible course of LV remodeling. This study assessed the use of serial BNP serum levels combined with early creatine kinase-MB (CK-MB) to predict the development of significant LV remodeling in AMI patients. Methods: Nighty-seven patients with new onset AMI were assessed using serial echocardiographic studies and serial measurements of BNP levels, both performed on day-2 (BNP1), day-7 (BNP2), day-90 (BNP3), and day-180 (BNP4) after admission. LV remodeling was defined as >20% increase in biplane LV end-diastolic volume on day-180 compared to baseline (day-2). Results: Patients were divided into LV remodeling [LVR(+)] and non LV remodeling [LVR(-)] groups. No first-week BNP level was found to predict remodeling. However, the two groups had significantly different day-90 BNP level (208.1 ± 263.7 pg/ml vs. 82.4 ± 153.7 pg/ml, P = 0.039) and significantly different 3-month BNP decrease ratios ( R BNP13) (14.4 ± 92.2% vs. 69.4 ± 25.9%, P MB (cut-off 48.2 ng/ml; AUC = 0.672; P = 0.014) was another independent predictor of remodeling. Additionally, combining peak CK-MB and R BNP13 offered an excellent discrimination for half-year remodeling when assessed by ROC curve (AUC = 0.818, P MB additionally offered an incremental power to the predictions derived from serial BNP examinations.

  16. Molecular cloning of natriuretic peptides from the heart of reptiles: loss of ANP in diapsid reptiles and birds.

    Science.gov (United States)

    Trajanovska, Sofie; Donald, John A

    2008-04-01

    Atrial natriuretic peptide (ANP) and B-type NP (BNP) are hormones involved in homeostatic control of body fluid and cardiovascular regulation. Both ANP and BNP have been cloned from the heart of mammals, amphibians, and teleost fishes, while an additional cardiac peptide, ventricular NP, has been found in selected species of teleost fish. However, in chicken, BNP is the primary cardiac peptide identified thus far. In contrast, the types of NP/s present in the reptilian heart are unknown, representing a considerable gap in our understanding of NP evolution. In the present study, we cloned and sequenced a BNP cDNA from the atria of representative species of reptile, including crocodile, lizard, snake, and tortoise. In addition, we cloned BNP from the pigeon atria. The reptilian and pigeon BNP cDNAs had ATTTA repeats in the 3' untranslated region, as observed in all vertebrate BNP mRNAs. A high sequence homology was evident when comparing reptile and pigeon preproBNP with the previously identified chicken preproBNP. In particular, the predicted mature BNP-29 was identical between crocodile, tortoise, and chicken, with pigeon having a single amino acid substitution; lizard and snake BNP had seven and nine substitutions, respectively. Furthermore, an ANP cDNA could only be cloned from the tortoise atria. Since ANP was not isolated from the heart of any non-chelonian reptile and appears to be absent in birds, we propose that the ANP gene has been lost after branching of the turtles in the amniote line. This data provides new avenues for research on NP function in reptiles.

  17. 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.

  18. Factors Associated with Serum B-Type Natriuretic Peptide in Infants with Single Ventricles

    Science.gov (United States)

    Butts, Ryan J.; Zak, Victor; Hsu, Daphne; Cnota, James; Colan, Steven D.; Hehir, David; Kantor, Paul; Levine, Jami C.; Margossian, Renee; Richmond, Marc; Szwast, Anita; Williams, Derek; Williams, Richard; Atz, Andrew M.

    2014-01-01

    Background Data regarding the value of B-type natriuretic peptide measurements (BNP) in infants with single ventricle (SV) physiology are lacking. The objective of this analysis was to describe the changes in BNP in infants with SV physiology before and after superior cavopulmonary connection (SCPC) surgery. Methods BNP levels were measured by a core laboratory pre-SCPC (5.0 ± 1.6 months) and at age 14 months during a multicenter trial of angiotensin converting enzyme inhibition therapy in infants with SV. Multivariable longitudinal analysis was utilized to model the associations between BNP with three sets of grouped variables (echocardiographic, catheterization, growth). Multivariable analysis was performed to assess associations with patient characteristics at both visits. Associations between BNP and neurodevelopmental variables were investigated at the 14 month visit as neurodevelopmental assessment was performed only at this visit. Results BNP was significantly higher before SCPC (n=173) than at 14 months (n=134); median [IQR] 80.8 pg/ml [35–187] v. 34.5 pg/ml [17–67], p 100 pg/ml was present in 72 (42%) subjects pre-SCPC and 21 (16%) at 14 months. In the 117 patients who had BNP at both visits, the median BNP decreased 32 pg/mL [1–79 pg/mL], p<0.01. In longitudinal multivariable analysis, higher BNP were associated with a higher end-systolic volume z-score (p=0.01), greater degree of atrioventricular (AV) valve regurgitation (p<0.01), lower weight z-score (p<0.01), and lower length z-score (p=0.02) In multivariable analyses, higher BNP at 14 months was associated with presence of arrhythmia post-SCPC surgery (p<0.01), prior Norwood procedure (p<0.01), longer length of hospital stay post-SCPC surgery (p=0.04), and lower Bayley Psychomotor Developmental Index (p=0.02). Conclusion BNP decreases in infants with SV from the pre- SCPC visit to 14 months. Higher BNP is associated with increased ventricular dilation in systole, increased AV valve

  19. 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。

  20. 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.

  1. B-type natriuretic peptide is an independent predictor of endothelial function in man.

    Science.gov (United States)

    Pauriah, Maheshwar; Khan, Faisel; Lim, Tiong K; Elder, Douglas H; Godfrey, Valerie; Kennedy, Gwen; Belch, Jill J F; Booth, Nuala A; Struthers, Allan D; Lang, Chim C

    2012-09-01

    BNP (B-type natriuretic peptide) has been reported to be elevated in preclinical states of vascular damage. To elucidate the relationship between plasma BNP and endothelial function, we have investigated the relationship between BNP and endothelial function in a cohort of subjects comprising healthy subjects as well as at-risk subjects with cardiovascular risk factors. To also clarify the relative contribution of different biological pathways to the individual variation in endothelial function, we have examined the relationship between a panel of multiple biomarkers and endothelial function. A total of 70 subjects were studied (mean age, 58.1±4.6 years; 27% had a history of hypertension and 18% had a history of hypercholesterolaemia). Endothelium-dependent vasodilatation was evaluated by the invasive ACH (acetylcholine)-induced forearm vasodilatation technique. A panel of biomarkers of biological pathways was measured: BNP, haemostatic factors PAI-1 (plasminogen-activator inhibitor 1) and tPA (tissue plasminogen activator), inflammatory markers, including cytokines [hs-CRP (high sensitive C-reactive protein), IL (interleukin)-6, IL-8, IL-18, TNFα (tumour necrosis factor α) and MPO (myeloperoxidase] and soluble adhesion molecules [E-selectin and sCD40 (soluble CD40)]. The median BNP level in the study population was 26.9 pg/ml. Multivariate regression analyses show that age, the total cholesterol/HDL (high-density lipoprotein) ratio, glucose and BNP were independent predictors of endothelial function, and BNP remained an independent predictor (P=0.009) in a binary logistic regression analysis using FBF (forearm blood flow) as a dichotomous variable based on the median value. None of the other plasma biomarkers was independently related to ACH-mediated vasodilatation. In a strategy using several biomarkers to relate to endothelial function, plasma BNP was found to be an independent predictor of endothelial function as assessed by endothelium

  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. 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.

  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. The Utility of B-type Natriuretic Peptide to Predict Prognosis of Acute Myocardial Infarction Patients Complicated With Cardiogenic Shock Treated With Intra-aortic Ballon Counterpulsation

    Institute of Scientific and Technical Information of China (English)

    Jiang Xie; Xian Wang; Chen Tan

    2008-01-01

    Objectives To assess the prognostic value of B-type natriuretic peptide (BNP) in severe AMI patients treated with intra-aortic ballon counterpulsation(IABP).Methods A total of 42 AMI patients with cardiogenic shock were retrospectively studied.BNP plasma level was recorded in the 24th hour and 4th day after myocardial infarction.The different mortality were compared among patients with different BNP levels.Results With aggressive treatment,20 patients survived short term hospitalization.Plasma concentration of BNP in dying patients is much higher than in survivals (1369±353 vs 651±302 pg/ml.P<0.01).Patients with BNP higher than 1474 pg/mL had a mortality of 92.9%.Conclusions Elevated BNP level in AMI patients with cardiogenic shock treated with IABP is highly associated with poor prognosis.

  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. 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.

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. 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...

  13. B-Type Natriuretic Peptide Deletion Leads to Progressive Hypertension, Associated Organ Damage, and Reduced Survival: Novel Model for Human Hypertension.

    Science.gov (United States)

    Holditch, Sara J; Schreiber, Claire A; Nini, Ryan; Tonne, Jason M; Peng, Kah-Whye; Geurts, Aron; Jacob, Howard J; Burnett, John C; Cataliotti, Alessandro; Ikeda, Yasuhiro

    2015-07-01

    Altered myocardial structure and function, secondary to chronically elevated blood pressure, are leading causes of heart failure and death. B-type natriuretic peptide (BNP), a guanylyl cyclase A agonist, is a cardiac hormone integral to cardiovascular regulation. Studies have demonstrated a causal relationship between reduced production or impaired BNP release and the development of human hypertension. However, the consequences of BNP insufficiency on blood pressure and hypertension-associated complications remain poorly understood. Therefore, the goal of this study was to create and characterize a novel model of BNP deficiency to investigate the effects of BNP absence on cardiac and renal structure, function, and survival. Genetic BNP deletion was generated in Dahl salt-sensitive rats. Compared with age-matched controls, BNP knockout rats demonstrated adult-onset hypertension. Increased left ventricular mass with hypertrophy and substantially augmented hypertrophy signaling pathway genes, developed in young adult knockout rats, which preceded hypertension. Prolonged hypertension led to increased cardiac stiffness, cardiac fibrosis, and thrombi formation. Significant elongation of the QT interval was detected at 9 months in knockout rats. Progressive nephropathy was also noted with proteinuria, fibrosis, and glomerular alterations in BNP knockout rats. End-organ damage contributed to a significant decline in overall survival. Systemic BNP overexpression reversed the phenotype of genetic BNP deletion. Our results demonstrate the critical role of BNP defect in the development of systemic hypertension and associated end-organ damage in adulthood.

  14. 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.

  15. 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....

  16. B-type natriuretic peptide and C-reactive protein in the prediction of atrial fibrillation risk: the CHARGE-AF Consortium of community-based cohort studies

    NARCIS (Netherlands)

    M.F. Sinner (Moritz); K.A. Stepas (Katherine A.); C.B. Moser (Carlee B.); B.P. Krijthe (Bouwe); T. Aspelund (Thor); N. Sotoodehnia (Nona); M. Fontes (Michel); A.C.J.W. Janssens (Cécile); R.A. Kronmal (Richard); J.W. Magnani (Jared); J.C.M. Witteman (Jacqueline); A.M. Chamberlain (Alanna); S.A. Lubitz (Steven); R. Schnabel (Renate); R.S. Vasan (Ramachandran S.); T.J. Wang (Thomas); S.K. Agarwal (Sunil); D.D. McManus (David); O.H. Franco (Oscar); X. Yin (Xiaoyan); M.G. Larson (Martin); G.L. Burke (Greg); L.J. Launer (Lenore); A. Hofman (Albert); D. Levy (Daniel); J.S. Gottdiener (John); S. Kääb (Stefan); D.J. Couper (David); T.B. Harris (Tamara); B.C. Astor (Brad); C. Ballantyne (Christie); R.C. Hoogeveen (Ron); T. Arai (Takashi); E.Z. Soliman (Elsayed Z.); P.T. Ellinor (Patrick); B.H.Ch. Stricker (Bruno); V. Gudnason (Vilmundur); S.R. Heckbert (Susan); M. Pencina (Michael); E.J. Benjamin (Emelia); A. Alonso (Alvaro)

    2014-01-01

    textabstractAIMS: B-type natriuretic peptide (BNP) and C-reactive protein (CRP) predict atrial fibrillation (AF) risk. However, their risk stratification abilities in the broad community remain uncertain. We sought to improve risk stratification for AF using biomarker information.METHODS AND RESULTS

  17. Prognostic assessment of elderly patients with symptoms of heart failure by combining high-sensitivity troponin T and N-terminal pro-B-type natriuretic peptide measurements

    DEFF Research Database (Denmark)

    Alehagen, Urban; Dahlström, Ulf; Rehfeld, Jens F.

    2010-01-01

    N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a useful biomarker in heart failure assessment, whereas measurement of cardiac troponin is central in the diagnosis of patients with acute coronary syndromes. This report examined the prognostic use of combining high-sensitivity cardiac...

  18. Increased B-type natriuretic peptide and decreased proteinuria might reflect decreased capillary leakage and is associated with a better outcome in patients with severe burns

    NARCIS (Netherlands)

    de Leeuw, Karina; Nieuwenhuis, Marianne K; Niemeijer, Anuschka S; Eshuis, Hans; Beerthuizen, Gerard I J M; Janssen, Wilbert M

    2011-01-01

    INTRODUCTION: It is difficult to adjust fluid balance adequately in patients with severe burns due to various physical changes. B-type natriuretic peptide (BNP) is emerging as a potential marker of hydration state. Proteinuria is used as a predictor of outcome in severe illness and might correlate t

  19. Mechanical stretch up-regulates the B-type natriuretic peptide system in human cardiac fibroblasts: a possible defense against transforming growth factor-ß mediated fibrosis

    LENUS (Irish Health Repository)

    Watson, Chris J

    2012-07-07

    AbstractBackgroundMechanical overload of the heart is associated with excessive deposition of extracellular matrix proteins and the development of cardiac fibrosis. This can result in reduced ventricular compliance, diastolic dysfunction, and heart failure. Extracellular matrix synthesis is regulated primarily by cardiac fibroblasts, more specifically, the active myofibroblast. The influence of mechanical stretch on human cardiac fibroblasts’ response to pro-fibrotic stimuli, such as transforming growth factor beta (TGFβ), is unknown as is the impact of stretch on B-type natriuretic peptide (BNP) and natriuretic peptide receptor A (NPRA) expression. BNP, acting via NPRA, has been shown to play a role in modulation of cardiac fibrosis.Methods and resultsThe effect of cyclical mechanical stretch on TGFβ induction of myofibroblast differentiation in primary human cardiac fibroblasts and whether differences in response to stretch were associated with changes in the natriuretic peptide system were investigated. Cyclical mechanical stretch attenuated the effectiveness of TGFβ in inducing myofibroblast differentiation. This finding was associated with a novel observation that mechanical stretch can increase BNP and NPRA expression in human cardiac fibroblasts, which could have important implications in modulating myocardial fibrosis. Exogenous BNP treatment further reduced the potency of TGFβ on mechanically stretched fibroblasts.ConclusionWe postulate that stretch induced up-regulation of the natriuretic peptide system may contribute to the observed reduction in myofibroblast differentiation.

  20. 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

  1. ANP, BNP and D-dimer predict right ventricular dysfunction in patients with acute pulmonary embolism

    DEFF Research Database (Denmark)

    Mortensen, Jann; Jensen, Claus V; Von Der Recke, Peter;

    2010-01-01

    The aim of this study was to predict right ventricular dysfunction (RVD) using plasma concentration of D-dimer, pro-atrial natriuretic peptide (pro-ANP), brain natriuretic peptide (BNP), endothelin-1 (ET-1) and cardiac troponin I (TNI) in patients with pulmonary embolism (PE).......The aim of this study was to predict right ventricular dysfunction (RVD) using plasma concentration of D-dimer, pro-atrial natriuretic peptide (pro-ANP), brain natriuretic peptide (BNP), endothelin-1 (ET-1) and cardiac troponin I (TNI) in patients with pulmonary embolism (PE)....

  2. 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.

  3. Predictive value of B-type natriuretic peptide level on the postoperative course of infants with congenital heart disease.

    Science.gov (United States)

    Nahum, Elhanan; Pollak, Uri; Dagan, Ovdi; Amir, Gabriel; Frenkel, George; Birk, Einat

    2013-05-01

    B-type natriuretic peptide (BNP) has been shown to have prognostic value for morbidity and mortality after cardiac surgery. Less is known about its prognostic value in infants. To investigate the predictive value of BNP levels regarding the severity of the postoperative course in infants undergoing surgical repair of congenital heart disease. We conducted a prospective comparative study. Plasma BNP levels in infants aged 1-12 months with congenital heart disease undergoing complete repair were measured preoperatively and 8, 24 and 48 hours postoperatively. Demographic and clinical data included postoperative inotropic support and lactate level, duration of mechanical ventilation, intensive care unit (ICU) and hospitalization stay. Cardiac surgery was performed in 19 infants aged 1-12 months. Preoperative BNP level above 170 pg/ml had a positive predictive value of 100% for inotropic score > or = 7.5 at 24 hours (specificity 100%, sensitivity 57%) and 48 hours (specificity 100%, sensitivity 100%), and was associated with longer ICU stay (P = 0.05) and a trend for longer mechanical ventilation (P = 0.12). Similar findings were found for 8 hours postoperative BNP above 1720 pg/ml. BNP level did not correlate with measured fractional shortening. In infants undergoing heart surgery, preoperative and 8 hour BNP levels were predictive of inotropic support and longer ICU stay. These findings may have implications for preplanning ICU loads in clinical practice. Further studies with larger samples are needed.

  4. Clinical value of plasma B-type natriuretic peptide assay in pediatric pneumonia accompanied by heart failure

    Science.gov (United States)

    HU, DAN; LIU, YANG; TAO, HUIXIAN; GAO, JINPING

    2015-01-01

    Previous studies have shown that B-type natriuretic peptide (BNP) is useful in differentiating cardiac from pulmonary causes of dyspnea in adults. To date, international guidelines have recommended measurements of circulating BNP as a biomarker for diagnostic and prognostic purposes, as well as therapeutic monitoring, in adults with cardiac diseases, particularly those suffering from acute and chronic heart failure (HF). The aim of the present study was to investigate the differential diagnostic and therapeutic analysis of BNP levels assayed in pediatric pneumonia accompanied by HF. The clinical data of 80 patients with pneumonia, aged 1–3 years, were analyzed. The patients were divided into two groups: Simple pneumonia (46 cases) and pneumonia accompanied by HF (34 cases). All patients underwent two plasma BNP assays: The first one upon admission to the hospital and the second one prior to discharge. The plasma BNP levels of 20 healthy children were used as the negative control. Plasma BNP levels were measured using the Triage® BNP automated immunoassay systems and reagents. Statistical analysis showed that the plasma BNP levels of the patients upon admission were higher in the pneumonia accompanied by HF group compared with those in the simple pneumonia group (750±120 vs. 135±50 pg/ml; P<0.05). In addition, in the pneumonia accompanied by HF group, the plasma BNP levels of the patients were higher upon admission to the hospital than they were prior to discharge (750±120 vs. 115±45 pg/ml; P<0.05); therefore, plasma BNP may comprise a sensitive diagnostic and therapeutic evaluative marker for pediatric patients with pneumonia accompanied by HF. This finding could prove invaluable in the clinical diagnosis and treatment of the disease. PMID:26668612

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. 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

    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...... 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......) (95% CI 3-14), P = 0.007) and an increase in levels of BNP (median (ranges) 7 (0.58-286) vs. 20 (1-489) pg/mL, P = 0.033) and of NT-proBNP (63 (20-1004) vs. 80 (20-3391) pg/mL, P = 0.027). Assessed by the highly sensitive and precise CMRI method, 3 months treatment of acromegaly resulted...

  12. ANP and BNP in atrial fibrillation before and after cardioversion--and their relationship to cardiac volume and function

    DEFF Research Database (Denmark)

    Therkelsen, Susette Krohn; Groenning, Bjoern Aaris; Kjaer, Andreas;

    2007-01-01

    The role of atrial (ANP) and B-type (BNP) natriuretic peptide in atrial fibrillation (AF) is not clear. Our aim was to describe ANP and BNP in AF, and their changes following cardioversion in persistent AF. Furthermore, we wanted to assess the association between ANP and BNP and cardiac volume...

  13. Association between left ventricular global longitudinal strain and natriuretic peptides in outpatients with chronic systolic heart failure

    DEFF Research Database (Denmark)

    Gaborit, F; Bosselmann, H; Tønder, N;

    2015-01-01

    BACKGROUND: Both impaired left ventricular (LV) global longitudinal strain (GLS) and increased plasma concentrations of natriuretic peptides(NP) are associated with a poor outcome in heart failure (HF). Increased levels of NP reflect increased wall stress of the LV. However, little is known about...... ventricular ejection fraction (LVEF) was 33 % and median LV GLS was -11 %. LV GLS was associated with increased plasma concentrations of NT-proBNP and proANP in multivariate logistic regression (NT-proBNP: Odds RatioGLS: 7.25, 95 %-CI: 2.48-21.1, P ....28-8.30, P = 0.013) and linear regression (NT-proBNP: βGLS: 1.19, 95 %-CI: 0.62-1.76, P fibrillation, renal function) and left atrial volume index...

  14. 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

  15. 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.

  16. 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.

  17. The evaluation of B-type Natriuretic Peptide and Troponin I in acute myocardial infarction and unstable angina

    Directory of Open Access Journals (Sweden)

    Nafija Serdarevic

    2014-09-01

    Full Text Available Introduction: The diagnostic utility of B-type natriuretic peptide (BNP has prompted interest in its use as an aid in the detection of early heart failure and assessment of diseases. The first objective of this study was measurement of BNP and troponin I (TnI blood levels in patients with acute myocardial infarction (AMI and unstable angina. The second objective of this study was to find a correlation between TnI and BNP in blood.Methods: The concentrations of BNP and TnI in 150 blood levels were determined using CMIA (chemiluminescent microparticle immunoassay Architect and 2000 (Abbott diagnostics. The retrospective study included 100 patients who were hospitalized at the Department of Internal Medicine of the University Clinical Center Sarajevo and 50 healthy control. The reference blood range of BNP is 0-100 pg/mL and TnI is 0.00-0.4 ng/mL.Results: In the patients with AMI the mean value of BNP is 764.48 ± 639.52 pg/mL and TnI is 2.50 ± 2.28ng/mL. The patients with unstable angina have BNP 287.18 ± 593.20 pg/mL and TnI 0.10 ± 0.23 ng/mL. Our studies have shown that the correlation between BNP and TnI was statistically significant for p< 0.05 using Student t test with correlation coefficient r = 0.36. Conclusions: BNP and TnI levels can help to identify the patients with a high risk for cardiovascular diseases.

