B-type natriuretic peptides as powerful markers in cardiac diseases: Analytical and clinical aspects

Background: Natriuretic peptides (NPs) have broad indications during heart failure (HF) and the detection of left ventricular dysfunction in high-risk patients. They can also be used for the diagnosis/management of other cardiac diseases. However, very little is known regarding their use in routine practice. Methods: We examined all biological tests performed from February 2010 to August 2015 in two districts from the French Brittany, covering 13,653 km2 and including 22,265 physicians. We report the settings and conditions of N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) measurements (the only locally NP available). Results: From a total of 3,606,432 tests requested in 557,650 adult (older than 20 years) patients, only 56,653 (1.6%) included at least one NT-proBNP measurement. NT-proBNP measurements gradually increased, from 9,188 in 2011 to 12,938 in 2014 (p<0.001). Most NT-proBNP tests were measured in urban laboratories (72.7%) and in private (62.9%) non-hospital/clinics laboratories, they were mostly ordered by general practitioners (66% compared with 11% by cardiologists). The number of NT-proBNP measurements increased with age up to 80-90 years, and 70.3% of tests were measured in â¥75y patients. Creatinine and electrolytes were not associated with NT-proBNP in 15.8% and 19.7% of tests, respectively. Conclusion: Among a very large cohort, we observed that NPs remain largely undermeasured. NT-proBNP is mostly measured in elderly patients, and its interpretation may be hazardous in up to 16% of all individuals because no measurement of creatinine was associated to NT-proBNP.

Download Full-text

Educational Recommendations on Selected Analytical and Clinical Aspects of Natriuretic Peptides with a Focus on Heart Failure: A Report from the IFCC Committee on Clinical Applications of Cardiac Bio-Markers

Clinical Chemistry ◽

10.1373/clinchem.2019.306621 ◽

2019 ◽

Vol 65 (10) ◽

pp. 1221-1227 ◽

Cited By ~ 5

Author(s):

Peter A Kavsak ◽

Carolyn S P Lam ◽

Amy K Saenger ◽

Allan S Jaffe ◽

Paul Collinson ◽

...

Keyword(s):

Heart Failure ◽

Natriuretic Peptide ◽

Natriuretic Peptides ◽

Task Force ◽

High Sensitivity ◽

Clinical Applications ◽

Cardiac Biomarkers ◽

Clinical Aspects ◽

Evidence Based ◽

Research Setting

Abstract The IFCC Committee on Clinical Applications of Cardiac Bio-Markers (C-CB) has directives and initiatives focused on providing evidence-based educational resources to aid and improve understanding around key analytical and clinical aspects of cardiac biomarkers used in clinical practice and the research setting. As a task force, we have previously published position statements and recommendations focused on use and analytical aspects of high-sensitivity cardiac troponin assays. The current educational document is the first from the C-CB highlighting important biochemical, analytical, and clinical aspects as they relate to the natriuretic peptides (NPs), including B-type natriuretic peptide (BNP) and N-terminal pro–B-type natriuretic peptide (NT-proBNP), with a focus on heart failure.

Download Full-text

Laboratory and Clinical Aspects of B-Type Natriuretic Peptides

Archives of Pathology & Laboratory Medicine ◽

10.5858/2004-128-697-lacaob ◽

2004 ◽

Vol 128 (6) ◽

pp. 697-699

Author(s):

Ronald J. Elin ◽

William E. Winter

Keyword(s):

Natriuretic Peptides ◽

Clinical Aspects

Download Full-text

Role of lysyl oxidase in myocardial fibrosis: from basic science to clinical aspects

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00335.2010 ◽

2010 ◽

Vol 299 (1) ◽

pp. H1-H9 ◽

Cited By ~ 150

Author(s):

Begoña López ◽

Arantxa González ◽

Nerea Hermida ◽

Félix Valencia ◽

Eduardo de Teresa ◽

...

Keyword(s):

Myocardial Fibrosis ◽

Lysyl Oxidase ◽

Left Ventricular ◽

Clinical Aspects ◽

Cross Linking ◽

Lv Function ◽

Cardiac Diseases ◽

Collagen Types ◽

And Function

Because of its dynamic nature, the composition and structure of the myocardial collagen network can be reversibly modified to adapt to transient cardiac injuries. In response to persistent injury, however, irreversible, maladaptive changes of the network occur leading to fibrosis, mostly characterized by the excessive interstitial and perivascular deposition of collagen types I and III fibers. It is now becoming apparent that myocardial fibrosis directly contributes to adverse myocardial remodeling and the resulting alterations of left ventricular (LV) anatomy and function present in the major types of cardiac diseases. The enzyme lysyl oxidase (LOX) is a copper-dependent extracellular enzyme that catalyzes lysine-derived cross-links in collagen and elastin. LOX-mediated cross-linking of collagen types I and III fibrils leads to the formation of stiff collagen types I and III fibers and their subsequent tissue deposition. Evidence from experimental and clinical studies shows that the excess of LOX is associated with an increased collagen cross-linking and stiffness. It is thus conceivable that LOX upregulation and/or overactivity could underlie myocardial fibrosis and altered LV mechanics and contribute to the compromise of LV function in cardiac diseases. This review will consider the molecular aspects related to the regulation and actions of LOX, namely, in the context of collagen synthesis. In addition, it will address the information related to the role of myocardial LOX in heart failure and the potential benefits of controlling its expression and function.

