Administration of brain natriuretic peptide improves cardiac function following operations using extracorporeal circulation in an animal model

The critical phase during cardiosurgical procedures is weaning the diseased heart from the ECC (extracorporeal circulation). Post-ischaemic heart failure sometimes requires the administration of inotropic and/or vasconstrictive agents. The natriuretic peptides influence pre- and after-load through their natriuretic, diuretic and vasodilating actions. To date, there are only a few reports describing the therapeutic effect of BNP (brain natriuretic peptide) administration during cardiosurgical procedures. The aim of the present study was to evaluate the effect of BNP administration following ECC in an animal model. Surgery was performed on 20 pigs using ECC. A 30-min ischaemic episode was simulated. Following de-clamping, BNP was administered to the BNP group (n=10) by an i.v. (intravenous) bolus at 0.3 μg·kg−1 of body weight·min−1, followed by an infusion at a rate of 0.015 μg·kg−1 of body weight·min−1 for 60 min. The animals in the control group (n=10) received a saline solution instead of BNP. Haemodynamic and clinical chemistry parameters as well as the amount of catecholamines that were required were measured. All of the animals in the BNP group had a significantly better cardiac output and cardiac index at the end of the experiment. Seven out of 10 animals from the control group required catecholamines, whereas only one animal from the BNP group did. Creatine kinase levels were significantly lower in the BNP group. Systemic vascular resistance was markedly lower in the BNP group. In conclusion, administration of BNP is highly effective in treating post-ischaemic heart failure following ECC. Haemodynamics are greatly improved, and there is almost no need for pharmacological support.

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Significance of Brain Natriuretic Peptide Measurement as a Diagnostic Indicator of Cardiac Function

Methods of Information in Medicine ◽

10.1055/s-0038-1634337 ◽

2000 ◽

Vol 39 (03) ◽

pp. 249-253 ◽

Cited By ~ 21

Author(s):

N. Iida ◽

T. Ishihara ◽

S. Waku

Keyword(s):

Heart Failure ◽

Blood Pressure ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Diagnostic Value ◽

Left Ventricular ◽

Control Group ◽

Healthy Control ◽

Group 5 ◽

Lv Diastolic Dysfunction

AbstractBrain natriuretic peptide (BNP) is increased in patients with heart failure due to myocardial infarction and cardiac hypertrophy, in proportion to the severity of left ventricular dysfunction. The aims of this study were to clarify the clinical features of BNP and to determine the diagnostic value of BNP for mass screening.The subjects were 818 office workers (565 males and 253 females; mean age 47 ± 12 years) who participated in a 1996 routine health check at Kansai University All individuals were examined for blood pressure, serological findings, ECG and plasma BNP level. Thirty-three males underwent 2-D echocardiography. Plasma BNP levels were measured using IRMA (immunoradiometric assay).The results were as follows: (1) BNP levels in females were higher than those in males for healthy subjects (N = 551), in each age group from 20 to 60 years. (2) BNP levels increased with age. (3) There were significant correlations between BNP level and systolic blood pressure and creatinine level. (4) There were significant differences in BNP level between the hypertensive groups with and without hypertensive ECG changes and the age-matched healthy control group. (5) Marked correlations were observed between BNP level and left ventricular wall thickness, fractional shortening, deceleration time and peak early filling velocity. (6) A BNP cut-off-point of 25 pg/ml was best for detecting LV diastolic dysfunction and LV hypertrophy. Measurement of BNP is useful for detecting asymptomatic heart failure in the general population, and is a clinical marker useful in preventing symptomatic heart failure.

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Discriminative Utility of Apelin-to-NT-Pro-Brain Natriuretic Peptide Ratio for Heart Failure with Preserved Ejection Fraction among Type 2 Diabetes Mellitus Patients

Journal of Cardiovascular Development and Disease ◽

10.3390/jcdd9010023 ◽

2022 ◽

Vol 9 (1) ◽

pp. 23

Author(s):

Alexander A. Berezin ◽

Ivan M. Fushtey ◽

Alexander E. Berezin

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Serum Levels ◽

Control Group ◽

Baseline Serum ◽

Reduced Ejection Fraction ◽

Multivariate Logistic Model ◽

Healthy Control

Background: Apelin is a regulatory vasoactive peptide, which plays a pivotal role in adverse cardiac remodeling and heart failure (HF) with reduced ejection fraction. The purpose of the study was to investigate whether serum levels of apelin is associated with HF with preserved election fraction (HFpEF) in patients with T2DM. Methods: The study retrospectively involved 101 T2DM patients aged 41 to 62 years (48 patients with HFpEF and 28 non-HFpEF patients). The healthy control group consisted of 25 individuals with matched age and sex. Data collection included demographic and anthropometric information, hemodynamic performances and biomarkers of the disease. Transthoracic B-mode echocardiography, Doppler and TDI were performed at baseline. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and apelin were measured by ELISA in all patients at the study entry. Results: Unadjusted multivariate logistic model yielded the only apelin to NT-proBNP ratio (OR = 1.44; p = 0.001), BMI > 34 кг/м2 (OR = 1.07; p = 0.036), NT-proBNP > 458 pmol/mL (OR = 1.17; p = 0.042), LAVI > 34 mL/m2 (OR = 1.06; p = 0.042) and E/e’ > 11 (OR = 1.04; p = 0.044) remained to be strong predictors for HFpEF. After obesity adjustment, multivariate logistic regression showed that the apelin to NT-proBNP ratio < 0.82 × 10−2 units remained sole independent predictor for HFpEF (OR = 1.44; 95% CI: 1.18–2.77; p = 0.001) HFpEF in T2DM patients. In conclusion, we found that apelin to NT-proBNP ratio < 0.82 × 10−2 units better predicted HFpEF in T2DM patients than apelin and NT-proBNP alone. This finding could open new approach for CV risk stratification of T2DM at higher risk of HF.