  18. 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.

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

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    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.

  20. 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

  1. 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.

  2. Cardiac tamponade as an independent condition affecting the relationship between the plasma B-type natriuretic peptide levels and cardiac function.

    Science.gov (United States)

    Minai, Kosuke; Komukai, Kimiaki; Arase, Satoshi; Nagoshi, Tomohisa; Matsuo, Seiichiro; Ogawa, Kazuo; Kayama, Yosuke; Inada, Keiichi; Tanigawa, Shin-Ichi; Takemoto, Tomoyuki; Sekiyama, Hiroshi; Date, Taro; Ogawa, Takayuki; Taniguchi, Ikuo; Yoshimura, Michihiro

    2013-07-01

    Plasma B-type natriuretic peptide (BNP) is finely regulated by the cardiac function and several extracardiac factors. Therefore, the relationship between the plasma BNP levels and the severity of heart failure sometimes seems inconsistent. The purpose of the present study was to investigate the plasma BNP levels in patients with cardiac tamponade and their changes after pericardial drainage. This study included 14 patients with cardiac tamponade who underwent pericardiocentesis. The cardiac tamponade was due to malignant diseases in 13 patients and uremia in 1 patient. The plasma BNP levels were measured before and 24-48 h after drainage. Although the patients reported severe symptoms of heart failure, their plasma BNP levels were only 71.2 ± 11.1 pg/ml before drainage. After appropriate drainage, the plasma BNP levels increased to 186.0 ± 22.5 pg/ml, which was significantly higher than that before drainage (P = 0.0002). In patients with cardiac tamponade, the plasma BNP levels were low, probably because of impaired ventricular stretching, and the levels significantly increased in response to the primary condition after drainage. This study demonstrates an additional condition that affects the relationship between the plasma BNP levels and cardiac function. If inconsistency is seen in the relationship between the plasma BNP levels and clinical signs of heart failure, the presence of cardiac tamponade should therefore be considered.

  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. 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.

  5. B-type natriuretic peptide and C-reactive protein in the prediction of atrial fibrillation risk: the CHARGE-AF Consortium of community-based cohort studies

    Science.gov (United States)

    Sinner, Moritz F.; Stepas, Katherine A.; Moser, Carlee B.; Krijthe, Bouwe P.; Aspelund, Thor; Sotoodehnia, Nona; Fontes, João D.; Janssens, A. Cecile J.W.; Kronmal, Richard A.; Magnani, Jared W.; Witteman, Jacqueline C.; Chamberlain, Alanna M.; Lubitz, Steven A.; Schnabel, Renate B.; Vasan, Ramachandran S.; Wang, Thomas J.; Agarwal, Sunil K.; McManus, David D.; Franco, Oscar H.; Yin, Xiaoyan; Larson, Martin G.; Burke, Gregory L.; Launer, Lenore J.; Hofman, Albert; Levy, Daniel; Gottdiener, John S.; Kääb, Stefan; Couper, David; Harris, Tamara B.; Astor, Brad C.; Ballantyne, Christie M.; Hoogeveen, Ron C.; Arai, Andrew E.; Soliman, Elsayed Z.; Ellinor, Patrick T.; Stricker, Bruno H.C.; Gudnason, Vilmundur; Heckbert, Susan R.; Pencina, Michael J.; Benjamin, Emelia J.; Alonso, Alvaro

    2014-01-01

    Aims B-type natriuretic peptide (BNP) and C-reactive protein (CRP) predict atrial fibrillation (AF) risk. However, their risk stratification abilities in the broad community remain uncertain. We sought to improve risk stratification for AF using biomarker information. Methods and results We ascertained AF incidence in 18 556 Whites and African Americans from the Atherosclerosis Risk in Communities Study (ARIC, n=10 675), Cardiovascular Health Study (CHS, n = 5043), and Framingham Heart Study (FHS, n = 2838), followed for 5 years (prediction horizon). We added BNP (ARIC/CHS: N-terminal pro-B-type natriuretic peptide; FHS: BNP), CRP, or both to a previously reported AF risk score, and assessed model calibration and predictive ability [C-statistic, integrated discrimination improvement (IDI), and net reclassification improvement (NRI)]. We replicated models in two independent European cohorts: Age, Gene/Environment Susceptibility Reykjavik Study (AGES), n = 4467; Rotterdam Study (RS), n = 3203. B-type natriuretic peptide and CRP were significantly associated with AF incidence (n = 1186): hazard ratio per 1-SD ln-transformed biomarker 1.66 [95% confidence interval (CI), 1.56–1.76], P < 0.0001 and 1.18 (95% CI, 1.11–1.25), P < 0.0001, respectively. Model calibration was sufficient (BNP, χ2 = 17.0; CRP, χ2 = 10.5; BNP and CRP, χ2 = 13.1). B-type natriuretic peptide improved the C-statistic from 0.765 to 0.790, yielded an IDI of 0.027 (95% CI, 0.022–0.032), a relative IDI of 41.5%, and a continuous NRI of 0.389 (95% CI, 0.322–0.455). The predictive ability of CRP was limited (C-statistic increment 0.003). B-type natriuretic peptide consistently improved prediction in AGES and RS. Conclusion B-type natriuretic peptide, not CRP, substantially improved AF risk prediction beyond clinical factors in an independently replicated, heterogeneous population. B-type natriuretic peptide may serve as a benchmark to evaluate novel putative AF risk biomarkers. PMID:25037055

  6. 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.

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

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    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

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

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    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.

  9. 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.

  10. Reference intervals for N-terminal pro-B-type natriuretic peptide in amniotic fluid between 10 and 34 weeks of gestation.

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    Waltraut M Merz

    Full Text Available BACKGROUND: In adult and pediatric cardiology, n-terminal pro-B-type natriuretic peptide (nt-proBNP serves as biomarker in the diagnosis and management of cardiovascular dysfunction. Elevated levels of circulating nt-proBNP are present in fetal conditions associated with myocardial pressure or volume load. Compared to fetal blood sampling, amniocentesis is technically easier and can be performed from early pregnancy onwards. We aimed to investigate amniotic fluid (AF nt-proBNP concentrations in normal pregnancies between 10 and 34 weeks of gestation. METHODS: Nt-proBNP and total protein (TP was measured in AF by chemiluminescence assay (photometry, respectively. To adjust for a potential dilutional effect, the AF-nt-proBNP/AF-TP ratio was analyzed. Reference intervals were constructed by regression modeling across gestational age. RESULTS: 132 samples were analyzed. A negative correlation between AF-nt-proBNP/AF-TP ratio and gestational age was observed. Curves for the mean and the 5% and 95% reference interval between 10 and 34 weeks of gestation were established. CONCLUSION: In normal pregnancy, nt-proBNP is present in AF and decreases during gestation. Our data provide the basis for research on AF-nt-proBNP as biomarker in fetal medicine.

  11. Amino-terminal pro-B-type natriuretic peptide testing to assist the diagnostic evaluation of heart failure in symptomatic primary care patients

    DEFF Research Database (Denmark)

    Hildebrandt, P.; Collinson, P.O.

    2008-01-01

    When used for the evaluation of symptomatic patients in general practice, amino-terminal pro-B-type natriuretic peptide (NT-proBNP) testing is highly sensitive, with an excellent negative predictive value for cost-effective exclusion of the diagnosis of heart failure (HF). Importantly (similar...... to other NP assays), lower values for NT-proBNP are expected among patients with HF in the primary care setting compared with patients with acute dyspnea. Among primary care patients with dyspnea, a noncardiac source of dyspnea is most likely in patients with findings below the recommended age......-stratified NT-proBNP cut points. Conversely, an NT-proBNP result above the age-stratified primary care cut points does not absolutely indicate the presence of HF; a more directed cardiovascular workup is indicated Udgivelsesdato: 2008/2/4...

  12. 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...

  13. 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...

  14. 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....

  15. 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.

  16. 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).

  17. 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.

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

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    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.

  19. Higher Serum Concentrations of N-Terminal Pro-B-Type Natriuretic Peptide Associate with Prevalent Hypertension whereas Lower Associate with Incident Hypertension

    DEFF Research Database (Denmark)

    Seven, Ekim; Husemoen, Lise L N; Ibsen, Hans

    2015-01-01

    BACKGROUND: The role of the natriuretic peptides (NPs) in hypertension is complex. Thus, a higher blood NP concentration is a robust marker of pressure-induced cardiac damage in patients with hypertension, whereas genetically elevated NP concentrations are associated with a reduced risk...... of hypertension and overweight individuals presumably at high risk of hypertension have lower NP concentrations. OBJECTIVE: To investigate the associations between serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), used as a surrogate marker for active BNP, and prevalent as well as 5-year incident...... hypertension in a Danish general population sample. METHODS: Cross-sectional and prospective population-based study. RESULTS: At baseline, among 5,307 participants (51.3% women, mean age 46.0±7.9 years) with a complete set of data, we recorded 1,979 cases with prevalent hypertension (PHT). Among 2...

  20. NT-pro-BNP during hypoglycemia and hypoxemia in normal subjects: Impact of renin-angiotensin system activity

    NARCIS (Netherlands)

    R. Due-Andersen (Rikke); U. Pedersen-Bjergaard (Ullrik); T. Høi-Hansen (Thomas); N.V. Olsen; C. Kistorp; J. Faber (Joerg); F. Boomsma (Frans); B. Thorsteinsson (Birger)

    2008-01-01

    textabstractBrain-derived natriuretic peptide (BNP) is a cardioprotective peptide released, together with the inactive NH2-terminal part of its prohormone (NT-pro-BNP), in response to different kinds of myocardial stress. Hypoglycemia and hypoxemia are conditions that threaten cellular function and

  1. Inverse association of N-terminal pro-B-type natriuretic peptide with metabolic syndrome in patients with congestive heart failure.

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    Huai-Ren Chang

    Full Text Available BACKGROUND: Metabolic syndrome has been shown to be associated with lower levels of plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP in the general population. We sought to elucidate the relationship between Nt-proBNP and components of metabolic syndrome in patients with congestive heart failure (CHF. METHODS: Fasting blood samples were obtained from 93 patients in our institution. Plasma levels of Nt-proBNP and other biochemical data were measured. The New York Heart Association (NYHA classification system (I-IV was used to define the functional capacity of CHF. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation. RESULTS: Forty-nine patients (52.7% had CHF. There was a positive correlation between plasma Nt-proBNP levels and NYHA functional capacity in CHF patients. Plasma Nt-proBNP levels increased significantly with each increasing NYHA class of the disease. The prevalence of metabolic syndrome in CHF patients was higher than that in patients without CHF. Most importantly, we found that plasma Nt-proBNP levels were lower in CHF patients with metabolic syndrome attributable to inverse relationships between plasma Nt-proBNP and body mass index (β = -0.297, plasma triglyceride (β = -0.286 and homeostasis model assessment of insulin resistance (HOMA-IR; β = -0.346. Fasting glucose to insulin ratio (FGIR, an insulin sensitivity index was positively associated with plasma Nt-proBNP levels (β = 0.491, and was the independent predictor of plasma Nt-proBNP levels in CHF patients. CONCLUSIONS: Plasma Nt-proBNP levels are inversely associated with metabolic syndrome in CHF patients. Reduced plasma Nt-proBNP levels in CHF patients may lead to impaired lipolysis and metabolic function, and may contribute to the development of metabolic syndrome in CHF patients.

  2. Cautious application of pleural N-terminal pro-B-type natriuretic peptide in diagnosis of congestive heart failure pleural effusions among critically ill patients.

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    Jiann-Horng Yeh

    Full Text Available Several studies on diagnostic accuracy of pleural N-terminal pro-B-type natriuretic peptide (NT-pro-BNP for effusions from congestive heart failure (CHF conclude that pleural NT-pro-BNP is a useful biomarker with high diagnostic accuracy for distinguishing CHF effusions. However, its applicability in critical care settings remains uncertain and requires further investigations.NT-proBNP was measured in pleural fluid samples of a prospective cohort of intensive care unit patients with pleural effusions. Receiver operating characteristic curve analysis was performed to determine diagnostic accuracy of pleural NT-proBNP for prediction of CHF effusions.One hundred forty-seven critically ill patients were evaluated, 38 (26% with CHF effusions and 109 (74% with non-CHF effusions of various causes. Pleural NT-proBNP levels were significantly elevated in patients with CHF effusions. Pleural NT-pro-BNP demonstrated the area under the curve of 0.87 for diagnosing effusions due to CHF. With a cutoff of 2200 pg/mL, pleural NT-proBNP displayed high sensitivity (89% but moderate specificity (73%. Notably, 29 (27% of 109 patients with non-CHF effusions had pleural NT-proBNP levels >2200 pg/mL and these patients were more likely to experience septic shock (18/29 vs. 10/80, P<0.001 or acute kidney injury (19/29 vs. 9/80, P<0.001.Among critically ill patients, pleural NT-proBNP measurements remain a useful diagnostic aid in evaluation of pleural effusions. However, patients with non-CHF effusions may exhibit high pleural NT-proBNP concentrations if they suffer from septic shock or acute kidney injury. Accordingly, it is suggested that clinical context should be taken into account when interpreting pleural NT-proBNP values in critical care settings.

  3. 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.

  4. 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.

  5. Predictors of Left Ventricle Remodeling: Combined Plasma B-type Natriuretic Peptide Decreasing Ratio and Peak Creatine Kinase-MB

    Science.gov (United States)

    Hsu, Jen-Te; Chung, Chang-Min; Chu, Chi-Ming; Lin, Yu-Shen; Pan, Kuo-Li; Chang, Jung-Jung; Wang, Po-Chang; Chang, Shih-Tai; Yang, Teng-Yao; Jang, Shih-Jung; Yang, Tsung-Han; Hsiao, Ju-Feng

    2017-01-01

    Background: Previous studies reported that patients who had an acute myocardial infarction (AMI) have found that measuring B-type natriuretic peptide (BNP) during the subacute phase of left ventricular (LV) remodeling can predict the possible course of LV remodeling. This study assessed the use of serial BNP serum levels combined with early creatine kinase-MB (CK-MB) to predict the development of significant LV remodeling in AMI patients. Methods: Nighty-seven patients with new onset AMI were assessed using serial echocardiographic studies and serial measurements of BNP levels, both performed on day-2 (BNP1), day-7 (BNP2), day-90 (BNP3), and day-180 (BNP4) after admission. LV remodeling was defined as >20% increase in biplane LV end-diastolic volume on day-180 compared to baseline (day-2). Results: Patients were divided into LV remodeling [LVR(+)] and non LV remodeling [LVR(-)] groups. No first-week BNP level was found to predict remodeling. However, the two groups had significantly different day-90 BNP level (208.1 ± 263.7 pg/ml vs. 82.4 ± 153.7 pg/ml, P = 0.039) and significantly different 3-month BNP decrease ratios (RBNP13) (14.4 ± 92.2% vs. 69.4 ± 25.9%, P < 0.001). The appropriate cut-off value for RBNP13 was 53.2% (AUC = 0.764, P < 0.001). Early peak CK-MB (cut-off 48.2 ng/ml; AUC = 0.672; P = 0.014) was another independent predictor of remodeling. Additionally, combining peak CK-MB and RBNP13 offered an excellent discrimination for half-year remodeling when assessed by ROC curve (AUC = 0.818, P < 0.001). Conclusion: RBNP13 is a significant independent predictor of 6-month LV remodeling. The early peak CK-MB additionally offered an incremental power to the predictions derived from serial BNP examinations. PMID:28138312

  6. Mendelian randomization study of B-type natriuretic peptide and type 2 diabetes: evidence of causal association from population studies.

    Directory of Open Access Journals (Sweden)

    Roman Pfister

    2011-10-01

    Full Text Available BACKGROUND: Genetic and epidemiological evidence suggests an inverse association between B-type natriuretic peptide (BNP levels in blood and risk of type 2 diabetes (T2D, but the prospective association of BNP with T2D is uncertain, and it is unclear whether the association is confounded. METHODS AND FINDINGS: We analysed the association between levels of the N-terminal fragment of pro-BNP (NT-pro-BNP in blood and risk of incident T2D in a prospective case-cohort study and genotyped the variant rs198389 within the BNP locus in three T2D case-control studies. We combined our results with existing data in a meta-analysis of 11 case-control studies. Using a Mendelian randomization approach, we compared the observed association between rs198389 and T2D to that expected from the NT-pro-BNP level to T2D association and the NT-pro-BNP difference per C allele of rs198389. In participants of our case-cohort study who were free of T2D and cardiovascular disease at baseline, we observed a 21% (95% CI 3%-36% decreased risk of incident T2D per one standard deviation (SD higher log-transformed NT-pro-BNP levels in analysis adjusted for age, sex, body mass index, systolic blood pressure, smoking, family history of T2D, history of hypertension, and levels of triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. The association between rs198389 and T2D observed in case-control studies (odds ratio = 0.94 per C allele, 95% CI 0.91-0.97 was similar to that expected (0.96, 0.93-0.98 based on the pooled estimate for the log-NT-pro-BNP level to T2D association derived from a meta-analysis of our study and published data (hazard ratio = 0.82 per SD, 0.74-0.90 and the difference in NT-pro-BNP levels (0.22 SD, 0.15-0.29 per C allele of rs198389. No significant associations were observed between the rs198389 genotype and potential confounders. CONCLUSIONS: Our results provide evidence for a potential causal role of the BNP

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. Joint detection of troponin T,high sensitivity C-reactive protein,N-terminal probrain natriuretic peptide applied in the diagnosis of acute coronary syndrome for elderly patients

    Institute of Scientific and Technical Information of China (English)

    赵月霞

    2012-01-01

    Objective To investigate the value of the joint detection of Troponin T(TnT) ,highsensitivity C-reactive protein (hs-CRP) and N-terminal probrain natriuretic peptide(NT-proBNP) for the clinical diagnosis of acute coronary syndrome(ACS) in elderly patients.

  14. 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.

  15. 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...

  16. 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

  17. 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...

  18. 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...

  19. 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.

  20. 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....

  1. 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

  2. Endurance exercise-induced changes in BNP concentrations in cardiovascular patients versus healthy controls

    NARCIS (Netherlands)

    Aengevaeren, V.L.; Hopman, M.T.E.; Thijssen, D.H.J.; Kimmenade, R.R.J. van; Boer, M.J. de; Eijsvogels, T.M.H.

    2017-01-01

    BACKGROUND: Healthy athletes demonstrated increased B-type natriuretic peptide (BNP) concentrations following exercise, but it is unknown whether these responses are exaggerated in individuals with cardiovascular risk factors (CVRF) or disease (CVD). We compared exercise-induced increases in BNP

  3. Incremental predictive value of natriuretic peptides for prognosis in the chronic stable heart failure population: a systematic review.

    Science.gov (United States)

    Don-Wauchope, Andrew C; Santaguida, Pasqualina L; Oremus, Mark; McKelvie, Robert; Ali, Usman; Brown, Judy A; Bustamam, Amy; Sohel, Nazmul; Hill, Stephen A; Booth, Ronald A; Balion, Cynthia; Raina, Parminder

    2014-08-01

    The aim of this study was to determine whether measurement of natriuretic peptides independently adds incremental predictive value for mortality and morbidity in patients with chronic stable heart failure (CSHF). We electronically searched Medline®, Embase™, AMED, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL from 1989 to June 2012. We also searched reference lists of included articles, systematic reviews, and the gray literature. Studies were screened for eligibility criteria and assessed for methodological quality. Data were extracted on study design, population demographics, assay cutpoints, prognostic risk prediction model covariates, statistical methods, outcomes, and results. One hundred and eighty-three studies were identified as prognostic in the systematic review. From these, 15 studies (all NT-proBNP) considered incremental predictive value in CSHF subjects. Follow-up varied from 12 to 37 months. All studies presented at least one estimate of incremental predictive value of NT-proBNP relative to the base prognostic model. Using discrimination or likelihood statistics, these studies consistently showed that NT-proBNP increased model performance. Three studies used re-classification and model validation computations to establish incremental predictive value; these studies showed less consistency with respect to added value. Although there were differences in the base risk prediction models, assay cutpoints, and lengths of follow-up, there was consistency in NT-proBNP adding incremental predictive value for prognostic models in chronic stable CSHF patients. The limitations in the literature suggest that studies designed to evaluate prognostic models should be undertaken to evaluate the incremental value of natriuretic peptide as a predictor of mortality and morbidity in CSHF.

  4. 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.

  5. Degree and distribution of left ventricular hypertrophy as a determining factor for elevated natriuretic peptide levels in patients with hypertrophic cardiomyopathy: insights from cardiac magnetic resonance imaging.

    Science.gov (United States)

    Park, Jeong Rang; Choi, Jin-Oh; Han, Hye Jin; Chang, Sung-A; Park, Sung-Ji; Lee, Sang-Chol; Choe, Yeon Hyeon; Park, Seung Woo; Oh, Jae K

    2012-04-01

    Whether the left ventricular (LV) mass index (LVMI) and LV volumetric parameters are associated independently with natriuretic peptide levels is unclear in hypertrophic cardiomyopathy (HCM). Therefore, we investigated which parameters have an independent relationship with N-terminal pro-B type natriuretic peptide (NT-proBNP) levels in HCM patients using echocardiography and cardiac magnetic resonance imaging (CMR). A total of 103 patients with HCM (82 men, age 53 ± 12 years) were evaluated. Echocardiographic evaluations included left atrial volume index (LAVI) and early diastolic mitral inflow E velocity to early annular Ea velocity ratio (E/Ea). LVMI, maximal wall thickness and LV volumetric parameters were measured using CMR. The median value of NT-proBNP level was 387.0 pg/ml. The mean NT-proBNP level in patients with non-apical HCM (n = 69; 36 patients with asymmetric septal hypertrophy, 11 with diffuse, and 22 with mixed type) was significantly higher than in those with apical HCM (n = 34, P < 0.001). NT-proBNP level was negatively correlated with LV end-diastolic volume (LVEDV) (r = -0.263, P = 0.007) and positively with LVMI (r = 0.225, P = 0.022) and maximal wall thickness (r = 0.495, P < 0.001). Among the echocardiographic variables, LAVI (r = 0.492, P < 0.001) and E/Ea (r = 0.432, P < 0.001) were correlated with NT-proBNP. On multivariable analysis, non-apical HCM, increased maximal wall thickness and LAVI were independently related with NT-proBNP. Severity of LV hypertrophy and diastolic parameters might be important in the elevation of NT-proBNP level in HCM. Therefore, further evaluation of these parameters in HCM might be warranted.

