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Independent effects of both right and left ventricular function on plasma brain natriuretic peptide
Author(s) -
Vogelsang Thomas Wiis,
Jensen Ruben J.,
Monrad Astrid L.,
Russ Kaspar,
Olesen Uffe H.,
Hesse Birger,
Kjær Andreas
Publication year - 2007
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2007.05.015
Subject(s) - ejection fraction , cardiology , medicine , radionuclide ventriculography , heart failure , brain natriuretic peptide , natriuretic peptide , ventricular function
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 ventricular ejection fraction (LVEF), and left ventricular end‐diastolic volume index (LVEDVI) were determined in 105 consecutive patients by first‐pass radionuclide ventriculography (FP‐RNV) and multiple ECG‐gated equilibrium radionuclide ventriculography (ERNV), respectively. BNP was analyzed by immunoassay. Results Mean LVEF was 0.51 (range 0.10–0.83) with 36% having a reduced LVEF (<0.50). Mean RVEF was 0.50 (range 0.26–0.78) with 43% having a reduced RVEF (<0.50). The mean LVEDVI was 92 ml/m 2 with 22% above the upper normal limit (117 ml/m 2 ). Mean BNP was 239 pg/ml range (0.63–2523). In univariate linear regression analysis LVEF, LVEDVI and RVEF all correlated significantly with log BNP ( p <0.0001). In a multivariate analysis only RVEF and LVEF remained significant. The parameter estimates of the final adjusted model indicated that RVEF and LVEF influence on log BNP were of the same magnitude. Conclusion BNP, 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.