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Abnormal rhythmic oscillations of atrial natriuretic peptide and brain natriuretic peptide in heart failure

Clinical Science ◽

10.1042/cs1040303 ◽

2003 ◽

Vol 104 (3) ◽

pp. 303-312 ◽

Cited By ~ 10

Author(s):

Hans BENTZEN ◽

Robert S. PEDERSEN ◽

Henrik B. PEDERSEN ◽

Ole NYVAD ◽

Erling B. PEDERSEN

Keyword(s):

Heart Failure ◽

Atrial Natriuretic Peptide ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Left Ventricular ◽

Control Group ◽

Pulsatile Secretion ◽

Main Frequency ◽

Healthy Humans ◽

Atrial Natriuretic

The purpose of this study was to clarify whether the secretions of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are pulsatile in patients with chronic heart failure (CHF), and whether the rhythmic oscillations for ANP and BNP are abnormal in patients with CHF. Several reports have shown that ANP and especially BNP are valuable indicators of the prognosis in CHF. Previously, a pulsatile secretion has been described for ANP and BNP in healthy humans and for ANP in CHF patients. More information about the secretion pattern of BNP in heart failure is necessary to increase the clinical usefulness of BNP in patients with CHF. Patients with left ventricular systolic dysfunction and CHF (n = 12) and controls (n = 12) were investigated. Plasma ANP and BNP levels were determined every 2min during a 2-h period by radioimmunoassay and analysed for pulsatile behaviour by Fourier transformation. All patients and controls had significant rhythmic oscillations in plasma ANP levels, and 11 patients with CHF and 10 controls had significant rhythmic oscillations in plasma BNP levels. The amplitude of the main frequency was considerably higher in patients with CHF than in controls (ANP: CHF, 4.76pmol/l; controls, 0.75pmol/l; P<0.01. BNP: CHF, 3.24pmol/l; controls, 0.23pmol/l; P<0.001; all values are medians), but the main frequency did not differ significantly between the group with CHF and the control group for either ANP or BNP. Patients with CHF demonstrate pulsatile secretion of ANP and BNP with a much higher absolute amplitude, but with the same main frequency as healthy subjects.

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STUDY OF BRAIN-NATRIURETIC PEPTIDE, LACTATE LEVELS AND BLOOD PRESSURE IN PATIENTS WITH CONGESTIVE HEART FAILURE

10.36106/ijsr/3707165 ◽

2021 ◽

pp. 45-46

Author(s):

Shahrukh Khilji ◽

Bushra Fiza ◽

Shehreen Akhtar ◽

Jai Prakash ◽

Maheep Sinha

Keyword(s):

Heart Failure ◽

Blood Pressure ◽

Congestive Heart Failure ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Healthy Individual ◽

Control Group ◽

Heart Failure Patients ◽

Lactate Levels ◽

And Control

INTRODUCTION: Congestive Heart Failure is a complex physiological syndrome caused from structural or functional alterations to the myocardium. Lactate is produced by anaerobic metabolism and is secreted by the Brain-Natriuretic peptide heart ventricles in response to left ventricular stretching or wall tension. AIM: The aim of the study was to evaluate Brain-Natriuretic Peptide, Lactate levels and Blood pressure in Congestive Heart Failure patients and compared them with healthy individual. MATERIALS AND METHODS: Total 80 participants who fullled the inclusion and exclusion criteria were enrolled in the study. They were divided into two group i.e., case and control group. Case group included 40 patients of Congestive Heart Failure, age between 18-65 years and control group comprised of 40 healthy individuals with similar age range. Blood sample were drawn and analyzed for the evaluation of Serum lactate and Brain-Natriuretic Peptide. Blood Pressure was also measured in both the groups. RESULT: The present study has demonstrated that the level of Brain-Natriuretic Peptide and lactate were signicantly high in Congestive heart failure patients when compared with control group. Systolic and Diastolic blood pressure were also higher among patients group. CONCLUSION: The results of the study suggested that the levels of Lactate and Brain-Natriuretic Peptide were high in Congestive heart failure patients when compared with healthy individual. Systolic and Diastolic blood pressure were also higher among patients group. Elevated lactate and Brain-Natriuretic Peptide level can be recommended as useful indicator of poor prognosis and hence can be helpful in early identication of patients at risk.

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