  6. 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.

  7. Role of Right Ventricular Dysfunction and Diabetes Mellitus in N-terminal pro-B-type Natriuretic Peptide Response of Patients With Severe Mitral Regurgitation and Heart Failure After MitraClip.

    Science.gov (United States)

    Kaneko, Hidehiro; Neuss, Michael; Weissenborn, Jens; Butter, Christian

    2017-04-06

    MitraClip (MC) is an alternative therapeutic option for patients with severe mitral regurgitation (MR) who are at high surgical risk. Most candidates for MC have severe heart failure (HF) with increased N-terminal pro-B-type natriuretic peptide (NT-pro BNP) levels. We sought to clarify the response of NT-pro BNP after MC and to identify the determinants of NT-pro BNP nonresponders. Among 136 consecutive patients successfully treated with MC, we excluded 20 patients due to low baseline NT-pro BNP levels and therefore examined 116 patients. NT-pro BNP responders were defined as patients whose NT-pro BNP levels decreased by > 30% at 6 months after MC. Mean NT-pro BNP levels significantly decreased from 6,117 pg/mL at baseline to 4,143 pg/mL at 6 months after MC (P 5,000 pg/mL (OR, 0.204; P = 0.001) were independent determinants of nonresponders. All-cause death tended to be less common in responders to NT-pro BNP (20% versus 31%; P = 0.163). In conclusion, NT-pro BNP levels significantly decreased after MC. DM and RVSD were determinants of NT-pro BNP nonresponse after the MC procedure.

  8. 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.

  9. 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.

  10. The prognostic value of N-terminal proB-type natriuretic peptide in patients with acute respiratory distress syndrome

    Science.gov (United States)

    Lai, Chih-Cheng; Sung, Mei-I.; Ho, Chung-Han; Liu, Hsiao-Hua; Chen, Chin-Ming; Chiang, Shyh-Ren; Chao, Chien-Ming; Liu, Wei-Lun; Hsing, Shu-Chen; Cheng, Kuo-Chen

    2017-01-01

    We investigated whether N-terminal proB-type natriuretic peptide (NT-proBNP) predicts the prognosis of patients with acute respiratory distress syndrome (ARDS). Between December 1, 2012, and May 31, 2015, this observational study recruited patients admitted to our tertiary medical center who met the Berlin criteria for ARDS and who had their NT-proBNP measured. The main outcome was 28-day mortality. We enrolled 61 patients who met the Berlin criteria for ARDS: 7 were classified as mild, 29 as moderate, and 25 as severe. The median APACHE II scores were 23 (interquartile range [IQR], 18–28), and SOFA scores were 11 (IQR, 8–13). The median lung injury score was 3.0 (IQR, 2.50–3.25), and the median level of NT-proBNP was 2011 pg/ml (IQR, 579–7216). Thirty-four patients died during this study, and the 28-day mortality rate was 55.7%. Patients who die were older and had significantly (all p < 0.05) higher APACHE II scores and NT-proBNP levels than did patients who survived. Multivariate analysis identified age (HR: 1.546, 95% CI: 1.174–2.035, p = 0.0019) and NT-proBNP (HR: 1.009, 95% CI: 1.004–1.013, p = 0.0001) as significant risk factors of death. NT-proBNP was associated with poor outcomes for patients with ARDS, and its level predicted mortality. PMID:28322314

  11. Unexplained week-to-week variation in BNP and NT-proBNP is low in chronic heart failure patients during steady state

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Nielsen, Per H;

    2006-01-01

    BACKGROUND: The usefulness of brain-natriuretic-peptide (BNP) and N-terminal-pro-brain-natriuretic-peptide (NT-proBNP) for monitoring of chronic heart failure (CHF) patients has been questioned because of high levels of unexplained variation. AIMS: Week-to-week total variance (CV(T)), unexplained...... variation (CV(I)), reference change values (RCV), index of individualities (IOI) and number of samples (N) with week-to-week intervals needed to estimate the underlying homeostatic set point (+/-15%) for BNP and NT-proBNP were calculated in pre-specified stable CHF patients. METHODS AND RESULTS: We measured...... plasma concentrations of BNP and NT-proBNP, clinical and laboratory variables in 20 CHF patients with a 7-days interval. Only patients considered to be in steady state were included. The CV(I) was 15% (BNP) and 8% (NT-proBNP). CV(T) was 16% (BNP) and 8% (NT-proBNP) and RCV was 43% (BNP) and 23% (NT...

  12. 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...

  13. 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.

  14. 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...

  15. 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...

  16. 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.

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. 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.

  1. A functional genetic variant (N521D in natriuretic peptide receptor 3 is associated with diastolic dysfunction: the prevalence of asymptomatic ventricular dysfunction study.

    Directory of Open Access Journals (Sweden)

    Naveen L Pereira

    Full Text Available To evaluate the impact of a functional genetic variant in the natriuretic peptide clearance receptor, NPR3, on circulating natriuretic peptides (NPs and myocardial structure and function in the general community.NPR3 plays an important role in the clearance of NPs and through direct signaling mechanisms modulates smooth muscle cell function and cardiac fibroblast proliferation. A NPR3 nonsynonymous single nucleotide polymorphism (SNP rs2270915, resulting in a N521D substitution in the intracellular catalytic domain that interacts with Gi could affect receptor function. Whether this SNP is associated with alterations in NPs levels and altered cardiac structure and function is unknown.DNA samples of 1931 randomly selected residents of Olmsted County, Minnesota were genotyped. Plasma NT-proANP1-98, ANP1-28, proBNP1-108, NT-proBNP1-76, BNP1-32 and BNP3-32 levels were measured. All subjects underwent comprehensive echocardiography.Genotype frequencies for rs2270915 were as follows: (A/A 60%, A/G 36%, G/G 4%. All analyses performed were for homozygotes G/G versus wild type A/A plus the heterozygotes A/G. Diastolic dysfunction was significantly more common (p = 0.007 in the homozygotes G/G (43% than the A/A+A/G (28% group. Multivariate regression adjusted for age, sex, body mass index and hypertension demonstrated rs2270915 to be independently associated with diastolic dysfunction (odds ratio 1.94, p = 0.03. There was no significant difference in NPs levels between the 2 groups suggesting that the clearance function of the receptor was not affected.A nonsynonymous NPR3 SNP is independently associated with diastolic dysfunction and this association does not appear to be related to alterations in circulating levels of natriuretic peptides.

  2. B-type natriuretic peptide measurement in primary care; magnitude of associations with cardiovascular risk factors and their therapies. Observations from the STOP-HF (St. Vincent's Screening TO Prevent Heart Failure) study.

    LENUS (Irish Health Repository)

    Conlon, Carmel M

    2012-02-01

    BACKGROUND: An effective prevention strategy for heart failure in primary care requires a reliable screening tool for asymptomatic ventricular dysfunction. Preliminary data indicate that B-type natriuretic peptide (BNP) may be suitable for this task. However, for the most effective use of this peptide, the interrelationships between associated risk factors and their therapies on BNP, and in particular their magnitude of effect, needs to be established in a large primary care population. Therefore, the objective of the study was to establish the extent of the association between BNP, cardiovascular risk factors and their therapies. METHODS: BNP measurement and clinical review was preformed on 1122 primary care patients with cardiovascular risk factors. Multivariate analyses identified significant associates of BNP concentrations which were further explored to establish the magnitude of their association. RESULTS: Associates of BNP were age (1.36-fold increase in BNP\\/decade), female (1.28), beta-blockers (1.90), myocardial infarction (1.36), arrhythmia (1.98), diastolic blood pressure; all p<0.01. A novel method was devised that plotted median BNP per sliding decade of age for the various combinations of these principal associates. CONCLUSIONS: The data presented underline the importance of considering several clinical and therapeutic factors when interpreting BNP concentrations. Most of these variables were associated with increased concentrations, which may in part explain the observed false-positive rates for detecting ventricular dysfunction using this peptide. Furthermore, the design of studies or protocols using BNP as an endpoint or a clinical tool should take particular account of these associations. This analysis provides the foundation for age, risk factor and therapy adjusted reference ranges for BNP in this setting.

  3. 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

  4. Hemodynamic Determinants of the Biologic Variation of N-Terminal Pro-B-Type Natriuretic Peptide in Patients With Stable Systolic Chronic Heart Failure.

    Science.gov (United States)

    Täger, Tobias; Wiedergruen, Ann-Kathrin; Fröhlich, Hanna; Cebola, Rita; Corletto, Anna; Horsch, Andrea; Hess, Georg; Slottje, Karen; Zdunek, Dietmar; Katus, Hugo A; Wians, Frank H; Frankenstein, Lutz

    2017-07-27

    Biologic variation of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in chronic heart failure (CHF) may affect blood levels and risk stratification. The sources of NT-proBNP variation are unknown. We performed NT-proBNP measurements and clinical and hemodynamic assessments in 50 patients with heart failure with reduced ejection fraction (HFrEF) who met criteria for clinical stability over 2 time intervals. Hemodynamic variables were measured with the use of inert gas rebreathing and impedance cardiography. Heart rhythm was monitored with the use of external electrocardiographic event recorders throughout the study. Determinants of NT-proBNP-levels and both absolute (ΔNT-proBNPabs) and relative (ΔNT-proBNP%) changes at 1-week and 2-week intervals were identified with the use of univariable and multivariable linear mixed-effects models and linear regression analyses, respectively. Clinical and hemodynamic variables did not significantly change between study visits. The individual variation of NT-proBNP at 2 weeks was 9.2% (range 3.9%-18.6%). Weight and glomerular filtration rate were independently associated with baseline NT-proBNP concentrations (P = .01 and P = .005, respectively). There was no relationship between absolute and relative changes of NT-proBNP at 1-week intervals and changes in clinical and hemodynamic variables. Absolute change of NT-proBNP at 2-week intervals was associated with absolute change in left cardiac work index (P = .008), and relative change in NT-proBNP at 2-week intervals was determined by relative change of thoracic fluid content index (P = .008) and diastolic blood pressure (P = .01). The coefficients of determination (R(2)) for the multivariable models with Δ1wkNT-proBNPabs, Δ2-weeksNT-proBNPabs, Δ1wkNT-proBNP%, and Δ2wksNT-proBNP% as dependent variables were 0.21, 0.19, 0.10, and 0.32, respectively. In patients with stable HFrEF, changes in clinical and hemodynamic variables only marginally

  5. 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.

  6. Placental expression of proBNP/NT-proBNP and plasma levels of NT-proBNP in early- and late-onset preeclampsia.

    Science.gov (United States)

    Junus, Katja; Wikström, Anna-Karin; Larsson, Anders; Olovsson, Matts

    2014-09-01

    Levels of plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) are elevated in preeclampsia. In this study, the possibility that the placenta produces and releases proBNP/NT-proBNP was explored. Plasma levels of NT-proBNP in early- and late-onset preeclampsia were also measured. Placental proBNP mRNA in early-onset preeclampsia (n = 7), late-onset preeclampsia (n = 8), and controls of similar gestational age (n = 10) was assessed by quantitative real-time polymerase chain reaction. ProBNP/NT-proBNP protein was studied in placental samples with immunohistochemistry (n = 8) and tissue culture (n = 2). Plasma levels of NT-proBNP were measured in early-onset preeclampsia (n = 18), late-onset preeclampsia (n = 20), and relevant controls (n = 36). Transcripts of proBNP mRNA were found in 20 out of 25 samples, there were no differences in expression between the groups. ProBNP/NT-proBNP protein was observed in maternal spiral arteries and in syncytiotrophoblasts in all placental samples. After placental tissue culture, there were measurable amounts of NT-proBNP in the culture media. Women with both early- (365 [14-9815] pg/ml) and late-onset preeclampsia (176 [33-2547] pg/ml) had higher levels of NT-proBNP than their controls (P preeclampsia than in women with late-onset preeclampsia (P = 0.057). The results indicate possible placental production and release of proBNP/NT-proBNP into the maternal circulation. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. 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.

  8. 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.

  9. 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

  10. Impact of obesity on the expression profile of natriuretic peptide system in a rat experimental model.

    Directory of Open Access Journals (Sweden)

    Manuela Cabiati

    Full Text Available Natriuretic peptides (NPs play an important role in obesity and aim of this study was to evaluate, in cardiac tissue of obese Zucker rats (O, n = 29 their transcriptomic profile compared to controls (CO, n = 24 by Real-Time PCR study; CNP protein expression was evaluated by immunostaining and immunometric tests. Myocardial histology was performed, confirming no alteration of organ structure. While ANP and BNP are cardiac peptides, CNP is mainly an endothelial hormone; thus its expression, as well as that of NPR-B and NPR-C, was also evaluated in kidney and lung of an animal subgroup (n = 20. In heart, lower BNP mRNA levels in O vs CO (p = 0.02 as well as ANP and CNP (p = ns, were detected. NPR-B/NPR-A mRNA was similar in O and CO, while NPR-C was numerically lower (p = ns in O than in CO. In kidney, CNP/NPR-B/NPR-C mRNA was similar in O and CO, while in lung CNP/NPR-C expression decreased and NPR-B increased (p = ns in O vs CO. Subdividing into fasting and hyperglycemic rats, the pattern of mRNA expression for each gene analyzed remained unchanged. The trend observed in heart, kidney and lung for CNP protein concentrations and immunohistochemistry reflected the mRNA expression. TNF-α and IL-6 mRNA were measured in each tissue and no significant genotype effect was detected in any tissue. The main NP variations were observed at the cardiac level, suggesting a reduced release by cardiac cells. The understanding of mechanisms involved in the modulation of the NP system in obesity could be a useful starting point for future clinical study devoted to identifying new obesity treatment strategies.

  11. 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.

  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 human endolymphatic sac expresses natriuretic peptides

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Kirkeby, Svend; Vikeså, Jonas

    2017-01-01

    in intracranial pressure homeostasis. However, no direct evidence of such capacity exists. This study aims to explore and identify the hypothesized endocrine capacity of the human ES. STUDY DESIGN: DNA microarrays and immunohistochemistry were used for analyses of fresh human ES tissue samples. METHODS: Twelve...... vasopressin receptors and aquaporin-2 channels in the inner ear via OXT expression. We hypothesize that the ES is likely to regulate inner ear endolymphatic homeostasis, possibly through secretion of several peptides, but it may also influence systemic and/or intracranial blood pressure through direct...

  14. N-Terminal Pro-B Type Natriuretic Peptide as a Marker of Bronchopulmonary Dysplasia or Death in Very Preterm Neonates: A Cohort Study.

    Directory of Open Access Journals (Sweden)

    Anna Sellmer

    Full Text Available Bronchopulmonary dysplasia (BPD is a serious complication of preterm birth. Plasma N-terminal pro-B type natriuretic peptide (NT-proBNP has been suggested as a marker that may predict BPD within a few days after birth.To investigate the association between NT-proBNP day three and bronchopulmonary dysplasia (BPD or death and further to assess the impact of patent ductus arteriosus (PDA on this association in neonates born before 32 gestational weeks.A cohort study of 183 neonates born before 32 gestational weeks consecutively admitted to the Neonatal Intensive Care Unit, Aarhus University Hospital, Denmark. On day three plasma samples were collected and echocardiography carried out. NT-proBNP was measured by routine immunoassays. The combined outcome BPD or death was assessed at 36 weeks of postmenstrual age. Receiver operator characteristic (ROC analysis was performed to determine the discrimination ability of NT-proBNP by the natural log continuous measure to recognize BPD or death. The association of BPD or death was assessed in relation to natural log NT-proBNP levels day three.The risk of BPD or death increased 1.7-fold with one unit increase of natural log NT-proBNP day three when adjusted for gestational age at birth (OR = 1.7, 95% CI 1.3; 2.3. The association was found both in neonates with and without a PDA. Adjusting for GA, PDA diameter, LA:Ao-ratio, or early onset sepsis did not change the estimate.We found NT-proBNP to be associated with BPD or death in very preterm neonates. This association was not only explained by the PDA. We speculate that NT-proBNP may help the identification of neonates at risk of BPD as early as postnatal day three.

  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. 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.

  17. Decrease of plasma N-terminal pro β-type natriuretic peptide as a predictor of clinical improvement after cardiac resynchronization therapy for heart failure

    Institute of Scientific and Technical Information of China (English)

    DING Li-gang; HUA Wei; ZHANG Shu; CHU Jian-min; CHEN Ke-ping; WANG Yang; WANG Fang-zheng; CHEN Xin

    2009-01-01

    Background N-terminal pro β-type natriuretic peptide (NT pro BNP) has been shown to predict the prognosis and could guide the treatment of heart failure. We aimed to investigate the values of NT pro BNP in predicting the clinical response to cardiac resynchronization therapy (CRT).Methods A total of 44 patients with chronic heart failure (34 male and 10 female, mean age of (58±13) years, New York Heart Association (NYHA) class 3.3±0.5, QRS duration (150±14) milliseconds) who underwent successful implantation of a CRT system were enrolled in this study. Pharmacotherapy remained stable during the first 3 months of follow-up. Plasma levels of NT pro BNP were evaluated before and 3 months after implantation. Clinical, echocardiographic and exercise parameters were monitored at each clinical visit after CRT implantation. Receiver operating characteristic analysis and a paired ttest were performed to analyze the data.Results After a mean of (16.3±5.5) months of follow-up, 11 nonresponders were identified. CRT resulted in a significant reduction in NT pro BNP ((1.70±1.28) vs (1.07±0.88) pmol/ml, P <0.001) in responders. Percentage change in NT pro BNP level (△BNP%) was a statistically significant predictor of long term clinical improvement at 3 months of follow-up.Conclusions △BNP% from baseline to 3 months of follow-up is a predictor of long term response to CRT. NT pro BNP may be a simple method for monitoring the effects of CRT.

  18. 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.

  19. 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...

  20. 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...

  1. 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.

  2. 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.

  3. 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

  4. Long-term effects of peroxisome proliferator-activated receptor ligand bezafibrate on N-terminal pro-B type natriuretic peptide in patients with advanced functional capacity impairment

    Directory of Open Access Journals (Sweden)

    Matas Zipora

    2009-01-01

    Full Text Available Abstract Background The effects of pan-peroxisome proliferator-activated receptor (PPAR ligand bezafibrate on N-terminal pro-B type natriuretic peptide (ProBNP level in patients with coronary artery disease (CAD is unknown. The current study aimed to investigate the long-term effects of bezafibrate on ProBNP level in patients with pre-existing CAD and advanced functional capacity impairment. Methods Metabolic and inflammatory parameters were analyzed from stored frozen serum samples obtained from 108 patients enrolled in the Bezafibrate Infarction Prevention (BIP Study. They presented with New York Heart Association (NYHA functional class III, comprising 58 patients in the bezafibrate group and 50 in the placebo groups, and completed a 2-year prospective, double-blind, placebo-controlled follow-up. Results During follow-up ProBNP level did not change significantly in the placebo group, whereas it increased slightly in the bezafibrate group, which was older and with lower baseline ProBNP values. No significant differences between the groups were found for ProBNP levels after 2 year of follow-up. Analysis-of-covariance (ANCOVA -taking into account age and baseline ProBNP level- showed that bezafibrate was not associated with longitudinal ProBNP changes during the follow-up period (p = 0.3. Conclusion Long-term treatment by bezafibrate was not associated with longitudinal ProBNP changes in patients with pre-existing CAD and advanced functional capacity impairment.

  5. 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.

  6. N-terminal pro-B-type natriuretic peptide as a marker of blunt cardiac contusion in trauma.

    Science.gov (United States)

    Dogan, Halil; Sarikaya, Sezgin; Neijmann, Sebnem Tekin; Uysal, Emin; Yucel, Neslihan; Ozucelik, Dogac Niyazi; Okuturlar, Yıldız; Solak, Suleyman; Sever, Nurten; Ayan, Cem

    2015-01-01

    Cardiac contusion is usually caused by blunt chest trauma and, although it is potentially a life-threatening condition, the diagnosis of a myocardial contusion is difficult because of non-specific symptoms and the lack of an ideal test to detect myocardial damage. Cardiac enzymes, such as creatine kinase (CK), creatine kinase MB fraction (CK-MB), cardiac troponin I (cTn-I), and cardiac troponin T (cTn-T) were used in previous studies to demonstrate the blunt cardiac contusion (BCC). Each of these diagnostic tests alone is not effective for diagnosis of BCC. The aim of this study was to investigate the serum heart-type fatty acid binding protein (h-FABP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), CK, CK-MB, and cTn-I levels as a marker of BCC in blunt chest trauma in rats. The eighteen Wistar albino rats were randomly allocated to two groups; group I (control) (n=8) and group II (blunt chest trauma) (n=10). Isolated BCC was induced by the method described by Raghavendran et al. (2005). All rats were observed in their cages and blood samples were collected after five hours of trauma for the analysis of serum h-FABP, NT-pro BNP, CK, CK-MB, and cTn-I levels. The mean serum NT-pro BNP was significantly different between group I and II (10.3 ± 2.10 ng/L versus 15.4 ± 3.68 ng/L, respectively; P=0.0001). NT-pro BNP level >13 ng/ml had a sensitivity of 87.5%, a specificity of 70%, a positive predictive value of 70%, and a negative predictive value of 87.5% for predicting blunt chest trauma (area under curve was 0.794 and P=0.037). There was no significant difference between two groups in serum h-FABP, CK, CK-MB and c Tn-I levels. A relation between NT-Pro BNP and BCC was shown in this study. Serum NT-proBNP levels significantly increased with BCC after 5 hours of the blunt chest trauma. The use of NT-proBNP as an adjunct to other diagnostic tests, such as troponins, electrocardiography (ECG), chest x-ray and echocardiogram may be beneficial for diagnosis of

  7. 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....

  8. 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.

