Capability of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP as Indicators of Cardiac Structural Disease in Asymptomatic Patients with Systemic Arterial Hypertension

Abstract Background: The aim of the present study was to prospectively evaluate the diagnostic utility of B-type natriuretic peptide (BNP) and amino-terminal proBNP (NT-proBNP) measurements for the detection of cardiac structural disease in asymptomatic patients with systemic arterial hypertension and to test the hypothesis that the 2 analytes are equally useful in this clinical setting. Methods: We studied a consecutive series of 149 asymptomatic patients referred for echocardiographic evaluation of the cardiac effects of systemic arterial hypertension. Diagnosis of cardiac structural disease was based on the presence of systolic or diastolic dysfunction, left atrial dilatation, left ventricular dilatation or hypertrophy, pulmonary hypertension, and wall motion or valvular abnormalities. Blood concentrations of BNP and NT-proBNP were measured by 2 commercially available assays (Abbott AxSYM and Roche Elecsys, respectively). Diagnostic accuracies of BNP and NT-proBNP were assessed by ROC curve analysis. Areas under the curves were compared by analysis of equivalency. Results: In distinguishing between hypertensive patients with cardiac structural disease (n = 118) and hypertensive patients without (n = 31), areas under the curves were 0.740 (95% confidence interval, 0.662–0.808) for BNP and 0.762 (0.685–0.828) for NT-proBNP and were significantly equivalent (P = 0.015). Cutoff values with a 90% sensitivity for cardiac structural disease were 17 ng/L for BNP and 39 ng/L for NT-proBNP, with 29% and 32% specificity, respectively. Conclusions: BNP and NT-proBNP have similar capabilities for detecting cardiac structural disease in asymptomatic patients with systemic arterial hypertension. However, in the setting evaluated, a screening strategy relying on measurement of BNP or NT-proBNP may be of limited value because of the low specificity at the selected cutoff values.

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USEFULNESS OF AMINO-TERMINAL PRO-B-TYPE NATRIURETIC PEPTIDE (NT-PROBNP) TO DIAGNOSE LEFT VENTRICULAR HYPERTROPHY IN PATIENTS WITH ARTERIAL HYPERTENSION: PP.35.457

Journal of Hypertension ◽

10.1097/01.hjh.0000383794.21675.b5 ◽

2010 ◽

Vol 28 ◽

pp. e586

Author(s):

H Andrade Gomes ◽

J Quiles Granado ◽

P Morillas Blasco ◽

I Mateo Rodríguez ◽

P Agudo Quílez ◽

...

Keyword(s):

Left Ventricular Hypertrophy ◽

Arterial Hypertension ◽

Natriuretic Peptide ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Amino Terminal

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Plasma B-type natriuretic peptide is related to left ventricular mass in hypertensive patients

European Heart Journal ◽

10.1016/j.ehj.2004.05.030 ◽

2004 ◽

Vol 25 (21) ◽

pp. 1967-1967 ◽

Cited By ~ 3

Author(s):

A KARAGIANNIS

Keyword(s):

Left Ventricular Mass ◽

Natriuretic Peptide ◽

Left Ventricular ◽

Hypertensive Patients ◽

Ventricular Mass

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B-type natriuretic peptide predicts left ventricular response to surgery in patients with severe mitral regurgitation in asymptomatic patients with preserved left ventricular function

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(03)82758-4 ◽

2003 ◽

Vol 41 (6) ◽

pp. 509 ◽

Cited By ~ 1

Author(s):

W.H.Wilson Tang ◽

Richard W. Troughton ◽

Deborah A. Agler ◽

Kathy Morris ◽

Gary S. Francis ◽

...

