Methods Inf Med 2000; 39(03): 249-253
DOI: 10.1055/s-0038-1634337
Original Article
Schattauer GmbH

Significance of Brain Natriuretic Peptide Measurement as a Diagnostic Indicator of Cardiac Function

S. Waku
1   Kansai University, Health Administration Center, Osaka
,
N. Iida
1   Kansai University, Health Administration Center, Osaka
,
T. Ishihara
2   The First Department of Internal Medicine, Osaka Medical College, Osaka, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
07 February 2018 (online)

Abstract

Brain natriuretic peptide (BNP) is increased in patients with heart failure due to myocardial infarction and cardiac hypertrophy, in proportion to the severity of left ventricular dysfunction. The aims of this study were to clarify the clinical features of BNP and to determine the diagnostic value of BNP for mass screening.

The subjects were 818 office workers (565 males and 253 females; mean age 47 ± 12 years) who participated in a 1996 routine health check at Kansai University All individuals were examined for blood pressure, serological findings, ECG and plasma BNP level. Thirty-three males underwent 2-D echocardiography. Plasma BNP levels were measured using IRMA (immunoradiometric assay).

The results were as follows: (1) BNP levels in females were higher than those in males for healthy subjects (N = 551), in each age group from 20 to 60 years. (2) BNP levels increased with age. (3) There were significant correlations between BNP level and systolic blood pressure and creatinine level. (4) There were significant differences in BNP level between the hypertensive groups with and without hypertensive ECG changes and the age-matched healthy control group. (5) Marked correlations were observed between BNP level and left ventricular wall thickness, fractional shortening, deceleration time and peak early filling velocity. (6) A BNP cut-off-point of 25 pg/ml was best for detecting LV diastolic dysfunction and LV hypertrophy. Measurement of BNP is useful for detecting asymptomatic heart failure in the general population, and is a clinical marker useful in preventing symptomatic heart failure.

 
  • REFERENCES

  • 1 Dougherty AH, Naccarelli GV, Gray EL. et al. Congestive heart failure with normal systolic function. Am J Cardiol 1984; 54: 778-82.
  • 2 Soufer R, Wohlgelernter D, Vita NA. et al. Intact systolic left ventricular function in clinical congestive heart failure. Am J Cardiol 1985; 55: 1032-5.
  • 3 Motwani JG, McAlpine H, Kennedy N. et al. Plasma brain natriuretic peptide as an indicator for angiotensin-converting enzyme inhibition after myocardial infarction. Lancet 1993; 341: 1109-13.
  • 4 Buckley MG, Markandu ND, Miller MA. et al. Plasma concentrations and comparisons of brain and atrial natriuretic peptide in normal subjects and in patients with essential hypertension. J Hum Hypertension 1993; 7: 245-50.
  • 5 Kohno M, Horio T, Yokokawa K. et al. Brain natriuretic peptide as a cardiac hormone in essential hypertension. Am J Med 1992; 92: 29-34.
  • 6 Nishikimi T, Yoshihara F, Morimoto A. et al. Relationship between left ventricular geometry and natriuretic peptide levels in essential hypertension. Hypertension 1996; 28: 22-30.
  • 7 McDonagh TA, Robb SD, Murdoch JJ. et al. Biochemical detection of left ventricular systolic dysfunction. Lancet 1998; 351: 9-13.
  • 8 Cowie MR, Struthers AD, Wood DA. et al. Value of natriuretic peptides in assessment of patients with possible new heart failure in primary care. Lancet 1997; 350: 1349-53.
  • 9 Sudoh T, Kangawa K, Minamino N. et al. A new natriuretic peptide in porcine brain. Nature 1988; 332: 78-81.
  • 10 Mukoyama M, Nakao K, Hosoda K. et al. Brain natriurtic peptide as a novel cardiac hormone in humans. J Clin Invest 1991; 87: 1402-12.
  • 11 McGregor A, Richard SM, Espiner E. et al. Brain natriuretic peptide administered to man: actions and metabolism. J Clin Endocrinol Metab 1990; 70: 1103-7.
  • 12 Motwani JG, McAlpine H, Kennedy N. et al. Plasma brain natriuretic peptide as an indicator for angiotensin-converting-enzyme inhibition after myocardial infarction. Lancet 1993; 341: 1109-13.
  • 13 Needleman P, Greenwald JE. Atriopeptin: a cardiac hormone intimately involved in fluid, electrolyte, and blood pressure homeostasis. N Engl J Med 1986; 314: 828-34.
  • 14 Dunn BR, Ichikawa I, Pfeffer JM. et al. Renal and systemic hemodynamic effect of synthetic atrial natriuretic peptide in the anesthetized rat. Circ Res 1986; 59: 237-46.
  • 15 Yasue H, Yoshimura M, Shimada H. et al. Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure. Circulation 1994; 90: 195-203.
  • 16 Mukoyama M, Nakao K, Saito Y. et al. Human brain natriuretic peptide, a novel cardiac hormone. Lancet 1990; 335: 801.
  • 17 Koren MJ, Devereux RB, Casale PN. et al. Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 1991; 114: 345-52.