  9. Gene expression of ANP, BNP and ET-1 in the heart of rats during pulmonary embolism.

    Directory of Open Access Journals (Sweden)

    Henrik Gutte

    Full Text Available AIMS: Atrial natriuretic petide (ANP, brain natriuretic peptide (BNP and endothelin-1 (ET-1 may reflect the severity of right ventricular dysfunction (RVD in patients with pulmonary embolism (PE. The exact nature and source of BNP, ANP and ET-1 expression and secretion following PE has not previously been studied. METHODS AND RESULTS: Polystyrene microparticles were injected to induce PE in rats. Gene expression of BNP, ANP and ET-1 were determined in the 4 cardiac chambers by quantitative real time polymerase chain reaction (QPCR. Plasma levels of ANP, BNP, ET-1 and cardiac troponin I (TNI were measured in plasma. PE dose-dependently increased gene expression of ANP and BNP in the right ventricle (RV and increased gene expression of ANP in the right atrium (RA. In contrast PE dose-dependently decreased BNP gene expression in both the left ventricle (LV and the left atrium (LA. Plasma levels of BNP, TNI and ET-1 levels dose-dependently increased with the degree of PE. CONCLUSION: We found a close correlation between PE degree and gene-expression of ANP, and BNP in the cardiac chambers with a selective increase in the right chambers of the heart. The present data supports the idea of natriuretic peptides as valuable biomarkers of RVD in PE.

  10. NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve: a multicentre PROSTAVA study

    NARCIS (Netherlands)

    Schoonbeek, R.C.; Pieper, P.G.; Slooten, Y.J. van; Freling, H.G.; Sieswerda, G.T.; Dijk, A.P.J. van; Jongbloed, M.R.; Post, M.C.; Bouma, B.J.; Berger, R.M.; Ebels, T.; Melle, J.P. van

    2016-01-01

    OBJECTIVES: N-terminal Btype natriuretic peptide (NT-proBNP) is an important biomarker for the detection of heart failure. Adults with congenital heart disease (ACHD) and a prosthetic heart valve are at risk for heart failure. This study aimed to determine the value of NT-proBNP in ACHD patients wit

  11. NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve : a multicentre PROSTAVA study

    NARCIS (Netherlands)

    Schoonbeek, R C; Pieper, P G; van Slooten, Y J; Freling, H G; Sieswerda, G T; van Dijk, A. P. J.; Jongbloed, M R M; Post, M. C.; Bouma, B. J.; Berger, R M F; Ebels, T; van Melle, J P

    2016-01-01

    OBJECTIVES: N-terminal B‑type natriuretic peptide (NT-proBNP) is an important biomarker for the detection of heart failure. Adults with congenital heart disease (ACHD) and a prosthetic heart valve are at risk for heart failure. This study aimed to determine the value of NT-proBNP in ACHD patients wi

  12. 血浆NT-proBNP水平对脓毒症合并心肌损伤的诊断价值%Diagnostic value of plasma N-terminal pro-B-type natriuretic peptide(NT-proBNP) in patients with sepsis combined with myocardial injury

    Institute of Scientific and Technical Information of China (English)

    贺红霞; 胡苏萍; 黄毅

    2011-01-01

    目的 观察N-末端B型利钠肽原(NT-proBNP)在脓毒症及其脓毒症合并心肌损伤患者的水平变化.方法 武汉大学人民医院住院的脓毒症患者37例,其中并心肌损伤者17例(A组),非心肌损伤者20例(B组),健康对照者20例(C组).测定入院后24 h内血浆NT-proBNP水平及肌钙蛋白I的水平,对比各组之间血浆NT-proBNP水平,并将NT-proBNP水平与肌钙蛋白I进行相关性分析.结果 A、B、C组NT-proBNP水平入院后分别为(3180.6±1420.57)pg/ml,(746.66±225.63)pg/ml,(60.195±28.305)pg/ml.对比各组入院后NT-proBNP的水平,有统计学意义(P<0、01).且脓毒症并心肌损伤组肌钙蛋白I为3.8822±1.8221 ng/ml,与NT-proBNP成正相关.结论 NT-proBNP在脓毒症患者血浆中水平升高,且在心肌损伤组与非心肌损伤组中有差异,血浆NT-proBNP与肌钙蛋白I成正相关,两者升高越明显病情越危重,可作为判断心肌是否受损的指标.%Objective To observe the variation of NT-proBNP level in patients with sepsis and sepsis combined with myocardial injury. And search for the early diagnostic index of myocardial injury. Methods We recruited 37 patients received a diagnosis of sepsis according to the diagnosis and treatment program of septicemia in 2003 by the American College of Chest Physicians and the Society of Critical Care Medicine(ACCP/SCCM). The 37 cases were divided into myocardial injury group (group A ) and non-myocardial injury group ( group B). Meanwhile,twenty non-sepsis patients were enrolled as control group( group C). We measured NT-proBNP in plasma in these 57 patients and then analyzed the differences of its level among the 3 groups. Meanwhile,the results were compaired to troponin Ⅰ in group A. Results There were significant differences among NT - proBNP levels in plasma of the 3 groups: ( 3180. 6 ± 1420. 57 ) pg/ml in group A, (746. 66 ± 22.5.63 ) pg/ml in group B, and (60. 195 ± 28. 305 ) pg/ml in group C( P < 0. 01 ). Conclusion The

  13. Clinical Significance of Brain Natriuretic Peptide(BNP),Cadiac TroponinⅠ(cTnⅠ),and D-dimer Detection in the Acute Pulmonary Embolism(APE)%血浆脑钠肽、肌钙蛋白Ⅰ联合D-二聚体检测对急性肺栓塞患者的临床意义

    Institute of Scientific and Technical Information of China (English)

    常慧

    2016-01-01

    Objective:To discuss the clinical significance of BNP, cTnⅠ and D-dimer detection in patients with APE.Method:76 patients with APE were divided into the massive APE group of 36 cases and the non massive APE group of 40 cases according to the embolization area, then the levels of BNP,cTnⅠ and D-dimer, right heart function and mortality of two groups were contrasted.Result:The levels of BNP and cTnⅠ in the massive APE group were significantly higher than the non massive APE group,the differences were statistically significant(P0.05).The incidence of right heart function failure and the fatality rate in the massive APE group was respectively 69.4% and 22.2%, significantly higher than 15.0% and 2.5% in the non massive PE group,the difference was statistically significant(P0.05)。大面积APE患者患右心功能不全发生率及病死率分别为69.4%与22.2%,均显著高于非大面积APE组的15.0%与2.5%,两组比较差异均有统计学意义(P<0.01)。结论:通过对APE患者血浆BNP、cTnⅠ水平的检测可对患者进行危险分层及预后评估,D-二聚体水平的检测可作为诊断APE的排除指标。

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. Plasma B-type Natriuretic Peptide as a Predictor of Cardiovascular Events in Subjects with Atrial Fibrillation: A Community-Based Study

    Science.gov (United States)

    Nakamura, Motoyuki; Koeda, Yorihiko; Tanaka, Fumitaka; Onoda, Toshiyuki; Itai, Kazuyoshi; Ohsawa, Masaki; Tanno, Kozo; Sakata, Kiyomi; Omama, Shinich; Ishibashi, Yasuhiro; Makita, Shinji; Ohta, Mutsuko; Ogasawara, Kuniaki; Komatsu, Takashi; Okayama, Akira

    2013-01-01

    Objectives Atrial fibrillation (AF) is a significant public health issue due to its high prevalence in the general population, and is associated with an increased risk of cardiovascular (CV) events including systemic thrombo-embolism, heart failure, and coronary artery disease. The relationship between plasma B-type natriuretic peptide (BNP) and CV risk in real world AF subjects remains unknown. Methods The subject of the study (n = 228; mean age = 69 years) was unselected individuals with AF in a community-based population (n = 15,394; AF prevalence rate = 1.5%). The CV event free rate within each BNP tertile was estimated, and Cox regression analysis was performed to examine the relative risk of the onset of CV events among the tertiles. The prognostic ability of BNP was compared to an established risk score for embolic events (CHADS2 score). In addition, to determine the usefulness of BNP as a predictor in addition to CHADS2 score, we calculated Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) indices. Results During the follow-up period 58 subjects experienced CV events (52 per 1,000 person-years). The event-free ratio was significantly lower in the highest tertile (p < 0.02). After adjustment for established CV risk factors, the hazard ratio (HR) of the highest tertile was significantly higher than that of the lowest tertile (HR = 2.38; p < 0.02). The predictive abilities of plasma BNP in terms of sensitivity and specificity for general CV events were comparable to those of CHADS2 score. Adding BNP to the CHADS2 score only model improved the NRI (0.319; p < 0.05) and the IDI (0.046; p < 0.05). Conclusion Plasma BNP is a valuable biomarker both singly or in combination with an established scoring system for assessing general CV risk including stroke, heart failure and acute coronary syndrome in real-world AF subjects. PMID:24312541

  20. Plasma B-type natriuretic peptide as a predictor of cardiovascular events in subjects with atrial fibrillation: a community-based study.

    Directory of Open Access Journals (Sweden)

    Motoyuki Nakamura

    Full Text Available OBJECTIVES: Atrial fibrillation (AF is a significant public health issue due to its high prevalence in the general population, and is associated with an increased risk of cardiovascular (CV events including systemic thrombo-embolism, heart failure, and coronary artery disease. The relationship between plasma B-type natriuretic peptide (BNP and CV risk in real world AF subjects remains unknown. METHODS: The subject of the study (n = 228; mean age = 69 years was unselected individuals with AF in a community-based population (n = 15,394; AF prevalence rate = 1.5%. The CV event free rate within each BNP tertile was estimated, and Cox regression analysis was performed to examine the relative risk of the onset of CV events among the tertiles. The prognostic ability of BNP was compared to an established risk score for embolic events (CHADS2 score. In addition, to determine the usefulness of BNP as a predictor in addition to CHADS2 score, we calculated Net Reclassification Improvement (NRI and Integrated Discrimination Improvement (IDI indices. RESULTS: During the follow-up period 58 subjects experienced CV events (52 per 1,000 person-years. The event-free ratio was significantly lower in the highest tertile (p < 0.02. After adjustment for established CV risk factors, the hazard ratio (HR of the highest tertile was significantly higher than that of the lowest tertile (HR = 2.38; p < 0.02. The predictive abilities of plasma BNP in terms of sensitivity and specificity for general CV events were comparable to those of CHADS2 score. Adding BNP to the CHADS2 score only model improved the NRI (0.319; p < 0.05 and the IDI (0.046; p < 0.05. CONCLUSION: Plasma BNP is a valuable biomarker both singly or in combination with an established scoring system for assessing general CV risk including stroke, heart failure and acute coronary syndrome in real-world AF subjects.

  1. 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.

  2. Model-based cost-effectiveness analysis of B-type natriuretic peptide-guided care in patients with heart failure

    Science.gov (United States)

    Mohiuddin, Syed; Reeves, Barnaby; Pufulete, Maria; Maishman, Rachel; Dayer, Mark; Macleod, John; McDonagh, Theresa; Purdy, Sarah; Rogers, Chris; Hollingworth, William

    2016-01-01

    Objective Monitoring B-type natriuretic peptide (BNP) to guide pharmacotherapy might improve survival in patients with heart failure with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF). However, the cost-effectiveness of BNP-guided care is uncertain and guidelines do not uniformly recommend it. We assessed the cost-effectiveness of BNP-guided care in patient subgroups defined by age and ejection fraction. Methods We used a Markov model with a 3-month cycle length to estimate the lifetime health service costs, quality-adjusted life years (QALYs) and incremental net monetary benefits (iNMBs) of BNP-guided versus clinically guided care in 3 patient subgroups: (1) HFrEF patients HFpEF patients HFpEF aged ≥75 years. We used individual patient data meta-analyses and linked primary care, hospital and mortality data to inform the key model parameters. We performed probabilistic analysis to assess the uncertainty in model results. Results In younger patients (HFpEF (£3155 (−£10 307 to £11 613)) and older patients (≥75 years) with HFrEF (£2267 (−£1524 to £6074)). BNP-guided care remained cost-effective in the sensitivity analyses, albeit the results were sensitive to assumptions on its sustained effect. Conclusions We found strong evidence that BNP-guided care is a cost-effective alternative to clinically guided care in younger patients with HFrEF. It is potentially cost-effective in younger patients with HFpEF and older patients with HFrEF, but more evidence is required, particularly with respect to the frequency, duration and BNP target for monitoring. Cost-effectiveness results from trials in specialist settings cannot be generalised to primary care. PMID:28031211

  3. High N-terminal pro-B-type natriuretic peptide levels are associated with reduced heart rate variability in acute myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Luc Lorgis

    Full Text Available AIM: We investigated the relationships between the autonomic nervous system, as assessed by heart rate variability (HRV and levels of N-terminal Pro-B-type Natriuretic Peptide (Nt-proBNP in patients with acute myocardial infarction (MI. METHODS AND RESULTS: The mean of standard deviation of RR intervals (SDNN, the percentage of RR intervals with >50 ms variation (pNN50, square root of mean squared differences of successive RR intervals (rMSSD, and frequency domain parameters (total power (TP, high frequency and low frequency power ratio (LF/HF were assessed by 24 h Holter ECG monitoring. 1018 consecutive patients admitted <24 h for an acute MI were included. Plasma Nt-proBNP (Elecsys, Roche was measured from blood samples taken on admission. The median (IQR Nt-proBNP level was 681(159-2432 pmol/L. Patients with the highest quartile of Nt-proBNP were older, with higher rate of risk factors and lower ejection fraction. The highest Nt-proBNP quartile group had the lowest SDNN, LF/HF and total power but similar pNN50 and rMSSD levels. Nt-proBNP levels correlated negatively with SDNN (r = -0.19, p<0.001, LF/HF (r = -0.37, p<0.001, and LF (r = -0.29, p<0.001 but not HF (r = -0.043, p = 0.172. Multiple regression analysis showed that plasma propeptide levels remained predictive of LF/HF (B(SE = -0.065(0.015, p<0.001, even after adjustment for confounders. CONCLUSIONS: In conclusion, our population-based study highlights the importance of Nt-proBNP levels to predict decreased HRV after acute MI.

  4. 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.

  5. 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...

  6. 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...

  7. 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...

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

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    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.

  10. 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.

  11. 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.

  12. Hormone therapy with tamoxifen reduces plasma levels of NT-B-type natriuretic peptide but does not change ventricular ejection fraction after chemotherapy in women with breast cancer

    Directory of Open Access Journals (Sweden)

    F.B. Silva

    2015-02-01

    Full Text Available The objective of this study was to evaluate the effect of tamoxifen on the plasma concentration of NT-pro-B-type natriuretic peptide (NT-proBNP in women undergoing chemotherapy for breast cancer and to correlate changes in NT-proBNP with the left ventricular ejection fraction (LVEF. Over a period of 12 months, we followed 60 women with a diagnosis of breast cancer. The patients were separated into a group that received only chemotherapy (n=23, a group that received chemotherapy + tamoxifen (n=21, and a group that received only tamoxifen (n=16. Plasma levels of NT-proBNP were assessed at 0 (T0, 6 (T6, and 12 (T12 months of treatment, and echocardiography data were assessed at T0 and T12. Plasma NT-proBNP levels were increased in the chemotherapy-only group at T6 and T12, whereas elevated NT-proBNP levels were only found at T6 in the chemotherapy + tamoxifen group. At T12, the chemotherapy + tamoxifen group exhibited a significant reduction in the peptide to levels similar to the group that received tamoxifen alone. The chemotherapy-only group exhibited a significant decrease in LVEF at T12, whereas the chemotherapy + tamoxifen and tamoxifen-only groups maintained levels similar to those at the beginning of treatment. Treatment with tamoxifen for 6 months after chemotherapy significantly reduced the plasma levels of NT-proBNP and did not change LVEF in women with breast cancer.

  13. 螺内酯对老年慢性心力衰竭患者心功能和血浆脑钠肽的影响%Effect of spironolactone on the cardiac function and plasma brain natriuretic peptide (BNP) in elderly patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    上官佳红; 张红苗; 苏杨

    2012-01-01

    目的 探讨螺内酯在老年慢性心力衰竭患者治疗中的作用.方法 62例老年慢性心力衰竭患者根据治疗方法不同分为常规组(30例)和螺内酯组(32例).常规组:接受ACEI、洋地黄、噻嗪类利尿剂、β受体阻滞剂等常规治疗.螺内酯组:在常规治疗基础上口服螺内酯.观察各组患者在治疗前及治疗后4个月的血清BNP水平、LVEF、V/VA,观察治疗后1个月的临床疗效.结果 螺内酯组治疗后1个月的总有效率(90.6%)明显高于常规组(70%);螺内酯组治疗后LVEF、VE/VA较常规组明显升高(P<0.05).2组治疗后血清BNP水平均较治疗前明显降低,螺内酯组降低更加明显(P<0.05).结论 螺内酯能明显改善老年慢性心力衰竭患者的心功能,降低血清BNP水平.%Objective To investigate the role of spironolactone in the treatment of chronic heart failure. Methods Sixty- two patients with chronic heart failure were divided into conventional group (n = 30) and spironolactone group ( n = 32). The conventional group received ACEI, digitalis, thiazide diuretics, β-blockers and other conventional treatments. Spironolactone group took oral spironolactone treatment in addition to the conventional treatment. Serum BNP levels, LVEF and VE/VA before and after 4 months of the treatment were observed. The treatment efficacy after 1 month of the treatment was observed as well. Results One month after treatment, the total efficiency (90.6% ) of spironolactone group was significantly higher than that of the conventional group (70%). LVEF and VE/VA of spironolactone group were significantly higher than those of the conventional group (P<0.05). After treatment, the serum BNP levels of both groups decreased. The spironolactone group had more significant decreases (P < 0. 05). Conclusion Spironolactone can significantly improve cardiac function and decrease serum BNP levels in elderly patients with chronic heart failure.

  14. The predictive capacity and additional prognostic power of N-terminal pro-B-type natriuretic peptide in Chinese elderly with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Fu S

    2015-01-01

    Full Text Available Shihui Fu,1,2,* Leixing Xie,2,* Dongyun Li,1,2 Ping Ye,1 Leiming Luo11Department of Geriatric Cardiology, 2Department of Cardiology and Hainan Branch, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China*These authors are joint first authorsObjective: This study was conducted to research the prognostic utility of N-terminal pro-B-type natriuretic peptide (NT-proBNP, compare the utility of the Seattle Heart Failure Score (SHFS with NT-proBNP, develop a risk-evaluation model based on NT-proBNP, assess the associations of NT-proBNP with patient characteristics, and screen for decisive factors of NT-proBNP in Chinese elderly with chronic heart failure (CHF.Patients and methods: There were 306 patients (≥60 years with CHF chosen as study subjects. Each one received an assessment of NT-proBNP on serum. The end point was all-cause mortality during a mean follow-up period of 471 days.Results: Subjects had a median age of 85 (60–100 years, a median NT-proBNP of 1,743.4 pg/mL, and a median SHFS of 1.87. During the follow-up period, 104 deaths occurred. NT-proBNP was significantly related to mortality (odds ratio 1.603, 95% confidence interval 1.407–1.826; P<0.001 and the significance persisted after full adjustment (odds ratio 1.282, 95% confidence interval 1.103–1.489; P=0.001. Age, New York Heart Association class IV CHF, plasma albumin, and neutrophils/lymphocytes were also independent predictors for mortality (P<0.05 for all. NT-proBNP and the SHFS showed similar predictive capacities (0.736 versus 0.796, P=0.105. The addition of NT-proBNP to the SHFS (0.818 versus 0.796, P=0.168 generated marginal growth in the c-statistic. The model based on NT-proBNP consisting of all selected predictors in this study, including age, New York Heart Association class IV CHF, plasma albumin, neutrophils/lymphocytes, and NT-proBNP, had a moderately higher c-statistic compared with the SHFS (0.846 versus 0.796, P=0.066. NT-proBNP

  15. 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.

  16. EXPRESSION OF RECOMBINANT ANTIBODY FRAGMENT, ANTI BNP-SCFV ON THE PERIPLASM OF Escherichia coli FOR THE DETECTION OF HEART FAILURE

    Directory of Open Access Journals (Sweden)

    Shabarni Gaffar

    2017-05-01

    Full Text Available Basic natriuretic peptide (BNP is a polypeptide hormone consist of 32 amino acids that secreted by the heart ventricle to respond the excessive stretching of heart muscle cells. BNP can be used as prognostic marker for patients with heart failure. The presence of BNP in blood can be detected by BNP antibody, which is anti BNP-single chain variable fragment (Anti BNP-SCFV. The antibody is a combination of polypeptides between varying region on the heavy chain (VH and the light chain (VL of immunoglobulin. Anti BNP-SCFV will bind to BNP through the antigen-antibody interaction. Concentration of BNP in a patient’s blood can be detected through the interaction of BNP with Anti BNP-SCFV using immunosensor method. Production of recombinant Anti BNP-SCFV in Escherichia coli as host is reported in the present study. Anti BNP-SCFV was expressed in fusion form with OmpC signal peptide that direct the protein to a periplasmic space. Expression was performed under RhaBad promoter as control using L-rhamnose as inducer. SDS-PAGE characterization showed consistent band at 28 kDa, which was assumed as Anti BNP-SCFV. The optimum expression was found at four hours after induction with 4 mM inducer. Anti BNP-SCFV was secreted from the cell as characterized by the presence of the protein on periplasmic membrane and extracellular fraction.

  17. Natriuretic Peptides in Kawasaki Disease: the Myocardial Perspective

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    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.

  18. 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....

  19. 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.

  20. 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.