Keyword(s):

Mitral Regurgitation ◽

Left Ventricular Function ◽

Ventricular Function ◽

Natriuretic Peptide ◽

Left Ventricular ◽

Severe Mitral Regurgitation ◽

Asymptomatic Patients ◽

Ventricular Response

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Atrial natriuretic peptide, B-type natriuretic peptide, and serum collagen markers after acute myocardial infarction

Journal of Applied Physiology ◽

10.1152/japplphysiol.00557.2003 ◽

2004 ◽

Vol 96 (4) ◽

pp. 1306-1311 ◽

Cited By ~ 24

Author(s):

Jarkko Magga ◽

Mikko Puhakka ◽

Seppo Hietakorpi ◽

Kari Punnonen ◽

Paavo Uusimaa ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Atrial Natriuretic Peptide ◽

Natriuretic Peptide ◽

Type I Collagen ◽

Left Ventricular ◽

Type I ◽

Amino Terminal ◽

Collagen Markers ◽

Atrial Natriuretic

Experimental data suggest that atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) act locally as antifibrotic factors in heart. We investigated the interrelationships of natriuretic peptides and collagen markers in 93 patients receiving thrombolytic treatment for their first acute myocardial infarction (AMI). Collagen formation following AMI, evaluated as serum levels of amino terminal propeptide of type III procollagen, correlated with NH2-terminal proANP ( r = 0.45, P < 0.001), BNP ( r = 0.55, P < 0.001) and NH2-terminal proBNP ( r = 0.50, P < 0.01) on day 4 after thrombolysis. Levels of intact amino terminal propeptide of type I procollagen decreased by 34% ( P < 0.001), and levels of carboxy terminal cross-linked telopeptide of type I collagen (ICTP) increased by 65% ( P < 0.001). ICTP levels correlated with NH2-terminal proBNP ( r = 0.25, P < 0.05) and BNP ( r = 0.28, P < 0.05) on day 4. Our results suggest that ANP and BNP may act as regulators of collagen scar formation and left ventricular remodeling after AMI in humans. Furthermore, degradation of type I collagen is increased after AMI and may be regulated by BNP.

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Serum Zinc and Selenium Concentrations in Patients with Hypertrophy and Remodelling of the Left Ventricle Secondary to Arterial Hypertension

Antioxidants ◽

10.3390/antiox10111803 ◽

2021 ◽

Vol 10 (11) ◽

pp. 1803

Author(s):

Paweł Gać ◽

Karolina Czerwińska ◽

Małgorzata Poręba ◽

Adam Prokopowicz ◽

Helena Martynowicz ◽

...

Keyword(s):

Left Ventricle ◽

Left Ventricular Hypertrophy ◽

Arterial Hypertension ◽

Ventricular Hypertrophy ◽

Serum Zinc ◽

Left Ventricular ◽

Left Ventricular Geometry ◽

Serum Selenium ◽

Hypertensive Patients ◽

Concentric Hypertrophy

The aim of the study was to assess the relationship between serum selenium and zinc concentrations (Se-S and Zn-S) and the left ventricle geometry in patients suffering from arterial hypertension. A total of 78 people with arterial hypertension (mean age: 53.72 ± 12.74 years) participated in the study. Se-S and Zn-S were determined in all patients. The type of left ventricular remodelling and hypertrophy was determined by the left ventricular mass index (LVMI) and relative wall thickness (RWT) measured by echocardiography. Se-S and Zn-S in the whole group were 89.84 ± 18.75 µg/L and 0.86 ± 0.13 mg/L. Normal left ventricular geometry was found in 28.2% of patients; left ventricular hypertrophy (LVH) in 71.8%, including concentric remodelling in 28.2%, concentric hypertrophy in 29.5%, and eccentric hypertrophy in 14.1%. LVH was statistically significantly more frequent in patients with Se-S < median compared to patients with Se-S ≥ median (87.2% vs. 56.4%, p < 0.05), as well as in patients with Zn-S < median compared to patients with Zn-S ≥ median (83.8% vs. 60.9%, p < 0.05). In hypertensive patients, older age, higher LDL cholesterol, higher fasting glucose, lower Se-S, and lower Zn-S were independently associated with LVH. In conclusion, in hypertensive patients, left ventricular hypertrophy may be associated with low levels of selenium and zinc in the serum.

