scholarly journals NT pro- B-type Natriuretic Peptide in the Small Ventricular Septal Defect in Children

2021 ◽  
Vol 9 (B) ◽  
pp. 1677-1680
Author(s):  
Rahmat Budi Kuswiyanto ◽  
Putria Apandi ◽  
Dany Hilmanto ◽  
Muhammad Hasan Bashari ◽  
Sri Endah Rahayuningsih
Keyword(s):  
Natriuretic Peptide ◽  
Transcatheter Closure ◽  
Volume Overload ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
Natriuretic Peptide Level ◽  
Peptide Level ◽  
Before And After ◽  
Male Patients

Background: Brain natriuretic peptide is a cardiac hormone secreted from the left ventricular myocardium due to ventricular expansion and volume overload. A recent study shows that small VSD will have risk of ventricular dysfunction in adulthood. Another complications such as endocarditis, congestive heart failure, aortic regurgitation, arrhythmia also we should be aware. Evaluations of the plasma B-type natriuretic peptide level (NT pro BNP) are currently being considered as methods to identify the possible presence of ventricular dilation in small VSD. Objective: To evaluate the change in plasma B-type natriuretic peptide after transcatheter closure of VSD. Methods: A pretest-posttest design was conducted on VSD patients before and after transcatheter closure. Plasma B-type natriuretic peptide level were measured before and 30 days after the transcatheter closure of VSD. Result: A total of 32 peri membranous VSD patients were included in this study with 62.5 % female patients (n=20) and 37.5 % male patients (n=12). A significant decrease was observed in the median NT pro BNP level when the level before closure of 1.08 (0.74 – 3.47) ng/ml was compared to the level after closure of 0.91 (0.68 – 2.07) ng/ml (p<0.05). Conclusion: Significant decreases in NT pro BNP level are seen in small VSD patients 30 days after transcatheter closure. Patients with small peri membranous VSD are generally considered to need occlusion for their childhood defect.  

Abstract 12667: Serum Brain Natriuretic Peptide Level as a Predictive Factor of Pre-Procedural Thrombi in Atrial Fibrillation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Takehiro Kimura ◽  
Seiji Takatsuki ◽  
Shin Kashimura ◽  
Yoshinori Katsumata ◽  
Takahiko Nishiyama ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Brain Natriuretic Peptide ◽  
Flow Velocity ◽  
Natriuretic Peptide ◽  
Predictive Factor ◽  
Left Ventricular ◽  
Brain Natriuretic Peptide Level ◽  
Left Ventricular Ejection ◽  
Natriuretic Peptide Level ◽  
Peptide Level

Introduction: A scheduled catheter ablation for atrial fibrillation (AF) can be postponed due to preexisting thrombi in the left atrial appendage (LAA) identified by trans-esophageal echocardiography (TEE). We aimed to elucidate the predictive factor for thrombi formation. Methods: A total of 372 AF ablation candidates (male, 312; age, 59.8±10.4 years; CHA2DS2-VASc, 1.3±1.3; paroxysmal, 219) were evaluated. Warfarin was administered in 226 patients and dabigatran in 146 patients. A pre-procedural TEE identified thrombi in 24 patients (6.5%: postponed group). The patient background, pre-procedural blood sample data, transthoracic echocardiography (TTE), and TEE were compared between the performed and postponed groups. Results: Thu number of patients with hypertension (P=0.040), vascular disease (P<0.001), sleep apnea syndrome (P<0.001), and a TEE performed during AF (P=0.001) were significantly higher in the postponed group. The type of AF (paroxysmal, 11) and anticoagulants (warfarin, 16) did not differ between the groups. The age (P=0.007), CHA2DS2-VASc score (P=0.015), average flow velocity of the LAA measured using TEE (P<0.001), left ventricular ejection fraction (LVEF; P=0.006), size of the left atrium (LA; P=0.001) measured using TTE, and serum brain natriuretic peptide level (BNP; 82.4±81.4 pg/ml vs. 236.7±141.9; P<0.001) were significantly higher in the postponed group. The prothrombin time (P=0.087) and activated clotting time (P=0.178) did not differ. A multivariate analysis adjusted for the confounding factors such as the age, CHA2DS2-VASc score, LAA flow velocity, LA size and LVEF revealed that a serum BNP level of >135 pg/ml was the independent predictive factor for LAA thrombi (odds ratio, 14.178; 95% confidence interval [CI], 2.907 to 69.149; P=0.001). The area under the receiver operating characteristic (ROC) curve (AUC) for predicting a thrombus with the serum BNP level was 0.860 (95% CI: 0.775 to 0.944). The sensitivity and specificity for predicting a thrombus with a BNP value of >135 pg/ml were 81.8% and 83.6%, respectively. Conclusions: A serum BNP level of >135 pg/ml might be a noninvasive predictive factor for LAA thrombi in AF patients under anticoagulation therapy with warfarin and dabigatran.

scholarly journals N-terminal pro brain natriuretic peptide as a cardiac biomarker in Japanese hemodialysis patients

2018 ◽  
Vol 41 (3) ◽  
pp. 135-143 ◽  
Author(s):  
Minako Shimizu ◽  
Shigehiro Doi ◽  
Ayumu Nakashima ◽  
Takayuki Naito ◽  
Takao Masaki
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Odds Ratio ◽  
Ventricular Hypertrophy ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Ultrafiltration Rate ◽  
Natriuretic Peptide Level ◽  
Peptide Level