  1. Relationship between N-terminal pro-B type natriuretic peptide and extensive echocardiographic parameters in mild to moderate aortic stenosis

    Directory of Open Access Journals (Sweden)

    Cemri M

    2008-01-01

    Full Text Available Context: The N-terminal pro-B type natriuretic peptide levels (NT pro-BNP are increased in cases of volume or pressure overload. Aims: To examine NT pro-BNP levels and enclose whether any relationship is present between the levels of NT pro-BNP and extensive echocardiographic parameters in asymptomatic patients with mild to moderate aortic stenosis (AS. Settings and Design: A cross-sectional study about the NT pro-BNP levels was conducted in 37 asymptomatic AS patients and compared with 40 controls. Methods: Patients < 70 years old with mild to moderate AS with a peak transaortic gradient> 20 mm Hg in transthoracic echocardiogram were included in our study. Extensive echocardiographic parameters and NT pro-BNP levels were obtained from these patients and these indices were compared with the control population selected from the patients who had similar clinical characteristics with the AS patients. Statistical Analysis: NT-proBNP values were found to be distribution free. Spearman correlation coefficient was used for correlation analysis. Mean values were compared by the Kruskal-Wallis test. Results: The NT pro-BNP levels were increased in patients with AS (median; interquartiles range: 686 [449-855] pg/mL vs. 140 [116-150] pg/mL, P < 0.001. Among patients with AS, when correlation analysis was performed mean transaortic gradient, aortic valve area index, myocardial performance index, E m /A m ratio, left-ventricular mass index (LVMI and E/E m ratio had correlations (r=0.38, P = 0.026; r=-0.46, P =0.008; r=0.19, P =0,049; r=-0.22, P =0.04, r=0.49, P =0.003 and r=0.53, P < 0.001 respectively with plasma NT pro-BNP levels. The LVMI (r = 0.49, P = 0.003 and E/E m ratio (r = 0.53 P < 0.001 have the strongest correlations when compared to other parameters. Conclusion: Plasma NT pro-BNP levels are increased in even asymptomatic patients with AS and correlated with several echocardiographic parameters related to severity of AS and degree of diastolic

  2. Altered sodium intake affects plasma concentrations of BNP but not proBNP in healthy individuals and patients with compensated heart failure

    DEFF Research Database (Denmark)

    Damgaard, Morten; Goetze, Jens Peter; Norsk, Peter

    2007-01-01

    AIMS: Plasma B-type natriuretic peptide (BNP) and proBNP are promising markers for treatment of heart failure (HF), but the intra-individual biological variation is high. We investigated whether changes in sodium intake and posture contribute to this variation. METHODS AND RESULTS: A total of 12 ...... has a considerable effect on plasma BNP and therefore contributes to the intra-individual variability. We suggest dietary sodium intake to be standardized at least 3 days prior to blood sampling for the determination of plasma BNP.......AIMS: Plasma B-type natriuretic peptide (BNP) and proBNP are promising markers for treatment of heart failure (HF), but the intra-individual biological variation is high. We investigated whether changes in sodium intake and posture contribute to this variation. METHODS AND RESULTS: A total of 12...... healthy individuals and 12 patients with medically treated compensated HF were examined after 1 week of low (70 mmol [1.61 g] per day) and 1 week of high (250 mmol [5.75 g] per day) sodium intake. Plasma volume and plasma concentrations of BNP and proBNP were determined after 1 h in seated and 1 h...

  3. Short-term teriparatide treatment does not affect NT-proBNP, a marker of cardiac disease

    DEFF Research Database (Denmark)

    Ellegaard, Maria; Schwarz, Peter; Hansen, Ann Caroline;

    2012-01-01

    of cardiovascular disease (CVD) is seen in PHPT patients. The N-terminal fragment of the pro-peptide of Brain Natriuretic peptide (NT-proBNP), a risk marker of CVD, has been shown to be elevated in PHPT patients, indicating that continuously high concentrations of PTH affect the heart. Therefore the aim...... of this study was to investigate whether teriparatide treatment is associated with changes in plasma NT-proBNP....

  4. 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...

  5. 6 min步行运动训练对射血分数保留的心力衰竭患者脑钠肽水平的影响%The effects of six-minute walking exercise on plasma brain natriuretic peptide(BNP) levels of heart failure patients with preserved ejection fraction

    Institute of Scientific and Technical Information of China (English)

    任春琦; 张盼

    2014-01-01

    目的 探讨6 min步行运动训练对射血分数保留的心力衰竭(HFpEF)患者血浆脑钠肽水平(BNP)的影响.方法 随机将50例HFpEF患者分为训练组及对照组,每组25例.两组患者均给予常规药物治疗,训练组辅以6 min步行运动训练.6个月后观察两组治疗前后BNP水平及6 min步行距离(6-MWD).结果 两组患者治疗后BNP水平均有改善(P<0.05);训练组BNP水平显著低于对照组(P<0.05).结论 6 min步行运动训练能显著改善射血分数保留的心衰患者的BNP水平,有益于提高患者的生活质量.

  6. 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

  7. 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.

  8. 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.

  9. Troponin T and N-terminal pro B-Type natriuretic peptide and presence of coronary artery disease

    DEFF Research Database (Denmark)

    Mouridsen, Mette R; Sajadieh, Ahmad; Carlsen, Christian M

    2015-01-01

    BACKGROUND: We tested the effects of exercise intensity, sampling intervals, degree of coronary artery stenosis, and demographic factors on circulating N-terminal pro B-Type natriuretic peptide (NT-pro-BNP) and cardiac Troponin T (cTnT) in subjects suspected of coronary artery disease (CAD......). MATERIALS AND METHODS: A total of 242 subjects referred for diagnostic evaluation of possible CAD had blood samples obtained before, 5 min after, and again 20 h after a symptom-limited exercise test. RESULTS: Totally 40 subjects had CAD with ≥ 50% stenosis, 115 subjects had no stenosis and 87 subjects...... similarly after exercise in CAD-subjects, non-CAD-subjects, and controls (median increase 8.14 ng/L) and the increase was positively associated with baseline NT-pro-BNP but not presence of CAD. Median baseline cTnT was 6.25 ng/L in CAD-subjects and 3.00 ng/L in non-CAD-subjects as well as controls, both p...

  10. B-type Natriuretic Peptide Assay in Differentiating Congestive Heart Failure from Lung Disease in Patients Presenting with Dyspnea.

    Science.gov (United States)

    Islam, M A; Bari, M S; Islam, M N; Bari, M A; Siddique, S R; Islam, M Z; Begum, M S; Ahammed, S U; Rahman, M A

    2016-07-01

    This cross-sectional analytical study was conducted in Cardiology & Medicine Department of Mymensingh Medical College Hospital. After fulfilling the exclusion & inclusion criteria, B-type natriuretic peptide concentrations were measured in a convenience sample of 100 predominantly male (94%) dyspnic patients who got admitted in Cardiology & Medicine Department of Mymensingh Medical College & Hospital from November 2013 to October 2014. The diagnosis of Congestive Heart Failure (CHF) was based on generally accepted Framingham criteria with corroborative information including hospital course (response to diuretics, vasodilators, inotropes or hemodynamic monitoring) and results of further cardiac testing, including echocardiography. Patients with right heart failure from cor pulmonale were classified as having CHF. Pulmonary disease was confirmed by using the following diagnostic tools: i) A chest X-ray without signs of heart enlargement or pulmonary venous hypertension or a chest X-ray with signs of chronic obstructive lung disease, ii) Normal heart function as seen by echocardiography, iii) Abnormal pulmonary function tests or follow-up results and iv) A positive response to treatment with steroids, nebulizers or antibiotics in hospital. Patients with CHF (n=50) had mean BNP level 1146.72pg/ml (range 103 to 5000pg/ml), which is significantly higher than the group of patients with a final diagnosis of pulmonary disease (n=50) whose BNP was 34pg/ml (range 10 to 90pg/ml) (pcongestive heart failure from lung disease in patients presenting with dyspnea.

  11. 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.

  12. Midregional pro-adrenomedullin and copeptin: exercise kinetics and association with the cardiopulmonary exercise response in comparison to B-type natriuretic peptide.

    Science.gov (United States)

    Zurek, Marzena; Maeder, Micha T; Brutsche, Martin H; Lüthi, Adrian; Twerenbold, Raphael; Freese, Michael; Rickli, Hans; Mueller, Christian

    2014-04-01

    Midregional pro-adrenomedullin (MR-proADM) and C-terminal pro-vasopressin (copeptin) are novel biomarkers providing prognostic information in various settings. We aimed to (1) assess the kinetics of MR-proADM and copeptin during cardiopulmonary exercise testing (CPET); (2) assess the relationship of MR-proADM and copeptin measured at rest with peak oxygen consumption (peak VO2) and other key CPET parameters; (3) compare this relationship to that of B-type natriuretic peptide (BNP). In 162 patients undergoing symptom-limited CPET for evaluation of exercise intolerance, MR-proADM, copeptin, and BNP were measured at rest and peak exercise. There was a significant rise in copeptin and BNP (p exercise. MR-proADM (r = -0.57; p heart rate achieved and peak oxygen pulse and directly related to the peak ventilation/carbon dioxide production relationship, the physiological dead space-to-tidal volume ratio, and the alveolo-arterial oxygen gradient (p ≤ 0.01 for all), and these associations were at least as strong as for BNP. In contrast, copeptin was not significantly related to any of these parameters (p > 0.05 for all). In contrast to BNP and copeptin, MR-proADM is not immediately affected by a maximal exercise test. MR-proADM but not copeptin is at least as good an indicator of low peak VO2 and CPET parameters reflecting an impaired cardiac output reserve, ventilatory efficiency and diffusion capacity as BNP, and thereby a global cardiopulmonary stress marker.

  13. 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.

  14. The relation between electrocardiographic ST-T changes and NT-proBNP in patients with acute ischemic stroke

    DEFF Research Database (Denmark)

    Jensen, Jesper K; Korsholm, Lars; Høilund-Carlsen, Poul Flemming

    2007-01-01

    BACKGROUND: ST-segment depression and T-wave inversion (ST-T changes) in the electrocardiogram (ECG) and raised levels of natriuretic peptide have been observed in acute ischemic stroke patients. It is unknown whether any relation between ST-T changes and raised levels of natriuretic peptides...... in patients with an acute ischemic stroke exists. METHODS: Serial measurements of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) and 12-lead ECGs were obtained in 192 consecutive patients with an acute ischemic stroke without ischemic heart disease, atrial fibrillation, heart- or renal failure......-T changes in the ECG remained associated with increased levels of NT-proBNP (beta=76.5, p=0.011). CONCLUSIONS: ST-T changes suggestive of myocardial ischemia are independently associated with the levels of NT-proBNP in patients with acute ischemic stroke. The clinical importance of this observation remains...

  15. Overweight, hypertension and cardiovascular disease: focus on adipocytokines, insulin, weight changes and natriuretic peptides.

    Science.gov (United States)

    Seven, Ekim

    2015-11-01

    Paper I: In the prevalent model including leptin, CRP, adiponectin, sex, age, lifestyle risk factors, lipids, insulin, haemoglobin A1c, and in the incident model which also included baseline heart rate and blood pressure, only leptin of the three candidate intermediates was significantly associated with both prevalent and incident hypertension. Paper II: Five-year weight changes were associated with blood pressure alterations and had a substantial impact on both fasting and two-hour post-glucose serum insulin levels. However, in multivariable regression analyses, additional adjustments for insulin values only attenuated the associations between weight changes and blood pressure minimally. Paper III: Higher serum concentrations of NT-proBNP associated with prevalent hypertension whereas lower concentrations associated with incident hypertension. Paper IV: Among 6,502 participants with a mean follow-up time of 11.4 years, 527 participants experienced one or multiple cardio-vascular events. Among adiponectin, leptin and CRP, only CRP were significantly positive associated with CVD in all models.   Regarding the pathophysiology of overweight-related hypertension and CVD, our results indicate that:   • Leptin is possibly an independent risk factor for the development of hypertension.   • Albeit weight loss improves insulin-profile, the effect of insulin on blood pressure changes seems minimal, indicating that insulin does not play a major direct role in the early development of hypertension.   • A deficiency of the natriuretic peptides, resulting in reduced vasodilation and natriuresis, could be involved in the pathogenesis of hypertension in its early stages.   • Since adjustment for CRP decreased the BMI-associated CVD risk markedly, our data indirectly suggest that IL-6 originating from fat tissue could play a role in overweight and obesity-related cardiovascular disease.

  16. 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...

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. Natriuretic Peptides as Cardiovascular Safety Biomarkers in Rats: Comparison With Blood Pressure, Heart Rate, and Heart Weight.

    Science.gov (United States)

    Engle, Steven K; Watson, David E

    2016-02-01

    Cardiovascular (CV) toxicity is an important cause of failure during drug development. Blood-based biomarkers can be used to detect CV toxicity during preclinical development and prioritize compounds at lower risk of causing such toxicities. Evidence of myocardial degeneration can be detected by measuring concentrations of biomarkers such as cardiac troponin I and creatine kinase in blood; however, detection of functional changes in the CV system, such as blood pressure, generally requires studies in animals with surgically implanted pressure transducers. This is a significant limitation because sustained changes in blood pressure are often accompanied by changes in heart rate and together can lead to cardiac hypertrophy and myocardial degeneration in animals, and major adverse cardiovascular events (MACE) in humans. Increased concentrations of NPs in blood correlate with higher risk of cardiac mortality, all-cause mortality, and MACE in humans. Their utility as biomarkers of CV function and toxicity in rodents was investigated by exploring the relationships between plasma concentrations of NTproANP and NTproBNP, blood pressure, heart rate, and heart weight in Sprague Dawley rats administered compounds that caused hypotension or hypertension, including nifedipine, fluprostenol, minoxidil, L-NAME, L-thyroxine, or sunitinib for 1-2 weeks. Changes in NTproANP and/or NTproBNP concentrations were inversely correlated with changes in blood pressure. NTproANP and NTproBNP concentrations were inconsistently correlated with relative heart weights. In addition, increased heart rate was associated with increased heart weights. These studies support the use of natriuretic peptides and heart rate to detect changes in blood pressure and cardiac hypertrophy in short-duration rat studies. © The Author 2015. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Predictive Values of N-Terminal Pro-B-Type Natriuretic Peptide and Cardiac Troponin I for Myocardial Fibrosis in Hypertrophic Obstructive Cardiomyopathy.

    Directory of Open Access Journals (Sweden)

    Changlin Zhang

    Full Text Available Both high-sensitivity cardiac troponin T and B-type natriuretic peptide are useful in detecting myocardial fibrosis, as determined by late gadolinium enhancement (LGE cardiovascular magnetic resonance (CMR, in patients with non-obstructive hypertrophic cardiomyopathy. However, their values to predict myocardial fibrosis in hypertrophic obstructive cardiomyopathy (HOCM remain unclear. We investigated the role of N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP and cardiac troponin I (cTnI to identify LGE-CMR in patients with HOCM.Peripheral concentrations of NT-proBNP and cTnI were determined in patients with HOCM (n = 163; age = 47.2 ± 10.8 years; 38.7% females. Contrast-enhanced CMR was performed to identify and quantify myocardial fibrosis.LGE was detected in 120 of 163 patients (73.6%. Patients with LGE had significantly higher levels of NT-proBNP and cTnI than those without LGE (1386.2 [904.6-2340.8] vs. 866.6 [707.2-1875.2] pmol/L, P = 0.003; 0.024 [0.010-0.049] vs. 0.010 [0.005-0.021] ng/ml, P <0.001, respectively. The extent of LGE was positively correlated with log cTnI (r = 0.371, P <0.001 and log NT-proBNP (r = 0.211, P = 0.007. On multivariable analysis, both log cTnI and maximum wall thickness (MWT were independent predictors of the presence of LGE (OR = 3.193, P = 0.033; OR = 1.410, P < 0.001, respectively, whereas log NT-proBNP was not. According to the ROC curve analysis, combined measurements of MWT ≥21 mm and/or cTnI ≥0.025 ng/ml indicated good diagnostic performance for the presence of LGE, with specificity of 95% or sensitivity of 88%.Serum cTnI is an independent predictor useful for identifying myocardial fibrosis, while plasma NT-proBNP is only associated with myocardial fibrosis on univariate analysis. Combined measurements of serum cTnI with MWT further improve its value in detecting myocardial fibrosis in patients with HOCM.

  3. 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.

  4. 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.

  5. The plasma B-type natriuretic peptide levels are low in males with stable ischemic heart disease (IHD compared to those observed in patients with non-IHD: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Kosuke Minai

    Full Text Available OBJECTIVE: Although the plasma B-type natriuretic peptide (BNP level is a marker of heart failure, it is unclear whether BNP per se plays a pivotal role for pathogenic mechanisms underlying the development of ischemic heart disease (IHD. In this study, we retrospectively examined the plasma BNP levels in stable patients with IHD and compared to stable patients with cardiovascular diseases other than IHD. METHODS: The study population was 2088 patients (1698 males and 390 females who were admitted to our hospital due to IHD (n = 1,661 and non-IHD (n = 427 and underwent cardiac catheterization. Measurements of the hemodynamic parameters and blood sampling were performed. RESULTS: The plasma BNP levels were significantly lower in the IHD group than in the non-IHD group (p<0.001. The multiple regression analysis examining the logBNP values showed that age, a male gender, low left ventricular ejection fraction, low body mass index, serum creatinine, atrial fibrillation and IHD per se were significant explanatory variables. When the total study population was divided according to gender, the plasma BNP levels were found to be significantly lower in the IHD group than in the non-IHD group among males (p<0.001, but not females (p = NS. Furthermore, a multiple logistic regression analysis of IHD showed the logBNP value to be a significant explanatory variable in males (regression coefficient: -0.669, p<0.001, but not females (p = NS. CONCLUSIONS: The plasma BNP levels were relatively low in stable patients with IHD compared with those observed in stable patients with non-IHD; this tendency was evident in males. Perhaps, the low reactivity of BNP is causally associated with IHD in males. We hope that this study will serve as a test of future prospective studies.

  6. 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.

  7. 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.

  8. NT-proBNP, C-reactive protein and soluble uPAR in a bi-ethnic male population

    DEFF Research Database (Denmark)

    Kruger, Ruan; Schutte, Rudolph; Huisman, Hugo W

    2013-01-01

    This cross-sectional study aimed to investigate associations between a marker of cardiac strain, the N-terminal prohormone B-type natriuretic peptide (NT-proBNP), and inflammation as reflected by either a conventional or novel inflammatory marker in a bi-ethnic South African cohort.......This cross-sectional study aimed to investigate associations between a marker of cardiac strain, the N-terminal prohormone B-type natriuretic peptide (NT-proBNP), and inflammation as reflected by either a conventional or novel inflammatory marker in a bi-ethnic South African cohort....

  9. Impact of epitope specificity and precursor maturation in pro-B-type natriuretic peptide measurement

    DEFF Research Database (Denmark)

    Goetze, J.P.; Dahlstrom, U.; Alehagen, U.

    2008-01-01

    with different epitope specificities in a cohort of elderly patients presenting with symptoms associated with heart failure (n = 415). RESULTS: Comparison of N-terminal proBNP with proBNP 1-76 measurement in plasma revealed a high correlation on regression analysis (r(2) = 0.91, P ..., the proBNP 1-76 assay measured lower concentrations in the high range than the N-terminal proBNP assay. Correlations between assay measurements in a clinical setting were comparable for all the assays (r(2) approximately 0.57-0.83), and ROC analyses revealed area-under-the-curve values ranging between 0...... the impact of epitope specificity and precursor maturation on plasma measurement of proBNP-derived peptides. METHODS: We compared 2 assays, N-terminal proBNP and proBNP 1-76, in a randomly collected set of human plasma specimens (n = 370). Additionally, we evaluated the clinical performance of 4 assays...

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. NT-proBNP is associated with fibulin-1 in Africans

    DEFF Research Database (Denmark)

    Kruger, R; Schutte, R; Huisman, H W;

    2012-01-01

    The N-terminal prohormone B-type natriuretic peptide (NT-proBNP) is involved in the regulation of volume load and secreted when systemic cardiac overload occurs. Fibulin-1 on the other hand is a component of many extracellular matrix proteins including those present in atherosclerotic lesions, ex...

  16. 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.

  17. 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.

  18. 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.

  19. Association of N-Terminal Pro-B-Type Natriuretic Peptide with Left Ventricular Structure and Function in Chronic Kidney Disease (From the Chronic Renal Insufficiency Cohort [CRIC])

    Science.gov (United States)

    Mishra, Rakesh K.; Li, Yongmei; Ricardo, Ana C.; Yang, Wei; Keane, Martin; Cuevas, Magdalena; Christenson, Robert; DeFilippi, Christopher; Chen, Jing; He, Jiang; Kallem, Radhakrishna R.; Raj, Dominic S.; Schelling, Jeffrey R.; Wright, Jackson; Go, Alan S.; Shlipak, Michael G.

    2017-01-01

    We evaluated the cross-sectional associations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) with cardiac structural and functional abnormalities in a cohort of chronic kidney disease (CKD) patients without clinical heart failure (HF), the Chronic Renal Insufficiency Cohort (n=3,232). Associations of NT-proBNP with echocardiographically determined left ventricular (LV) mass and LV systolic and diastolic function were evaluated by multivariable logistic and linear regression models. Reclassification of participants’ predicted risk of LV hypertrophy (LVH), systolic and diastolic dysfunction was performed using a category-free net reclassification improvement (NRI) index that compared a clinical model with and without NT-proBNP. The median (interquartile range) NT-proBNP was 126.6 pg/ml (55.5–303.7). The highest quartile of NT-proBNP was associated with nearly three-fold odds of LVH (odds ratio (OR) 2.7, 95% confidence interval (CI) 1.8–4.0) and LV systolic dysfunction (2.7, 1.7–4.5) and two-fold odds of diastolic dysfunction (2.0, 1.3–2.9) in the fully adjusted models. When evaluated alone as a screening test, NT-proBNP functioned modestly for the detection of LVH (area under the curve, AUC 0.66) and LV systolic dysfunction (AUC 0.62), and poorly for the detection of diastolic dysfunction (AUC 0.51). However, when added to the clinical model, NT-proBNP significantly reclassified participants’ likelihood of having LVH (NRI 0.14, 95% CI 0.13–0.15; p<0.001) and LV systolic dysfunction (0.28, 0.27–0.30; p<0.001), but not diastolic dysfunction (0.10, 0.10–0.11; p=0.07). In conclusion, in this large CKD cohort without HF, NT-proBNP had strong associations with prevalent LVH and LV systolic dysfunction. PMID:23178053

  20. 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.

  1. Sensitive cardiac troponins and N-terminal pro-B-type natriuretic peptide in stable coronary artery disease: correlation with left ventricular function as assessed by myocardial strain.

    Science.gov (United States)

    Smedsrud, Marit Kristine; Gravning, Jørgen; Omland, Torbjørn; Eek, Christian; Mørkrid, Lars; Skulstad, Helge; Aaberge, Lars; Bendz, Bjørn; Kjekshus, John; Edvardsen, Thor

    2015-06-01

    N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponins (cTns) measured with sensitive assays provide strong prognostic information in patients with stable coronary artery disease. However, the relationship between these biomarkers and myocardial contractile function, as well as infarct size, in this patient group, remains to be defined. The study population consisted of 160 patients referred to a follow-up echocardiography scheduled 1 year after coronary revascularization. Concentrations of NT-proBNP, high-sensitive cTnT (hs-cTnT) and sensitive cTnI assays were assessed. Left ventricular function was measured as global peak systolic longitudinal strain by speckle tracking echocardiography and infarct size was assessed by late-enhancement MRI. NT-proBNP and sensitive cTnI levels were significantly associated with left ventricular function by peak systolic strain (R-values 0.243 and 0.228, p = 0.002 and 0.004) as well as infarct size (R-values 0.343 and 0.366, p = 0.014 and p = 0.008). In contrast, hs-cTnT did not correlate with left ventricular function (R = 0.095, p = 0.231) and only marginally with infarct size (R = 0.237, p = 0.094). NT-proBNP and sensitive cTnI levels correlate with left ventricular function and infarct size in patients with stable coronary artery disease after revascularization. As opposed to hs-cTnT, NT-proBNP and cTnI seem to be indicators of incipient myocardial dysfunction and the extent of myocardial necrosis.