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Procollagen type III amino terminal peptide and myocardial fibrosis: A study in hypertensive patients with and without left ventricular hypertrophy

Revista Portuguesa de Cardiologia (English Edition) ◽

10.1016/j.repce.2015.05.007 ◽

2015 ◽

Vol 34 (5) ◽

pp. 309-314

Author(s):

Carlos dos Santos Moreira ◽

Fátima Serejo ◽

Paula Alcântara ◽

Vítor Ramalhinho ◽

J. Braz Nogueira

Keyword(s):

Left Ventricular Hypertrophy ◽

Myocardial Fibrosis ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Hypertensive Patients ◽

Type Iii ◽

Procollagen Type ◽

Amino Terminal

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Long-Term Effects of Delapril Hydrochloride on Procollagen Type III Amino-Terminal Peptide, Left Ventricular Mass and Left Ventricular Function in Hypertensive Patients

Japanese Circulation Journal ◽

10.1253/jcj.62.900 ◽

1998 ◽

Vol 62 (12) ◽

pp. 900-902 ◽

Cited By ~ 2

Author(s):

Munetoshi Matoba ◽

Takayoshi Asaji ◽

Shinobu Matsui ◽

Noboru Takekoshi

Keyword(s):

Left Ventricular Function ◽

Ventricular Function ◽

Left Ventricular Mass ◽

Left Ventricular ◽

Long Term Effects ◽

Hypertensive Patients ◽

Type Iii ◽

Procollagen Type ◽

Amino Terminal

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Left ventricular performance in patients with left ventricular hypertrophy caused by systemic arterial hypertension.

Heart ◽

10.1136/hrt.39.11.1239 ◽

1977 ◽

Vol 39 (11) ◽

pp. 1239-1245 ◽

Cited By ~ 60

Author(s):

J S Karlinger ◽

D Williams ◽

J Gorwit ◽

M H Crawford ◽

R A O'Rourke

Keyword(s):

Left Ventricular Hypertrophy ◽

Arterial Hypertension ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Left Ventricular Performance ◽

Ventricular Performance ◽

Systemic Arterial Hypertension

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Biochemical diagnosis of impaired left ventricular ejection fraction - comparison of the diagnostic accuracy of brain natriuretic peptide (BNP) and amino terminal proBNP (NT-proBNP)

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm.2004.029 ◽

2004 ◽

Vol 42 (2) ◽

Cited By ~ 28

Author(s):

Thomas Mueller ◽

Alfons Gegenhuber ◽

Werner Poelz ◽

Meinhard Haltmayer

Keyword(s):

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Diagnostic Accuracy ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Amino Terminal ◽

Biochemical Diagnosis

AbstractThe aim of the present investigation was to evaluate the diagnostic accuracy of brain natriuretic peptide (BNP) and amino terminal proBNP (NT-proBNP) for the detection of mild/moderate and severe impairment of left ventricular ejection fraction (LVEF). In 180 subjects BNP and NT-proBNP were measured by two novel fully automated chemiluminescent assays (Bayer and Roche methods). LVEF as determined by echocardiography was categorized as normal (>60%), mildly/moderately reduced (35–60%) and severely diminished (<35%). Discriminating between patients with LVEF<35% (n=32) and subjects with LVEF ≥35% (n=148), receiver-operating characteristic (ROC) curve analysis revealed an area under the curve (AUC) of 0.912 for BNP and of 0.896 for NT-proBNP (difference 0.016, p=0.554). In contrast, BNP displayed an AUC of 0.843and NT-proBNP an AUC of 0.927 (difference of 0.084, p=0.034) when comparing patients with LVEF 35–60% (n=37) and individuals with LVEF >60% (n=111). Evaluation of discordant false classifications at cut-off levels with the highest diagnostic accuracy showed advantages for BNP in the biochemical diagnosis of LVEF<35% (4 misclassifications by BNP and 25 by NT-proBNP, p<0.001) and for NT-proBNP in the detection of LVEF 35–60% (25 misclassifications by BNP and 7 by NT-proBNP, p=0.002). In conclusion, the present study indicates a different diagnostic accuracy of BNP and NT-pro-BNP for the detection of mildly/moderately reduced LVEF and severely diminished LVEF. Advantages of BNP may be advocated for the biochemical diagnosis of more severely impaired LVEF, while NT-proBNP might be a more discerning marker of early systolic left ventricular dysfunction.

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