Open AccessB-Type Natriuretic Peptide Predicts Clinical Presentations and Ventricular Overloading in Patients with Heart Failure
Author(s) -
Boyoung Joung,
Byung Eun Park,
Dong Soo Kim,
Bum–Kee Hong,
Yun Hyeong Cho,
Sang Hak Lee,
Young Won Yoon,
Hyun Seung Kim,
Jeong-Ho Kim,
Hyuck Moon Kwon
Publication year - 2003
Publication title -
yonsei medical journal/yonsei medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.702
H-Index - 63
eISSN - 1976-2437
pISSN - 0513-5796
DOI - 10.3349/ymj.2003.44.4.623
Subject(s) - medicine , heart failure , cardiology , exacerbation , natriuretic peptide , asymptomatic , ejection fraction , diastole , hemodynamics , brain natriuretic peptide , diastolic heart failure , blood pressure
Brain natriuretic peptide (BNP), a neurohormone secreted from the ventricular myocardium in response to hemodynamic load/wall stress, in congestive heart failure (CHF). This study was performed to evaluate the correlation between BNP level and clinical presentations and hemodynamic parameters obtained by echo-Doppler (echo-Doppler) analysis, and its relation with disease severity and ventricular load/wall stress. CHF patients (n=246) were subgrouped by clinical presentations and echo-Doppler findings into 4 groups: diastolic HF only, chronic HF, acute HF, and chronic HF with acute exacerbation. A BNP level of 81.2 pg/ml showed a sensitivity/ specificity of 53.3%/98.4% for detecting CHF (AUC, 0.882; p < 0.0001), and was found to be closely related with the NYHA classification (p < 0.0001). Log BNP was related with LVEF (r2=0.3015, p < 0.0001) and the Meridional wall stress index (r2=0.4052, p < 0.0001). The difference between the BNP levels of the subgroups and BNP control was significant (p < 0.0001), except between the HF group and the controls; control (n=114, 20.9 +/- 31.4 pg/ml), only diastolic HF (n=84, 89.8 +/- 117.6 pg/ml), chronic HF (n=60, 208.2 +/- 210.2 pg/ml), acute HF (n=28, 477.9 +/- 498.4 pg/ml), chronic HF with acute exacerbation (n= 74, 754.1 +/- 419.2 pg/ml). The BNP level was significantly higher in the only diastolic HF group than in the asymptomatic control group with diastolic dysfunction (89.8 +/- 12.8 vs. 22.8 +/- 5.1 pg/ml, p < 0.0001). BNP may be a good indicator for the differential diagnosis of a broad spectrum of heart failures. And, elevated BNP might help to diagnose diastolic HF in patients with diastolic dysfunction.