  2. 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.

  3. NT-proBNP and potential vascular calcification in Black and Caucasian African men

    DEFF Research Database (Denmark)

    Kruger, Ruan; Schutte, Rudolph; Huisman, Hugo W;

    2012-01-01

    The N-terminal prohormone B-type natriuretic peptide (NT-proBNP) is a reliable marker of cardiac strain. In hypertensive heart disease, NT-proBNP levels increase and may lose its protective function. Simultaneously, the vasculature is also subject to hemodynamic stress, resulting in vascular matrix...... remodeling and stiffening which contribute to further cardiac alterations. Alkaline phosphatase (ALP) is a marker of osteoblast activity and is involved in vascular calcification. We explored the link between NT-proBNP and ALP in Black and Caucasian African men....

  4. 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 (...

  5. 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

  6. 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 ...

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. Natriuretic hormones in brain function

    Directory of Open Access Journals (Sweden)

    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.

  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. 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...

  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. 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.

  17. 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 ...

  18. 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...

  19. NT-pro-BNP is an independent predictor of mortality in patients with end-stage renal disease

    DEFF Research Database (Denmark)

    Svensson, M.; Gorst-Rasmussen, Anders; Schmidt, Erik Berg;

    2009-01-01

    Aim: Patients with end-stage renal disease (ESRD) have an increased mortality from cardiovascular disease (CVD). N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is an independent predictor of mortality in patients with ischemic heart disease and congestive heart failure. Previous data have...

  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. Midregional-proAtrial Natriuretic Peptide and High Sensitive Troponin T Strongly Predict Adverse Outcome in Patients Undergoing Percutaneous Repair of Mitral Valve Regurgitation.

    Directory of Open Access Journals (Sweden)

    Jochen Wöhrle

    Full Text Available It is not known whether biomarkers of hemodynamic stress, myocardial necrosis, and renal function might predict adverse outcome in patients undergoing percutaneous repair of severe mitral valve insufficiency. Thus, we aimed to assess the predictive value of various established and emerging biomarkers for major adverse cardiovascular events (MACE in these patients.Thirty-four patients with symptomatic severe mitral valve insufficiency with a mean STS-Score for mortality of 12.6% and a mean logistic EuroSCORE of 19.7% undergoing MitraClip therapy were prospectively included in this study. Plasma concentrations of mid regional-proatrial natriuretic peptide (MR-proANP, Cystatin C, high-sensitive C-reactive protein (hsCRP, high-sensitive troponin T (hsTnT, N-terminal B-type natriuretic peptide (NT-proBNP, galectin-3, and soluble ST-2 (interleukin 1 receptor-like 1 were measured directly before procedure. MACE was defined as cardiovascular death and hospitalization for heart failure (HF.During a median follow-up of 211 days (interquartile range 133 to 333 days, 9 patients (26.5% experienced MACE (death: 7 patients, rehospitalization for HF: 2 patients. Thirty day MACE-rate was 5.9% (death: 2 patients, no rehospitalization for HF. Baseline concentrations of hsTnT (Median 92.6 vs 25.2 ng/L, NT-proBNP (Median 11251 vs 1974 pg/mL and MR-proANP (Median 755.6 vs 318.3 pmol/L, all p<0.001 were clearly higher in those experiencing an event vs event-free patients, while other clinical variables including STS-Score and logistic EuroSCORE did not differ significantly. In Kaplan-Meier analyses, NT-proBNP and in particular hsTnT and MR-proANP above the median discriminated between those experiencing an event vs event-free patients. This was further corroborated by C-statistics where areas under the ROC curve for prediction of MACE using the respective median values were 0.960 for MR-proANP, 0.907 for NT-proBNP, and 0.822 for hsTnT.MR-proANP and hsTnT strongly

  2. 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...

  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. 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.

  5. 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...

  6. 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

  7. Multiplex detection of B-type natriuretic peptide, cardiac troponin I and C-reactive protein with photonic suspension array.

    Directory of Open Access Journals (Sweden)

    Wenbin Lu

    Full Text Available A novel photonic suspension array has been developed for multiplex immunoassay. The carriers of this array were silica colloidal crystal beads (SCCBs. The codes of these carriers have characteristic reflection peaks originating from their structural periodicity; therefore they do not suffer from fading, bleaching, quenching or chemical instability. In addition, the fluorescence background of SCCBs is negligible because no fluorescence materials or dyes are involved. With a sandwich method, the proposed suspension array was used for simultaneous multiplex detection of heart failure (HF and coronary heart disease (CAD biomarkers in one test tube. The results showed that the three biomarkers: cardiac troponin I (cTnI, C-reactive protein (CRP and B-type natriuretic peptide (BNP could be assayed in the ranges of 0.1-500 ng/ml, 1-500 mg/L and 0.02-50 ng/ml with detection limits of 0.01 ng/ml, 0.36 mg/L and 0.004 ng/ml at 3σ, respectively. There were no significant differences between the photonic suspension array and traditional parallel single-analyte test. This novel method demonstrated acceptable accuracy, high detection sensitivity and reproducibility and excellent storage stability. This technique provides a new strategy for low cost, automated, and simultaneous multiplex immunoassays of bio-markers.

  8. The relationship of NT-proBNP and dialysis parameters with outcome of incident haemodialysis patients: results from the membrane permeability outcome study.

    Science.gov (United States)

    Locatelli, Francesco; Hannedouche, Thierry; Martin-Malo, Alejandro; Jacobson, Stefan H; Vanholder, Raymond; Ronco, Claudio; La Milia, Vincenzo; Lopez Gomez, Juan M; Stefoni, Sergio; Maheut, Hervé; Klinger, Marian; Krummel, Thierry; Dhondt, Annemie; Berdud, Isabel; Gauly, Adelheid

    2013-01-01

    The association of raised levels of natriuretic peptides with elevated risk of mortality was investigated in the present analysis of the Membrane Permeability Outcome study. N-terminal probrain type natriuretic peptide (NT-proBNP) was measured in 618 incident haemodialysis patients, randomised to either high-flux or low-flux. Characteristics of patients with NT-proBNP levels below or above the median were descriptively analysed and survival analysis was performed. Median NT-proBNP value was 2,124 pg/ml, with 1,854 pg/ml in the high-flux and 2,919 pg/ml in the low-flux group. Survival probability was lowest in patients with both a history of cardiovascular disease and NT-proBNP values above the median (p dialysis suggest a possible biological link to improved survival in this group. Copyright © 2013 S. Karger AG, Basel.

  9. Evaluation of exercise capacity with cardiopulmonary exercise testing and type B natriuretic peptide concentrations in adult patients with patent atrial septal defect.

    Science.gov (United States)

    Trojnarska, Olga; Szyszka, Andrzej; Gwizdala, Adrian; Oko-Sarnowska, Zofia; Katarzynski, Slawomir; Siniawski, Andrzej; Chmara, Ewa; Cieslinski, Andrzej

    2006-01-01

    Adults with patent atrial septal defect (ASD) usually find their exercise capacity satisfactory, and therefore hesitate to accept proposed surgical treatment of the heart disease. The aim of our study was to evaluate both the exercise capacity, using the cardio-pulmonary stress test, and brain natriuretic peptide (BNP) levels in asymptomatic adults with ASD. Thirty-six patients with patent secundum type ASD (aged mean 44.7 +/- 8.2 years) were studied. The control group consisted of 25 healthy subjects at the mean age of 45.6 +/- 6.1 years. Echocardiography and CPST were performed and BNP levels measured in all subjects. Oxygen uptake (VO2 max) was lower in ASD patients than in controls (22.1 +/- 5.6 vs. 30.0 +/- 6.8 ml/kg/min, p = 0.00001); the VE/VO2 slope was elevated in ASD patients compared with healthy subjects (31.3 +/- 6.6 vs. 26.9 +/- 3.3, p = 0.001), and exceeded 34 in 5 patients. VO2 max showed a negative correlation with the pulmonary to systemic flow ratio Qp:Qs (r = -0.46, p = 0.004), and a positive correlation was found between the VE/VO2 slope and Qp:Qs (r = 0.32, p = 0.05). BNP levels were higher in the ASD group than in the controls (60.6 +/- 49.9 vs. 32.6 +/- 24.5 pg/ml, p = 0.02). BNP correlated positively with RV diameter and Qp:Qs (r = 0.38 and 0.39 respectively, p = 0.03) and negatively with maximum VO2 (r = -0.5, p = 0.004) and VO2% (r = -0.32, p = 0.07). Although most adult patients with ASD perceive their exercise capacity as satisfactory, objective assessment reveals that in fact it is significantly decreased. BNP levels are increased comparing to healthy individuals. Decreased exercise capacity and increased BNP levels seem to result from right ventricular volume overload. Copyright 2006 S. Karger AG, Basel.

  10. 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

  11. Relation of N-Terminal Pro-B-Type Natriuretic Peptide and Left Ventricular Diastolic Function to Exercise Tolerance in Patients With Significant Valvular Heart Disease and Normal Left Ventricular Systolic Function.

    Science.gov (United States)

    Hwang, Ji-Won; Park, Sung-Ji; Cho, Eun Jeong; Kim, Eun Kyoung; Lee, Ga Yeon; Chang, Sung-A; Choi, Jin-Oh; Lee, Sang-Chol; Park, Seung Woo

    2017-03-16

    An association between N-terminal prohormone brain natriuretic peptide (NT-proBNP) and exercise tolerance in patients with valvular heart disease (VHD) has been suggested; however, there are few data available regarding this relation. The aim of this study is to evaluate the correlation between exercise tolerance and NT-proBNP in patients with asymptomatic or mildly symptomatic significant VHD and normal left ventricular ejection fraction (LV EF). A total of 96 patients with asymptomatic or mildly symptomatic VHD and normal LV EF (≥50%) underwent cardiopulmonary exercise echocardiography. NT-proBNP levels were determined at baseline and after exercise in 3 hours. Patients were divided in 2 groups based on lower (<26 ml/kg/min, n = 47) or higher (≥26 ml/kg/min, n = 49) peak oxygen consumption (VO2) as a representation of exercise tolerance. In the 2 groups, after adjusting for age and gender, the NT-proBNP level after exercise in 3 hours, left atrial volume index before exercise, right ventricular systolic pressure before exercise, E velocity after exercise, and E/e' ratio after exercise varied significantly. In addition, peak VO2 was inversely related to NT-proBNP before (r = -0.352, p <0.001) and after exercise (r = -0.351, p <0.001). The NT-proBNP level before exercise was directly related to the left atrial volume index, E/e' ratio, and right ventricular systolic pressure before and after exercise. NT-proBNP after exercise was also directly related to the same parameters. NT-proBNP levels both before and after exercise were higher in the group with lower exercise tolerance. In conclusion, through the correlation among exercise tolerance, NT-proBNP, and parameters of diastolic dysfunction, we demonstrated that diastolic dysfunction and NT-proBNP could predict exercise tolerance in patients with significant VHD and normal LV EF.

  12. The value of the B-type natriuretic peptide in patients with acute renal failure during CRRT%脑钠肽在急性肾功能衰竭患者CRRT治疗中的变化

    Institute of Scientific and Technical Information of China (English)

    冯梅; 付平; 周莉; 黄燕; 陈大伟; 刘小箐; 秦伟

    2011-01-01

    目的 探讨血清B型脑钠肽(B-type natriuretic peptide,BNP)和净脱水量在急性肾衰竭患者持续性肾脏替代治疗(continous renal replacement therapy,CRRT)中的变化.方法 选择5例于四川大学华西医院行CRRT治疗超过24h的少尿型急性肾衰竭患者,采用ELISA方法测定0、4、8、12和24h的血清及超滤液BNP水平,运用Person分析对血清BNP降低值和净脱水量进行相关性分析.结果 血清BNP呈时间依赖性下降(P0.05).结论 少尿型急性肾衰竭患者进行CRRT治疗后的容量负荷有所减轻,血清BNP显著下降;血清BNP的下降与净脱水量成正相关;BNP可从滤液中滤出,但浓度极低.%Obstructive The purpose of the study is to investigate the relationship between the serum B-type natriuretie peptide (BNP) level and the net amount of dehydration in patients with acute renal failure who were undergoing CRRT.Methods 5 patients with oliguric acute renal failure were included in the study.All patients were undergoing CRRT longer than 24 hours.The serum BNP and ultrafiltration fluid in patients at the time of 0, 4, 8, 12 and 24h during the CRRT were measured with ELISA.The correlation between the decreased level of serum BNP and ultrafiltration volumes was analyzed with Person's linear correlation analysis.Results The serum BNP level was decreased gradually during the CRRT.The level of serum BNP at 24h significantly decreased compared with that at 0h(P<0.05).The decreased level of serum BNP was dramatically correlated to the ultrafiltration volume (r=0.698, P< 0.01).Conclusion After CRRT, the volume load of patients with oliguric acute renal failure decreased to a certain extent and the level of serum BNP were decreased dramatically.The decreased level of serum BNP had the positive correlation with the increased ultrafiltration volume.

  13. Changes in Serum NT-Pro BNP and Left Atrial BNP Levels after Percutaneous Transvenous Mitral Commissurotomy in Sinus Rhythm Versus Atrial Firilation

    Directory of Open Access Journals (Sweden)

    Leili Pourafkari

    2014-10-01

    Full Text Available Introduction: Natriuretic peptides are secreted from the heart in response to increased wall stress. Their levels are expected to be increased in patients with mitral stenosis (MS due tohigh left atrium (LA pressure and pulmonary artery pressure (PAP. Percutaneous transvenousmitral commissurotomy (PTMC if successful is pursued by a rapid decrease in LA pressure andsubsequent decrease in pulmonary artery pressure. The concurrent changes in natriuretic peptidelevels could be affected with heart rhythm.Methods: Forty five patients with severe rheumatic MS undergoing PTMC were enrolled. Weevaluated the serum NT-Pro BNP levels before and 24 hours after PTMC. BNP levels were alsomeasured from the blood samples obtained from LA before and 20 minutes after the procedure.Changes in biomarkers were assessed based on heart rhythm and success of the procedure.Results: While serum NT-Pro BNP levels showed significant decrease 24 hours after theprocedure (P= 0.04, BNP levels taken 20 minutes after PTMC from LA were similar to theirbaseline concentrations (P= 0.26. NT-Pro BNP levels decreased 51.7±182.86 pg/ml for SR and123.4±520 pg/ml for AF (P= 0.68.Conclusion: Immediate changes in BNP levels did not predict the success of procedure probablydue to the additional balloon inflation attempts in LA in several patients and half-life of BNP. BNPlevels obtained later may be of more value considering the half-life of this marker. Heart rhythmwas not found to influence the changes in biomarker levels. BNP and NT-pro BNP changes werenot found to predict success of the procedure.

  14. 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.

  15. Bradykinin-potentiating peptides and C-type natriuretic peptides from snake venom.

    Science.gov (United States)

    Higuchi, S; Murayama, N; Saguchi, K; Ohi, H; Fujita, Y; Camargo, A C; Ogawa, T; Deshimaru, M; Ohno, M

    1999-10-15

    Cloning of cDNAs encoding bradykinin-potentiating peptides (BPPs)-C-type natriuretic peptide (CNP) precursor or its homologue was performed for cDNA libraries of Bothrops jararaca (South American snake), Trimeresurus flavoviridis, Trimeresurus gramineus and Agkistrodon halys blomhoffi (Asian snakes), all belonging to Crotalinae subfamily. Each cDNA library was constructed from the venom glands of a single snake to preclude ambiguity by intraspecies variation in venom components. Thirteen positive clones derived from B. jararaca were divided into two types depending on restriction sites. Differences in the nucleotide sequence arise at three locations and two of them accompanied amino acid conversions. Despite the differences, both types of cDNA clones encode the BPP-CNP precursor of 256 amino acid residues. Sequence analysis demonstrated that cDNA clones from three Asian snakes encode homologues of the BPP-CNP precursor from B. jararaca. In a precursor polypeptide, a signal sequence (approximately 25 aa) at the N-terminus is followed by sequences of BPP or the analogue (5-13 aa) with flanking spacer sequences (indefinite number of aa), an intervening linker sequence (approximately 144 aa) with unidentified function, and a CNP sequence (22 aa) with a preceding processing signal sequence (10 aa). cDNA clones from A. halys blomhoffi encode two distinct peptides in place of BPP, and T. flavoviridis and T. gramineus were shown to have considerably different sequences in the BPP domain from those known as BPP sequences. The present results provide evidence for a wide distribution of the orthologous gene expressing a series of bioactive peptides among Crotalinae subfamily.

  16. Investigation of the relationship between the fragmented QRS and N-terminal pro-B-type natri-uretic peptide%碎裂QRS波与N末端B型利钠肽原相关性的探讨

    Institute of Scientific and Technical Information of China (English)

    曹木根; 章文杰; 林平; 郑炜平

    2015-01-01

    Objective To investigate the relationship between the fragmented QRS complex (fQRS)and N-terminalpro-B-type natriuretic peptide (NT-proBNP).Methods One hundred and two patients with fQRS were selected,and ninety eight patients with no fQRS and no ventricular block were selected as the control group,to compare the difference in NT-proBNP level between the two groups.Based on the occurrence of fQRS lead,the observation group was divided into three subgroups:1)limb lead,2)chest lead,and 3)chest lead and limb lead.By comparing the differ-ences in NT-proBNP level among the subgroups,Spearman correlation analysis was conducted. Results NT-proBNP levels were significantly higher in the fQRS group,compared to the control group (P patients with fQRS are higher than those normal person and the distribution range of fQRS lead and NT-proBNP level are positively correlated.It has certain clinical value for the diagnosis and progno-sis of patients with chronic heart failure.%目的:探讨碎裂 QRS 波(fragmented QRS,fQRS)与血浆 N 末端 B 型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)之间的关系。方法选取体表心电图有fQRS 患者共102例,同时选取同期无 fQRS、无室内阻滞患者98例作为对照组,比较两组患者NT-proBNP 的差异。根据出现 fQRS 导联将观察组分为肢体导联组、胸导联组和肢体导联+胸导联组三个亚组,比较各个亚组之间的 NT-proBNP 水平差异,并对三个亚组之间的 NT-proBNP 水平进行 Spearman 相关性分析。结果与对照组相比,fQRS 组 NT-proBNP 水平增高(P <0.01);与肢导联组相比,胸导联组、肢导联+胸导联组 NT-proBNP 水平均增高(P <0.01);与胸导联组相比,肢导联+胸导联组 NT-proBNP 水平进一步增高(P <0.01);三组之间的 NT-proBNP 值存在正相关。结论fQRS 患者的 NT-proBNP 水平高于正常人,且 fQRS 导联分布范围和 NT-pro

  17. 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...

  18. 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。

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. Prognostic potential of midregional pro-adrenomedullin following decompensation for systolic heart failure: comparison with cardiac natriuretic peptides.

    Science.gov (United States)

    Morbach, Caroline; Marx, Almuth; Kaspar, Mathias; Güder, Gülmisal; Brenner, Susanne; Feldmann, Carolin; Störk, Stefan; Vollert, Jörn O; Ertl, Georg; Angermann, Christiane E

    2017-05-17

    Whereas guidelines recommend the routine use of natriuretic peptides (NPs) in heart failure (HF) care, the clinical relevance and prognostic potential of midregional pro-adrenomedullin (MR-proADM) is less well established. We aimed to compare the prognostic potential of MR-proADM after acute decompensation for systolic HF with that of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and midregional pro-atrial NP (MR-proANP), to investigate the significance of high/rising MR-proADM, and to evaluate the incremental prognostic yield of repeat measurements. The Interdisciplinary Network Heart Failure (INH) programme enrolled patients hospitalized for acute systolic HF and followed them for 18 months (100% complete). Of 1022 INH participants, 917 (68 ± 12 years, 28% female) who had biomaterials available were enrolled. High MR-proADM was associated with more impaired left ventricular function, higher comorbidity burden, lower doses of HF medications, and lower likelihood of left ventricular reverse remodelling. Compared with NPs, MR-proADM had superior prognostic significance (concordance index 0.72 for all-cause mortality), improved Cox regression models including NPs (P < 0.001), and was the only biomarker also predicting non-cardiac death (hazard ratio 1.8 vs. 1.0). In the setting of low NPs, patients with high MR-proADM experienced non-cardiac death more often. Six month MR-proADM enhanced models including baseline MR-proADM (P < 0.001) for prediction of all-cause death (net reclassification index: 0.48, 95% confidence interval 0.19-0.78). MR-proADM was found to correlate with the global disease burden in HF and proved a potent prognostic indicator, capturing the risk for both cardiac and non-cardiac death. Serial MR-proADM measurements further enhanced risk assessment, thus facilitating substantial reclassification. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  4. 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...

  5. 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....

  6. 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.

  7. 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.

  8. 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....

  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. Different impact of aortic regurgitation assessed by aortic root angiography after transcatheter aortic valve implantation according to baseline left ventricular ejection fraction and N-terminal pro-B-type natriuretic peptide.