Purpose: This study examined the clinical significance of N-terminal pro brain natriuretic peptide level as a cardiac marker in Japanese hemodialysis patients. Methods: This was a multicenter cross-sectional study involving 1428 Japanese hemodialysis patients. Ultrasonic cardiography data at post-hemodialysis were obtained from 395 patients. We examined whether serum N-terminal pro brain natriuretic peptide levels were associated with cardiac parameters and assessed cut-off values and investigated factors associated with a reduced ratio of N-terminal pro brain natriuretic peptide levels pre- and post-hemodialysis. Results: Multivariate logistic regression analysis showed that pre- and post-hemodialysis N-terminal pro brain natriuretic peptide levels were associated with left ventricular hypertrophy on electrocardiogram (odds ratio: 3.10; p < 0.001 at pre-hemodialysis and odds ratio: 2.70; p < 0.001 at post-hemodialysis) and left ventricular hypertrophy on ultrasonic cardiography (odds ratio: 3.06; p < 0.001 at pre-hemodialysis and odds ratio: 3.15; p < 0.001 at post-hemodialysis). Post-N-terminal pro brain natriuretic peptide levels were also significantly associated with ejection fraction on urine chorionic gonadotrophin (ultrasonic cardiography; odds ratio: 35.83; p < 0.001). Receiver operating characteristic curves for predicting the presence of left ventricular hypertrophy on electrocardiogram and ultrasonic cardiography showed similar sensitivity (57.7%, 57.3% at pre-hemodialysis and 63.9%, 48.2% at post-hemodialysis) and specificity (66.5%, 72.9% at pre-hemodialysis and 59.2%, 81.9% at post-hemodialysis). Decreased ejection fraction on ultrasonic cardiography showed better sensitivity (78.6%) and specificity (88.7%). The N-terminal pro brain natriuretic peptide reduction ratio during a hemodialysis session correlated with Kt/V, membrane area, membrane type, modality, body weight gain ratio, treatment time, and ultrafiltration rate with multiple linear regression ( R: 0.53; p < 0.001 except for ultrafiltration rate ( p = 0.003)). Conclusion: Both pre- and post-hemodialysis N-terminal pro brain natriuretic peptide are associated with the presence of left ventricular hypertrophy in this population. The post-hemodialysis N-terminal pro brain natriuretic peptide level is a useful marker for systolic dysfunction.

Abstract 382: Kidney-Heart Connection: One Kidney Nephrectomy Results in Cardiac Fibrosis and Differential Ventricular Gene Profiles in the Absence of Heart Failure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Fernando L Martin ◽  
Brenda K Huntley ◽  
Gerald E Harders ◽  
John C Burnett
Keyword(s):  
Renal Insufficiency ◽  
Renal Dysfunction ◽  
Microarray Analysis ◽  
Volume Overload ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Unilateral Nephrectomy ◽  
Left Ventricular Myocardium ◽  
Cardiovascular Morbidity And Mortality ◽  
Mild Renal Insufficiency

Background: Decreased renal function is associated with increased cardiovascular morbidity and mortality by mechanisms that remain unclear. We hypothesized that even mild renal insufficiency produced by unilateral nephrectomy results in changes in ventricular structure and gene expression in the absence of hypertension or volume overload underscoring a kidney-heart connection in the control of myocardial structure. Methods: Cardiorenal function and structure were assessed in Wistar rats [sham (S; n=10) and unilateral nephrectomized (UNX; n=9)] 4 weeks after UNX. GFR was determined by inulin clearance and renal blood flow (RBF) by PAH. Blood was obtained for BNP, PRA, and aldosterone. Hearts and kidneys were harvested for histological analysis. Cardiac function was assessed by echo. Genome-wide microarray analysis was performed on left ventricular myocardium (Affymetrix GeneChip® Rat Genome 230 2.0). Results: Glomerular hypertrophy was observed in UNX (S:1±0.04, Nx:1.6±0.1 u3x106, p<0.001). GFR tended to decrease with a reduction in RBF (S:8±1, Nx:5±1 ml/min, p<0.005). Sodium and water excretions were not different between groups with no activation of PRA, aldosterone or BNP. LVEF and LV end-systolic and end-diastolic diameters were normal. Blood pressure (BP) was not different between groups. Importantly, Picrosirius Red staining in the ventricular myocardium of UNX compared to S revealed greater fibrosis (S:2.4±0.1, Nx:4.2±0.4 %, p<0.001). Further, microarray analysis of ventricular myocardium revealed that 278 genes significantly changed with UNX (1.5 fold, P<0.05) compared to S in genes related to cell growth, bone remodeling and muscle contraction (Z value>2). Conclusion: We conclude that even mild renal insufficiency produced by unilateral nephrectomy initiates myocardial gene responses and fibrosis independent of alterations in the circulating RAAS, BNP, BP, volume overload or systolic dysfunction. These studies support a kidney - heart connection in early renal dysfunction resulting in molecular ventricular remodeling and fibrosis. These studies in experimental mild renal dysfunction produced by removal of one kidney reveal a renal mediated mechanism for myocardial remodeling.

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