Download Full-text

Using natriuretic peptides to detect cardiac diseases in horses

Veterinary Record ◽

10.1136/vr.h6887 ◽

2015 ◽

Vol 177 (24) ◽

pp. 622-623 ◽

Cited By ~ 1

Author(s):

Aurélia A. Leroux

Keyword(s):

Natriuretic Peptides ◽

Cardiac Diseases

Download Full-text

Detection of atrial natriuretic peptides (ANP) in rat atria by immunogold-silver staining (IGSS)

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100169250 ◽

1994 ◽

Vol 52 ◽

pp. 304-305

Author(s):

Robyn Rufner ◽

Gerhard W. Hacker ◽

Michele Forte ◽

Nancyleigh E. Carson ◽

Cristina Xenachis ◽

...

Keyword(s):

Natriuretic Peptides ◽

Silver Staining ◽

Sodium Thiosulfate ◽

Atrial Natriuretic Peptides ◽

Paraffin Sections ◽

Glass Slides ◽

Metallic Salts ◽

Wistar Kyoto ◽

Right Atria

The use of immunogold-silver staining (IGSS) to enhance label penetration and Localization for immunocytochemistry or in situ hybridization utilizing a variety of metallic salts has been documented. In this morphological study, the effects of silver acetate, silver lactate and silver nitrate were evaluated for immunogold-labeling of a trial natriuretic peptides (ANP) in rat right atria.Eight Wistar Kyoto retired breeders were sedated with pentobarbital, perfused with either 4% paraformaldehyde (LM) or Karnovsky's fixative (EM), and right atria were dissected, processed, embedded in paraffin or epon, respectively and sectioned according to conventional methods. For light microscopy, an indirect IGSS method according to Hacker (3) was performed. Paraffin sections on glass slides were washed in ddH2O, immersed in Lugol's iodine, washed in ddH2O and treated with 2.5% aqueous sodium thiosulfate for 20 sec. After additional washes in ddH2O and TBS-0.1% fish gelatin, 10% normal goat serum (PBS with 1% BSA) was applied for 20 min before an overnight incubation at 4°C with a polyclonal α-ANP primary antibody (Peninsula Labs, 1:1000 in TBS/BSA).

Download Full-text

Clinical aspects of reactive oxygen and nitrogen species

Biochemical Society Symposium ◽

10.1042/bss0710121 ◽

2004 ◽

Vol 71 ◽

pp. 121-133 ◽

Cited By ~ 25

Author(s):

Ascan Warnholtz ◽

Maria Wendt ◽

Michael August ◽

Thomas Münzel

Keyword(s):

Oxidative Stress ◽

Reactive Oxygen Species ◽

Risk Factor ◽

Endothelial Dysfunction ◽

Vascular Tissue ◽

Rapid Development ◽

Reactive Oxygen ◽

Clinical Aspects ◽

No Production ◽

Oxygen Species

Endothelial dysfunction in the setting of cardiovascular risk factors, such as hypercholesterolaemia, hypertension, diabetes mellitus and chronic smoking, as well as in the setting of heart failure, has been shown to be at least partly dependent on the production of reactive oxygen species in endothelial and/or smooth muscle cells and the adventitia, and the subsequent decrease in vascular bioavailability of NO. Superoxide-producing enzymes involved in increased oxidative stress within vascular tissue include NAD(P)H-oxidase, xanthine oxidase and endothelial nitric oxide synthase in an uncoupled state. Recent studies indicate that endothelial dysfunction of peripheral and coronary resistance and conductance vessels represents a strong and independent risk factor for future cardiovascular events. Ways to reduce endothelial dysfunction include risk-factor modification and treatment with substances that have been shown to reduce oxidative stress and, simultaneously, to stimulate endothelial NO production, such as inhibitors of angiotensin-converting enzyme or the statins. In contrast, in conditions where increased production of reactive oxygen species, such as superoxide, in vascular tissue is established, treatment with NO, e.g. via administration of nitroglycerin, results in a rapid development of endothelial dysfunction, which may worsen the prognosis in patients with established coronary artery disease.

Download Full-text