    Science.gov (United States)

    Kaneko, Hidehiro; Hoelschermann, Frank; Schau, Thomas; Tambor, Grit; Neuss, Michael; Butter, Christian

    2017-05-31

    Transcatheter aortic valve implantation (TAVI) is an alternative therapeutic option for severe aortic stenosis. Aortic regurgitation (AR) is commonly observed after TAVI and increases the mortality rate. We hypothesized that the influence of significant AR, defined as that more severe than mild AR, on survival rate after TAVI might differ according to the baseline left ventricular ejection fraction (LVEF) and N-terminal pro-B-type natriuretic peptide (NT-pro BNP) level. We categorized 856 patients who underwent transfemoral TAVI into 2 groups according to their baseline LVEF (pro BNP levels (≤5000 and >5000 pg/mL). Significant AR was observed in 92 patients (11%). Among patients with significant AR, the proportion of patients with CoreValve/EvolutR implantation was higher than that of patients with SAPIEN XT/3 implantation. Kaplan-Meier curves and the log-rank test showed that significant AR was not associated with 1-year mortality in patients with LVEF ≥40% and those with NT-pro BNP level ≤5000 pg/mL. On the other hand, it was significantly associated with a higher 1-year mortality in patients with LVEF pro BNP level >5000 pg/mL (p = 0.011). Similarly, multivariate Cox regression analysis showed that the presence of AR was significantly associated with a higher 1-year mortality in patients with LVEF pro BNP level >5000 pg/mL (p = 0.004, HR = 3.221). However, AR was not significantly associated with a higher 1-year mortality in patients with LVEF ≥40% and NT-pro BNP level ≤5000 pg/mL. Thus, the impact of significant AR on mortality after TAVI seems to be considerable in patients with reduced LVEF or high NT-pro BNP levels, but not those with preserved LVEF or low NT-pro BNP levels, suggesting that the influence of AR differs depending on the baseline LVEF and NT-pro BNP level.

  12. 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...

  13. 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.

  14. 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...

  15. N-Terminal Pro-B-Type Natriuretic Peptide Plasma Levels as a Potential Biomarker for Cardiac Damage After Radiotherapy in Patients With Left-Sided Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    D' Errico, Maria P., E-mail: patderrico@libero.it [Department of Laboratory Medicine, ' A. Perrino' Hospital, Brindisi (Italy); Grimaldi, Luca [Department of Medical Physics, ' A. Perrino' Hospital, Brindisi (Italy); Petruzzelli, Maria F. [Department of Radiation Oncology, ' A. Perrino' Hospital, Brindisi (Italy); Gianicolo, Emilio A.L. [Clinical Physiology Institute, National Research Council (IFC-CNR), Pisa-Lecce (Italy); Tramacere, Francesco [Department of Radiation Oncology, ' A. Perrino' Hospital, Brindisi (Italy); Monetti, Antonio; Placella, Roberto [Department of Laboratory Medicine, ' A. Perrino' Hospital, Brindisi (Italy); Pili, Giorgio [Department of Medical Physics, ' A. Perrino' Hospital, Brindisi (Italy); Andreassi, Maria Grazia; Sicari, Rosa; Picano, Eugenio [Clinical Physiology Institute, National Research Council (IFC-CNR), Pisa-Lecce (Italy); Portaluri, Maurizio [Department of Radiation Oncology, ' A. Perrino' Hospital, Brindisi (Italy); Clinical Physiology Institute, National Research Council (IFC-CNR), Pisa-Lecce (Italy)

    2012-02-01

    Purpose: Adjuvant radiotherapy (RT) after breast-conserving surgery has been associated with increased cardiovascular mortality. Cardiac biomarkers may aid in identifying patients with radiation-mediated cardiac dysfunction. We evaluated the correlation between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and troponin (TnI) and the dose of radiation to the heart in patients with left-sided breast cancer. Methods and Materials: NT-proBNP and TnI plasma concentrations were measured in 30 left-sided breast cancer patients (median age, 55.0 years) 5 to 22 months after RT (Group I) and in 30 left-sided breast cancer patients (median age, 57.0 years) before RT as control group (Group II). Dosimetric and geometric parameters of heart and left ventricle were determined in all patients of Group I. Seventeen patients underwent complete two-dimensional echocardiography. Results: NT-proBNP levels were significantly higher (p = 0.03) in Group I (median, 90.0 pg/ml; range, 16.7-333.1 pg/ml) than in Group II (median, 63.2 pg/ml; range, 11.0-172.5 pg/ml). TnI levels remained below the cutoff threshold of 0.07 ng/ml in both groups. In patients with NT-proBNP values above the upper limit of 125 pg/ml, there were significant correlations between plasma levels and V{sub 3Gy}(%) (p = 0.001), the ratios D{sub 15cm{sup 3}}(Gy)/D{sub mean}(Gy) (p = 0.01), the ratios D{sub 15cm}{sup 3}/D{sub 50%} (Gy) (p = 0.008) for the heart and correlations between plasma levels and V{sub 2Gy} (%) (p = 0.002), the ratios D{sub 1cm{sup 3}}(Gy)/D{sub mean}(Gy) (p = 0.03), and the ratios D{sub 0.5cm{sup 3}}(Gy)/D{sub 50%}(Gy) (p = 0.05) for the ventricle. Conclusions: Patients with left-sided breast cancer show higher values of NT-pro BNP after RT when compared with non-RT-treated matched patients, increasing in correlation with high doses in small volumes of heart and ventricle. The findings of this study show that the most important parameters are not the mean doses but instead the small

  16. 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

  17. Extracellular matrix biomarker, fibulin-1, is closely related to NT-proBNP and soluble urokinase plasminogen activator receptor in patients with aortic valve stenosis (the SEAS study)

    DEFF Research Database (Denmark)

    Kruger, Ruan; Rasmussen, Lars M; Argraves, William S;

    2014-01-01

    BACKGROUND: Fibulin-1, a circulating extracellular matrix glycoprotein, has been associated with arterial disease and elevated N-terminal prohormone B-type natriuretic peptide (NT-proBNP) in diabetes. Soluble urokinase plasminogen activator receptor (suPAR), a marker of inflammation, has been ass...

  18. B型利钠肽和氮端B型利钠肽原在早产儿动脉导管未闭诊治的研究进展%The use of B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide concentrations to guide diagnosis and treatment of patent ductus arteriosus in preterm infants

    Institute of Scientific and Technical Information of China (English)

    刘颖; 周于新

    2016-01-01

    早产儿动脉导管未闭(PDA)发病率高,可引发很多并发症,但其诊治和预后判断标准仍存在争议.近期报道B型利钠肽和氮端B型利钠肽原用于早产儿血流动力学显著PDA(hsPDA)的诊断,且有助于其治疗策略的选择和对药物治疗反应的判断,但研究方法和临界值等尚未统一,笔者将国内外B型利钠肽和氮端B型利钠肽原在早产儿动脉导管未闭诊治的研究进展作一综述,为儿科临床及基础研究提供依据.%The high morbidity and compliments of patent ductus arteriosus (PDA) in preterm infants are reported,but the diagnostic and prognostic appraisal of PDA is still debatable.The B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are found efficient in diagnosis of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants,and also helpful in therapy decisions and prediction of treatment response.However,the type of assay and cut-off values have not yet reached a consent,so that further researches are needed.

  19. 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

  20. Design and methodology of the NorthStar Study: NT-proBNP stratified follow-up in outpatient heart failure clinics -- a randomized Danish multicenter study

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Videbaek, Lars;

    2008-01-01

    BACKGROUND: Randomized clinical trials have shown that newly discharged and symptomatic patients with chronic heart failure (CHF) benefit from follow-up in a specialized heart failure clinic (HFC). Clinical stable and educated patients are usually discharged from the HFC when on optimal therapy....... It is unknown if risk stratification using natriuretic peptides could identify patients who would benefit from longer-term follow-up. Furthermore, data on the use of natriuretic peptides for monitoring of stable patients with CHF are sparse. AIMS: The aims of this study are to test the hypothesis that clinical...... stable, educated, and medical optimized patients with CHF with N-terminal pro-brain natriuretic peptide (NT-proBNP) levels > or = 1,000 pg/mL benefit from long-term follow-up in an HFC and to assess the efficacy of NT-proBNP monitoring. METHODS: A total of 1,250 clinically stable, medically optimized...

  1. ANP and BNP responses to dehydration in the one-humped camel and effects of blocking the renin-angiotensin system.

    Science.gov (United States)

    Adem, Abdu; Al Haj, Mahmoud; Benedict, Sheela; Yasin, Javed; Nagelkerke, Nicolas; Nyberg, Fred; Yandle, Tim G; Frampton, Chris M; Lewis, Lynley K; Nicholls, M Gary; Kazzam, Elsadig

    2013-01-01

    The objectives of this study were to investigate and compare the responses of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in the circulation of hydrated, dehydrated, and dehydrated losartan - treated camels; and to document the cardiac storage form of B-type natriuretic peptide in the camel heart. Eighteen male camels were used in the study: control or hydrated camels (n = 6), dehydrated camels (n = 6) and dehydrated losartan-treated camels (n = 6) which were dehydrated and received the angiotensin II (Ang II) AT-1 receptor blocker, losartan, at a dose of 5 mg/kg body weight intravenously for 20 days. Control animals were supplied with feed and water ad-libitum while both dehydrated and dehydrated-losartan treated groups were supplied with feed ad-libitum but no water for 20 days. Compared with time-matched controls, dehydrated camels exhibited a significant decrease in plasma levels of both ANP and BNP. Losartan-treated camels also exhibited a significant decline in ANP and BNP levels across 20 days of dehydration but the changes were not different from those seen with dehydration alone. Size exclusion high performance liquid chromatography of extracts of camel heart indicated that proB-type natriuretic peptide is the storage form of the peptide. We conclude first, that dehydration in the camel induces vigorous decrements in circulating levels of ANP and BNP; second, blockade of the renin-angiotensin system has little or no modulatory effect on the ANP and BNP responses to dehydration; third, proB-type natriuretic peptide is the storage form of this hormone in the heart of the one-humped camel.

  2. ANP and BNP responses to dehydration in the one-humped camel and effects of blocking the renin-angiotensin system.

    Directory of Open Access Journals (Sweden)

    Abdu Adem

    Full Text Available The objectives of this study were to investigate and compare the responses of atrial natriuretic peptide (ANP and B-type natriuretic peptide (BNP in the circulation of hydrated, dehydrated, and dehydrated losartan - treated camels; and to document the cardiac storage form of B-type natriuretic peptide in the camel heart. Eighteen male camels were used in the study: control or hydrated camels (n = 6, dehydrated camels (n = 6 and dehydrated losartan-treated camels (n = 6 which were dehydrated and received the angiotensin II (Ang II AT-1 receptor blocker, losartan, at a dose of 5 mg/kg body weight intravenously for 20 days. Control animals were supplied with feed and water ad-libitum while both dehydrated and dehydrated-losartan treated groups were supplied with feed ad-libitum but no water for 20 days. Compared with time-matched controls, dehydrated camels exhibited a significant decrease in plasma levels of both ANP and BNP. Losartan-treated camels also exhibited a significant decline in ANP and BNP levels across 20 days of dehydration but the changes were not different from those seen with dehydration alone. Size exclusion high performance liquid chromatography of extracts of camel heart indicated that proB-type natriuretic peptide is the storage form of the peptide. We conclude first, that dehydration in the camel induces vigorous decrements in circulating levels of ANP and BNP; second, blockade of the renin-angiotensin system has little or no modulatory effect on the ANP and BNP responses to dehydration; third, proB-type natriuretic peptide is the storage form of this hormone in the heart of the one-humped camel.

  3. Clinical value of natriuretic peptides in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Carla Santos-Araújo

    2015-05-01

    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.

  4. 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

  5. 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

  6. 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....

  7. Clinical characteristics of asymptomatic left ventricular diastolic dysfunction and its association with self‐rated health and N‐terminal B‐type natriuretic peptide: a cross‐sectional study

    Science.gov (United States)

    Bennet, Louise; Larsson, Charlotte A.; Andersson, Susanne; Månsson, Jörgen; Lindblad, Ulf

    2016-01-01

    Abstract Aims Left ventricular hypertrophy, obesity, hypertension, and N‐terminal B‐type natriuretic peptide (Nt‐proBNP) predict left ventricular diastolic dysfunction with preserved systolic function (DD‐PSF). Self‐rated health (SRH) is shown to be associated with chronic diseases, but the association of SRH with DD‐PSF is unclear. In light of the clinical implications of DD‐PSF, the following goals are of considerable importance: (1) to determine the role of SRH in patients with DD‐PSF in the general population and (2) to study the association between Nt‐proBNP and DD‐PSF. Methods and results The current study is a cross‐sectional study conducted on a random sampling of a rural population. Individuals 30–75 years of age were consecutively subjected to conventional echocardiography and tissue velocity imaging. Data were collected on 500 (48%) men and 538 (52%) women (n = 1038). DD‐PSF was the main outcome, and SRH and Nt‐proBNP were the primary indicators. Diabetes mellitus, hypertension, and obesity were accounted for as major confounders of the association with SRH. DD‐PSF was identified in 137 individuals, namely, 79 men (15.8%) and 58 women (10.8%). In a multivariate regression model, SRH (OR 2.95; 95% CI 1.02–8.57) and Nt‐proBNP (quartile 4 vs. quartile 1 OR 4.23; 95% CI 1.74–10.26) were both independently associated with DD‐PSF. Conclusions SRH, evaluated based on a descriptive question on general health, should be included in the diagnostic process of DD‐PSF. In agreement with previous studies, our study confirms that Nt‐proBNP is a major indicator of DD‐PSF.

  8. B-type natriuretic peptide as predictor of heart failure in patients with acute ST elevation myocardial infarction, single-vessel disease, and complete revascularization: follow-up study.

    LENUS (Irish Health Repository)

    Manola, Sime

    2012-01-31

    AIM: To assess the concentration of B-type natriuretic peptide (BNP) as a predictor of heart failure in patients with acute ST elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) with successful and complete revascularization. METHODS: Out of a total of 220 patients with acute STEMI admitted to the Sisters of Mercy University Hospital in the period January 1 to December 31, 2007, only patients with acute STEMI undergoing primary PCI who had single vessel disease and were successfully revascularized were included in the study. Selected patients had no history of myocardial infarction or heart failure and a normal or near-normal left ventricular ejection fraction (> or =50%) assessed by left ventriculography at admission. Only 58 patients met the inclusion criteria for the study. Out of those, 6 patients refused to participate in the study, and another 5 could not be followed up, so a total of 47 patients were evaluated. Blood samples were taken for measurement of BNP levels at admission, 24 hours later, and 7 days later. Patients were followed up for 1 year. The primary outcome was reduction in left ventricular ejection fraction (LVEF) to <50% after 1 year. RESULTS: Patients who developed echocardiographic signs of reduced systolic function defined as LVEF<50% had significantly higher values of BNP (> or =80 pg\\/mL) at 24 hours (P=0.001) and 7 days (P=0.020) after STEMI and successful reperfusion. Patients who had BNP levels > or =80 pg\\/mL after 7 days were 21 times more likely to develop LVEF<50 (odds ratio, 20.8; 95% confidence interval, 2.2-195.2; P=0.008). CONCLUSION: BNP can be used as a predictor of reduced systolic function in patients with STEMI who underwent successful reperfusion and had normal ejection fraction at admission.

  9. 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.

  10. 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.

  11. Effectiveness and cost-effectiveness of serum B-type natriuretic peptide testing and monitoring in patients with heart failure in primary and secondary care: an evidence synthesis, cohort study and cost-effectiveness model.

    Science.gov (United States)

    Pufulete, Maria; Maishman, Rachel; Dabner, Lucy; Mohiuddin, Syed; Hollingworth, William; Rogers, Chris A; Higgins, Julian; Dayer, Mark; Macleod, John; Purdy, Sarah; McDonagh, Theresa; Nightingale, Angus; Williams, Rachael; Reeves, Barnaby C

    2017-08-01

    Heart failure (HF) affects around 500,000 people in the UK. HF medications are frequently underprescribed and B-type natriuretic peptide (BNP)-guided therapy may help to optimise treatment. To evaluate the clinical effectiveness and cost-effectiveness of BNP-guided therapy compared with symptom-guided therapy in HF patients. Systematic review, cohort study and cost-effectiveness model. A literature review and usual care in the NHS. (a) HF patients in randomised controlled trials (RCTs) of BNP-guided therapy; and (b) patients having usual care for HF in the NHS. Systematic review: BNP-guided therapy or symptom-guided therapy in primary or secondary care. Cohort study: BNP monitored (≥ 6 months' follow-up and three or more BNP tests and two or more tests per year), BNP tested (≥ 1 tests but not BNP monitored) or never tested. Cost-effectiveness model: BNP-guided therapy in specialist clinics. Mortality, hospital admission (all cause and HF related) and adverse events; and quality-adjusted life-years (QALYs) for the cost-effectiveness model. Systematic review: Individual participant or aggregate data from eligible RCTs. Cohort study: The Clinical Practice Research Datalink, Hospital Episode Statistics and National Heart Failure Audit (NHFA). A systematic literature search (five databases, trial registries, grey literature and reference lists of publications) for published and unpublished RCTs. Five RCTs contributed individual participant data (IPD) and eight RCTs contributed aggregate data (1536 participants were randomised to BNP-guided therapy and 1538 participants were randomised to symptom-guided therapy). For all-cause mortality, the hazard ratio (HR) for BNP-guided therapy was 0.87 [95% confidence interval (CI) 0.73 to 1.04]. Patients who were aged cost-effectiveness model, in patients aged costs (£64,777 vs. £58,139). BNP-guided therapy is cost-effective at a threshold of £20,000 per QALY. The limitations of the trial were a lack of IPD for most RCTs

  12. Significance of NT-pro-BNP in acute exacerbation of COPD patients without underlying left ventricular dysfunction.

    Science.gov (United States)

    Adrish, Muhammad; Nannaka, Varalaxmi Bhavani; Cano, Edison J; Bajantri, Bharat; Diaz-Fuentes, Gilda

    2017-01-01

    B-type natriuretic peptide (BNP) and the N-terminal fragment of pro-BNP (NT-pro-BNP) are established biomarkers of heart failure. Increased levels of natriuretic peptide (NP) have been associated with poor outcomes in acute exacerbation of COPD (AECOPD); however, most studies did not address the conditions that can also increase NT-pro-BNP levels. We aimed to determine if NT-pro-BNP levels correlate with outcomes of AECOPD in patients without heart failure and other conditions that can affect NT-pro-BNP levels. We conducted a retrospective study in patients hospitalized for AECOPD with available NT-pro-BNP levels and normal left ventricular ejection fraction. We compared patients with normal and elevated NT-pro-BNP levels and analyzed the clinical and outcome data. A total of 167 of 1,420 (11.7%) patients met the study criteria. A total of 77% of male patients and 53% of female patients had elevated NT-pro-BNP levels (P=0.0031). NT-pro-BNP levels were not associated with COPD severity and comorbid illnesses. Log-transformed NT-pro-BNP levels were positively associated with echocardiographically estimated right ventricular systolic pressure (r=0.3658; 95% confidence interval [CI]: 0.2060-0.5067; Ppro-BNP levels were more likely to require intensive care (63% vs 43%; P=0.0207) and had a longer hospital length of stay (P=0.0052). There were no differences in the need for noninvasive positive pressure ventilation (P=0.1245) or mechanical ventilation (P=0.9824) or in regard to in-hospital mortality (P=0.5273). Patients with AECOPD and elevated NT-pro-BNP levels had increased hospital length of stay and need for intensive care. Based on our study, serum NT-pro-BNP levels cannot be used as a biomarker for increased mortality or requirement for invasive or noninvasive ventilation in this group of patients.

  13. 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

  14. Manifold implications of obesity in ischemic heart disease among Japanese patients according to covariance structure analysis: Low reactivity of B-type natriuretic peptide as an intervening risk factor.

    Science.gov (United States)

    Tsutsumi, Joshi; Minai, Kosuke; Kawai, Makoto; Ogawa, Kazuo; Inoue, Yasunori; Morimoto, Satoshi; Tanaka, Toshikazu; Nagoshi, Tomohisa; Ogawa, Takayuki; Yoshimura, Michihiro

    2017-01-01

    Obesity is believed to be one of the major risk factors for cardiovascular disease in Western countries. However, the effects of obesity should be continuously examined in the Japanese population because the average bodily habitus differs among countries. In this study, we collectively examined the significance of obesity and obesity-triggered risk factors including the low reactivity of B-type natriuretic peptide (BNP), for ischemic heart disease (IHD) in Japanese patients. The study patients consisted of 1252 subjects (IHD: n = 970; non-IHD: n = 282). Multiple logistic regression analysis revealed that dyslipidemia, hypertension, diabetes, and the low reactivity of BNP were significant risk factors for IHD, but body mass index (BMI) was not. A theoretical path model was proposed by positioning BMI at the top of the hierarchical model. Exploratory factor analysis revealed that BMI did not play a causative role in IHD (P = NS). BMI was causatively linked to other risk factors (Pfactors played a causative role in IHD (Pobesity per se is not a strong risk factor for IHD in Japanese patients. However, several important risk factors triggered by obesity exhibited a causative role for IHD. The low reactivity of BNP is a substantial risk factor for IHD.

  15. 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。

  16. 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...

  17. 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.

  18. 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.

  19. 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

  20. NT-proBNP

    DEFF Research Database (Denmark)

    Andersen, Charlotte; Mellemkjær, Søren; Hilberg, Ole;

    2016-01-01

    BACKGROUND: Pulmonary hypertension (PH) is a serious complication to interstitial lung disease (ILD) and has a poor prognosis. PH is often diagnosed by screening with echocardiography followed by right heart catheterisation. A previous study has shown that a value of NT-pro-brain natriuretic...... patients and obtain data from echocardiography, NT-proBNP, diagnosis and lung function. Signs of PH on echocardiography were defined as a tricuspid pressure gradient (TR) ≥40 mmHg, decreased right ventricular systolic function or dilatation. Sensitivity, specificity, negative predictive value (NPV...

  1. 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...

  2. 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...

  3. 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.

  4. 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...

  5. BNP predicts chemotherapy-related cardiotoxicity and death

    DEFF Research Database (Denmark)

    Skovgaard, Dorthe; Hasbak, Philip; Kjaer, Andreas

    2014-01-01

    UNLABELLED: Cardiotoxicity is a dose-limiting side-effect of cancer chemotherapeutics such as anthracyclines. The drug-induced cardiac toxicity is currently monitored with repeated assessments of the left ventricular ejection fraction (LVEF) using multigated equilibrium radionuclide ventriculogra......UNLABELLED: Cardiotoxicity is a dose-limiting side-effect of cancer chemotherapeutics such as anthracyclines. The drug-induced cardiac toxicity is currently monitored with repeated assessments of the left ventricular ejection fraction (LVEF) using multigated equilibrium radionuclide...... ventriculography (MUGA) or echocardiography. However, the plasma cardiac biomarker B-type natriuretic peptide (BNP) has been suggested for early identification of cardiac dysfunction. The aim of the study was to compare LVEF obtained by MUGA and plasma BNP as predictors of developing congestive heart failure (CHF...

  6. NT-pro-BNP during hypoglycemia and hypoxemia in normal subjects: impact of renin-angiotensin system activity

    DEFF Research Database (Denmark)

    Due-Andersen, R; Pedersen-Bjergaard, U; Høi-Hansen, T;

    2008-01-01

    Brain-derived natriuretic peptide (BNP) is a cardioprotective peptide released, together with the inactive NH2-terminal part of its prohormone (NT-pro-BNP), in response to different kinds of myocardial stress. Hypoglycemia and hypoxemia are conditions that threaten cellular function and hence...... potentially stimulate BNP release. BNP interacts with the renin-angiotensin system (RAS). The aim of this study was, therefore, to explore if basal RAS activity has an impact on NT-pro-BNP concentrations during myocardial stress induced by hypoglycemia and hypoxemia. From a cohort of 303 healthy young men, 10...... (mean nadir Po-2 5.8 +/- 0.5 kPa), and 3) normoglycemic normoxia (control). NT-pro-BNP was measured at baseline, during the stimuli, and in the recovery phase. Hypoxemia was associated with a 9% increase in NT-pro-BNP from 2.2 +/- 1.5 pmol/l at baseline to 2.4 +/- 1.5 pmol/l during hypoxemia (P

  7. The natriuretic peptide time-course in end-stage heart failure patients supported by left ventricular assist device implant: focus on NT-proCNP.

    Science.gov (United States)

    Cabiati, M; Caruso, R; Caselli, C; Frigerio, M; Prescimone, T; Parodi, O; Giannessi, D; Del Ry, S

    2012-08-01

    This study aimed to evaluate left ventricular assist device (LVAD) effects on natriuretic peptide (NP) prohormone plasma levels in end-stage heart failure (HF) patients, especially NT-proCNP, in order to better characterize the NP system during hemodynamic recovery by LVAD. HF patients (n=17, NYHA III-IV) undergoing LVAD were studied: 6 died of multi-organ failure syndrome (NS) and 11 survived (S). Total sequential organ failure assessment (t-SOFA) score and blood samples were obtained at admission (T1) and at 24, 72h and 1, 2, 4 weeks (T2-T6) after LVAD. In S, NT-proANP and NT-proCNP significantly increased at 24h after implantation, reaching a reduction to basal levels at 4 weeks following LVAD [NT-proANP: T1 vs. T2 p=0.017, NT-proCNP: T1 vs. T2 p=0.028, T1 vs. T3 p=0.043]. Elevated NT-proBNP plasma levels were observed at all times. In NS, NP plasma levels sustained higher with respect to S. No statistical variation was observed for NT-proCNP and NT-proANP in S and NS while NT-proBNP reached significant differences at T4 in NS. Considering S+NS, only NT-proCNP strongly correlated with t-SOFA score at T1 (rho=0.554, p=0.04) while subdividing patients NT-proCNP positively correlated in NS with t-SOFA score (rho=0.988, p=0.002) only at T4. In NS a correlation between NT-proCNP and NT-proBNP at T1 was observed (rho=-0.900, p=0.037). Both IL-6 and TNF-alpha sustained higher in NS patients than in S; in particular, statistical significance was observed for IL-6. The study of new peptides, such as NT-proCNP, would provide additional information for identifying patients who are more likely to recover. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Serum levels of N-terminal-pro B-type natriuretic peptide as a diagnostic marker for left ventricular dysfunction in children with end-stage renal disease on hemodialysis

    Directory of Open Access Journals (Sweden)

    Amr Mohamed Zoair

    2016-01-01

    Full Text Available The objective of this study was to determine the diagnostic cutoff value of N-terminal-pro B-type natriuretic peptide (NT-pro BNP as a marker of left ventricular (LV dysfunction in children with end-stage renal disease (ESRD on regular hemodialysis (HD. The study was carried out on thirty children with ESRD on regular HD and thirty healthy controls. Echocardiographic studies were done, including a conventional mode for ejection fraction, fractional shortening, tissue Doppler imaging, and longitudinal global strain by speckle tracking. Serum levels of NT-pro BNP were measured in venous blood samples before and about 30 min after HD by ELISA. Volume status was assessed by calculating interdialytic weight gain %. There were significant higher serum NT-pro BNP levels before HD (mean: 702.3 ± 274.3 ng/L compared to controls (mean: 365.55 ± 76.5 ng/L (P <0.001 and these levels decreased significantly after the HD session (mean: 625.1 ± 117.69 ng/L (P = 0.031. Echocardiographic studies showed a significant impairment of LV function of the patients compared to controls. Patients with LV dysfunction had significant higher serum concentrations of NT-pro BNP compared to patients without dysfunction both before (P = 0.003 and after dialysis (P <0.001. Receiver operating curve demonstrated better prediction of LV dysfunction by NT-pro BNP levels after HD compared to its levels before HD (area under the curve was 0.9 and 0.73, respectively. Using a cutoff value of 630 ng/L, serum NT-pro BNP levels after dialysis were a diagnostic predictor of LV dysfunction with a sensitivity of 86.6%, specificity of 93.3%, positive predictive value of 92.8%, and negative predictive value of 87.5%. Serum NT-pro BNP levels were strongly correlated with the parameters of LV dysfunction in children with ESRD on regular HD. A postdialysis cutoff value of 630 ng/L could serve as a biochemical marker of LV dysfunction in those children regardless of chronic fluid overload.

  9. Cystatin C, N-terminal probrain natriuretic peptides and outcomes in acute heart failure with acute kidney injury in a 12-month follow-up: Insights into the cardiorenal syndrome

    Directory of Open Access Journals (Sweden)

    Zhong-bao Ruan

    2014-01-01

    Full Text Available Background: Cystatin C (Cys C has been implicated as a prognostic marker in cardiovascular disease. The aim of this study was to evaluate the value of Cys C as a marker of acute kidney injury (AKI in acute heart failure (AHF, the impact of Cys C and N-terminal probrain natriuretic peptides (NT-proBNP on in-hospital and 12 months mortality were also investigated. Materials and Methods: A total of 162 patients with AHF were enrolled. NT-proBNP, Cys C, serum creatinine (Scr, blood urea nitrogen (BUN and parameters of echocardiography were measured for analyze. The in-hospital and 12 months mortality was analyzed. Results: There was 28 (17% of all AHF patients with AKI. Compared with no-AKI patients, the levels of Cys C (1.51 ± 0.34 vs. 1.32 ± 0.29, P = 0.003 and NT-proBNP (8163.87 ± 898.06 vs. 5922.45 ± 576.73, P = 0.001 were higher in AKI patients. Higher levels of NT-proBNP (odds ratio (OR = 1.92, 95% confidence interval (CI: 2.19-10.98, P = 0.018, OR = 4.31, 95% CI: 2.35-9.82, P = 0.002, respectively and Cys C (OR = 1.48, 95% CI: 1.75-4.16, P = 0.027, OR = 2.72, 95% CI: 1.92-4.28, P = 0.017, respectively were independent association with the in-hospital and 12 months mortality. Cys C was positively correlated with NT-proBNP (r = 0.87, P < 0.001. Combining tertiles of Cys C and NT-proBNP improved risk stratification further. Compared with patients without AKI cysC , patients with AKI cysC was associated with higher in-hospital (7/28 vs. 10/134, P = 0.002 and 12-month mortality (13/28 vs. 32/134, P = 0.001. Conclusion: Cys C was not only a promising risk marker in patients hospitalized for AHF, but also an independent predictor of 12-month mortality. Combining tertiles of Cys C and NT-proBNP could be used to distinguish the mortality risk identification of patients with AHF. AKI was an independent predictor of in-hospital and 12-month mortality.

  10. 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.

  11. 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.

  12. Neuroendocrine mechanisms of left ventricular dysfunction stimulated by anger stress in rats with atherosclerosis-a putative role of natriuretic peptide

    Institute of Scientific and Technical Information of China (English)

    Lin Chen; Xian-Zhi He; Qi-Ming Liu

    2014-01-01

    Objective: To investigate the role of natriuretic peptide in the process of left ventricular dysfunction caused by emotional stress. Methods: Adult male SD rats (n=30) and Wistar rats (n=60) were selected in this study. Atherosclerosis models were induced with high-fat diet and excess VD3 injection (eight consecutive weeks), and anger stress models were prepared by resident-intruder stress experiment (two consecutive weeks). Furthermore, left ventricular functions were examined by high-resolution echocardiograph, after which left ventricular myocardium and coronary arteries were prepared for pathological section and observed with electron microscope. At the same time, the hypothalamus, medulla oblongata and left ventricular myocardium were also prepared for pathological sections to detect the localization and expression of ANP, BNP and NPR-A with immunofluorescence and western blot. Results: We found that left ventricular functions of atherosclerosis or emotional stress modeled rats were both inferior to the healthy ones and superior to the combined (atherosclerosis and emotional stress) modeled ones (P<0.05). We also found that atherosclerosis and emotional stress could both cause morphological changes of left ventricular cells and capillary which contribute to apoptosis and hyperblastosis. Further more, there was NPR-A distributed in hypothalamus, medulla oblongata, as well as left ventricular tissues with the same express trend between groups, with atherosclerosis modeled rats the highest and the healthy rats the lowest. Conclusions: The results of our study suggest that anger stress could cause an excess consumption of ANP, BNP and NPR-A in nervous and cardiovascular system which inhibit the compensatory self-repair function of atherosclerosis rats, leading to a promotion of fibrosis and lipid peroxidation, offering insight into the neuroendocrine mechanisms of left heart function obstacle.

  13. 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.

  14. 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.

  15. 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.

  16. C-type natriuretic peptide is closely associated to obesity in Caucasian adolescents.

    Science.gov (United States)

    Del Ry, Silvia; Cabiati, Manuela; Bianchi, Vanessa; Caponi, Laura; Maltinti, Maristella; Caselli, Chiara; Kozakova, Michaela; Palombo, Carlo; Morizzo, Carmela; Marchetti, Sara; Randazzo, Emioli; Clerico, Aldo; Federico, Giovanni

    2016-09-01

    CNP is a natural regulator of adipogenesis playing a role in the development of obesity in childhood. Aim of the study was to evaluate CNP plasma levels in normal-weight (N), overweight (OW) and obese adolescents (O). Eighty two subjects (age:12.8±2.4, years) without cardiac dysfunction were enrolled and CNP plasma levels were measured by RIA. NT-proBNP, MR-proANP, AGEs, reactive hyperemia index (RHI) and standard clinical chemistry parameters were also measured. O and OW adolescents had higher values of BMI and fat mass than N. CNP levels were significantly lower in OW:4.79[3.29-21.15] and O:3.81[1.55-13.4] than in N:13.21[7.6-37.8]; pobesity resulted significantly (p≪0.0001) associated with CNP values (AUC=0.9724). These results suggest that CNP may play a more important role than BNP and ANP related peptides, as risk marker of obesity, in addition to its involvement in adipogenesis and endothelial dysfunction. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. 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.

  18. High NT-proBNP is a strong predictor of outcome in elderly heart failure patients

    DEFF Research Database (Denmark)

    Andersson, Sven; Edvinsson, Marie-Louise; Björk, Jonas;

    2008-01-01

    All patients older than 65 years (184 men; mean age, 78+/-0.8 years/181 women; mean age, 82+/-0.6 years) seeking medical attention at the Lund University Hospital Emergency Clinic during a 2-year period who had an N-terminal prohormone brain natriuretic peptide (NT-proBNP) value >2000 pg/mL were...... followed up for survival. Mortality in the entire population was 21% after 3 months, 35% after 1 year, and 40% after 2 years. Multivariate analysis indicated that the NT-proBNP level and the New York Heart Association (NYHA) functional class were stronger predictors of mortality than were echocardiographic...... that in this population, NT-proBNP level together with assessment of NYHA class gives the best prognostic information of 1-year mortality....

  19. Selective endothelin B receptor blockade does not influence BNP-induced natriuresis in man.

    Science.gov (United States)

    van der Zander, K; Houben, A J H M; Webb, D J; Udo, E; Kietselaer, B; Hofstra, L; De Mey, J G R; de Leeuw, P W

    2006-03-01

    Brain natriuretic peptide (BNP) and endothelin-1 (ET-1) both exhibit natriuretic activity within the human kidney. Furthermore, they both act partly through activation of the endothelial nitric oxide pathway. Since ET-1 may cause vasodilation and natriuresis via stimulation of the ET-B receptor, the aim of the present study was to investigate whether renal ET-B receptors participate in the renal actions of BNP. In this placebo-controlled, crossover study, we infused BNP (4 pmol/kg/min) or placebo (i.v.) for 1 h, with or without co-infusion of the ET-B receptor antagonist BQ-788 (50 nmol/min) for 15 min on 4 separate days, in 10 healthy subjects (mean age 54+/-6 years.). During infusion, we measured effective renal plasma flow (ERPF), and glomerular filtration rate (GFR) using PAH/inulin clearance. Cardiac output was measured before and after infusion, using echocardiography. Blood pressure and heart rate (HR) were monitored as well. Urine and plasma samples were taken every hour to measure diuresis, natriuresis, cyclic 3',5' guanosine monophosphate, and ET-1 levels. BNP with or without ET-B receptor blockade increased natriuresis and diuresis. In addition, BNP alone increased GFR and filtered load, without changing ERPF. BQ-788 infusion did not affect renal hemodynamics or natriuresis. Neither BNP nor BQ-788 altered cardiac output, blood pressure, and heart rate. In conclusion, the present study shows that selective ET-B receptor blockade has no effect on the BNP-induced natriuresis and glomerular filtration rate.

  20. 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

  1. 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.

  2. 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.

  3. 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...

  4. 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

  5. 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

  6. 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.

  7. 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...

  8. 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

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

    Directory of Open Access Journals (Sweden)

    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

  10. Crystal structure and thermodynamic analysis of diagnostic mAb 106.3 complexed with BNP 5-13 (C10A)

    Energy Technology Data Exchange (ETDEWEB)

    Longenecker, Kenton L.; Ruan, Qiaoqiao; Fry, Elizabeth H.; Saldana, Sylvia C.; Brophy, Susan E.; Richardson, Paul L.; Tetin, Sergey Y.; (Abbott)

    2010-09-02

    B-type natriuretic peptide (BNP) is a naturally secreted regulatory hormone that influences blood pressure and vascular water retention in human physiology. The plasma BNP concentration is a clinically recognized biomarker for various cardiovascular diseases. Quantitative detection of BNP can be achieved in immunoassays using the high-affinity monoclonal IgG1 antibody 106.3, which binds an epitope spanning residues 5-13 of the mature bioactive peptide. To understand the structural basis of this molecular recognition, we crystallized the Fab fragment complexed with the peptide epitope and determined the three-dimensional structure by X-ray diffraction to 2.1 {angstrom} resolution. The structure reveals the detailed interactions that five of the complementarity-determining regions make with the partially folded peptide. Thermodynamic measurements using fluorescence spectroscopy suggest that the interaction is enthalpy driven, with an overall change in free energy of binding, {Delta}G = -54 kJ/mol, at room temperature. The parameters are interpreted on the basis of the structural information. The kinetics of binding suggest a diffusion-limited mechanism, whereby the peptide easily adopts a bound conformation upon interaction with the antibody. Moreover, comparative analysis with alanine-scanning results of the epitope explains the basis of selectivity for BNP over other related natriuretic peptides.

  11. 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

  12. 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.

  13. 血BNP在急诊呼吸困难原因鉴别及心力衰竭危险分层中的作用%The diagnostic value of B-type natriuretic peptide in the patients with dyspean and effection of rish stratification with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    张卓一; 黄小民; 何煜舟; 周晶晶; 吴丽娟

    2011-01-01

    目的 探讨B型脑钠肽(BNP)在鉴别急诊呼吸困难病因中的价值及心力衰竭(以下简称心衰)分层中的作用.方法呼吸困难患者共204例,由两位不知BNP测定结果的心内科医师判断诊断,比较心源性呼吸困难、肺源性呼吸困难BNP值,心源性呼吸困难根据心功能(NYHA)分Ⅱ~Ⅳ级,分别测定BNP值和左室射血分数(LVEF),并比较左侧心衰和右侧心衰BNP值.结果心源性呼吸困难BNP值明显高于肺源性呼吸困难.NYHA分级为III、IV级的患者血BNP水平均高于II级患者(P<0.05或0.01);而NYHA分级为IV级患者的血BNP水平明显高于III级(P<0.01).NYHA分级为III、IV级患者血LVEF水平均低于II级患者(均P<0.05);而NYHA分级为IV级患者的血LVEF水平则低于III级(P<0.05).左侧心衰和右侧心衰BNP值均升高,但左侧心衰BNP升值大于右侧心衰.结论对急诊呼吸困难患者测定BNP可以鉴别心源性呼吸困难和肺源性呼吸困难,BNP含量变化与心功能变化密切相关.%Objective To evaluate the diagnostic value of B- type natriuretic peptide in the patients with dyspean and effection ofrish stratification of B-type natriuretic peptide for patients with congestive heart failure.Methods Plasma BNP were measured with rapid assay in 204 patients with dyspnea.The clinical diagnosis was adjudicated by two cardiologists, who were blinded to the results of the BNP assay.The level of BNP were compared between Cardie dyspnea group and pulmonary dyspnea group. The level of BNP and LVEF were determined in the different NYHA functional class of Cardic dyspnea group.The BNP were compared between patients with left heart failure and patients right heart failure. Results The level of BNP was significantly higher in the Cardie dyspnea group than pulmonary dyspnea group. The level of BNP relates with the NYHA heart function class and LVEF of patient. The BNP increased significantly in patients with left heart failure or with right

  14. 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.

  15. Long-term clinical variation of NT-proBNP in stable chronic heart failure patients

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Kjaer, Andreas;

    2007-01-01

    AIMS: Here, the aim is to assess long-term clinical variation (CV) of N-terminal pro-brain natriuretic peptide (NT-proBNP) in stable chronic heart failure (CHF) patients. The proposed use of NT-proBNP for monitoring of CHF patients will require accurate information about long-term CV of the peptide...... months after the second follow-up were included. A total of 78 patients fulfilled the criteria, and year-to-year CV was calculated to 30% (median) (range: 0-111%) (% changes range: -87 to 397%). Log transformation of NT-proBNP (skewed to the right) reduced the year-to-year CV to 4.7% (range: 0......-22%) (% changes range: -18 to 38%). CONCLUSION: Long-term CV of plasma concentrations of NT-proBNP in stable CHF patients is 30%, but the variation is substantial. Therefore, high long-term CV of NT-proBNP does not necessarily carry prognostic significance within the subsequent 12 months. Plasma concentrations...

  16. The prognostic value of estimated glomerular filtration rate, amino-terminal portion of the pro-hormone B-type natriuretic peptide and parameters of cardiopulmonary exercise testing in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    G.Aernout Somsen

    2012-06-01

    Full Text Available The aim of this study was to evaluate the prognostic value of renal function in relation to amino-terminal portion of the pro-hormone B-type natriuretic peptide (NT-proBNP and parameters of cardiopulmonary exercise testing in predicting mortality and morbidity in patients with moderate chronic heart failure (CHF. Sixty-one CHF patients were included in the study. Patients’ characteristics were: age 64.3±11.6 years; New York Heart Association class I/II/III: 14/37/10; left ventricular ejection fraction: 0.30±0.13 (%; NT-proBNP: 252.2±348.0 (ng/L; estimated creatinine clearance (e-CC: 73.6±31.4 (mL/min; estimated glomerular filtration rate (e-GFR: 66.1±24.6 (mL/min/1.73 m2; the highest O2 uptake during exercise (VO2-peak: 1.24±0.12 mL/kg/min; VO2/workload: 8.52±1.81 (mL/min/W]. During follow up (59.5±4.0 months there were 15 cardiac deaths and 16 patients were hospitalized due to progression of heart failure. NT-proBNP and VO2/workload were independently associated with cardiac death (P=0.007 and P=0.006, respectively. Hospitalization for progressive CHF was only associated with NT-proBNP (P=0.002. The combined cardiac events (cardiac death and hospitalization were associated with NT-proBNP and VO2/workload (P=0.007 and P=0.005, respectively. The addition of estimates of renal function (neither serum creatinine nor e-GFR did not improve the prognostic value for any of the models. In conclusion, in patients with moderate CHF, increased NT-proBNP and reduced VO2/workload identify those with increased mortality and morbidity, irrespective of estimates of renal function.

  17. The prognostic value of estimated glomerular filtration rate, amino-terminal portion of the pro-hormone B-type natriuretic peptide and parameters of cardiopulmonary exercise testing in patients with chronic heart failure.

    Science.gov (United States)

    Verberne, Hein J; van der Spank, Aukje; Bresser, Paul; Somsen, G Aernout

    2012-06-05

    The aim of this study was to evaluate the prognostic value of renal function in relation to amino-terminal portion of the pro-hormone B-type natriuretic peptide (NT-proBNP) and parameters of cardiopulmonary exercise testing in predicting mortality and morbidity in patients with moderate chronic heart failure (CHF). Sixty-one CHF patients were included in the study. Patients' characteristics were: age 64.3±11.6 years; New York Heart Association class I/II/III: 14/37/10; left ventricular ejection fraction: 0.30±0.13 (%); NT-proBNP: 252.2±348.0 (ng/L); estimated creatinine clearance (e-CC): 73.6±31.4 (mL/min); estimated glomerular filtration rate (e-GFR): 66.1±24.6 (mL/min/1.73 m(2)); the highest O2 uptake during exercise (VO(2-peak)): 1.24±0.12 mL/kg/min; VO(2)/workload: 8.52±1.81 (mL/min/W)]. During follow up (59.5±4.0 months) there were 15 cardiac deaths and 16 patients were hospitalized due to progression of heart failure. NT-proBNP and VO(2)/workload were independently associated with cardiac death (P=0.007 and P=0.006, respectively). Hospitalization for progressive CHF was only associated with NT-proBNP (P=0.002). The combined cardiac events (cardiac death and hospitalization) were associated with NT-proBNP and VO(2)/ workload (P=0.007 and P=0.005, respectively). The addition of estimates of renal function (neither serum creatinine nor e-GFR) did not improve the prognostic value for any of the models.In conclusion, in patients with moderate CHF, increased NT-proBNP and reduced VO(2)/ work-load identify those with increased mortality and morbidity, irrespective of estimates of renal function.

  18. 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