Associations between atrial natriuretic peptides, echocardiographic findings and mortality in an elderly population sample

Iivanainen, A. M.; Tikkanen, Ilkka; Tilvis, Reijo S.; Heikkilä, J; Helenius, T; Kupari, Markku

doi:10.1046/j.1365-2796.1997.113124000.x

Cited by 22 publications

(17 citation statements)

References 39 publications

(49 reference statements)

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“…In terms of population based work the only other study of the power of BNP in determining subsequent all cause prognosis is that of Wallen and colleagues,21 who similarly found BNP to be the best predictor of death in 541 elderly patients over the age of 85 years. Other work in an elderly population has also shown that ANP is associated with an adverse prognosis 22. This work reinforces the earlier studies in patient populations, which have vindicated the utility of BNP in determining mortality after myocardial infarction and in CHF 12-15…”

Section: Discussionsupporting

confidence: 82%

Left ventricular dysfunction, natriuretic peptides, and mortality in an urban population

McDonagh

Cunningham²,

Morrison³

et al. 2001

Heart

229

142

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Objective-To report the mortality of left ventricular systolic dysfunction (LVD), assessed objectively by echocardiography, and its association with natriuretic peptide hormones in a random sample of 1640 men and women aged 25-74 years from a geographical, urban population. Methods-Left ventricular function was measured by echocardiography in 1640 attendees studied in 1992-3. LVD was defined as a left ventricular ejection fraction (LVEF) < 30%. Plasma concentrations of N-terminal atrial natriuretic peptide (N-ANP) and brain natriuretic peptide (BNP) were measured by standard radioimmunoassays. Mortality was documented at four years. Results-The four year all cause mortality rate in the whole cohort was 4.9% (80 deaths). It was 21% (nine deaths) in those with an LVEF < 30% and 4% in those whose LVEF was > 30% (p < 0.001). The median (interquartile range) BNP concentration in those who died was 16.9 pg/ml (8.8-27) and 7.8 pg/ml (3.4-13) in survivors (p < 0.0001). Similarly, N-ANP had a median concentration of 2.35 ng/ml (1.32-3.36) in those with a fatal outcome and 1.27 ng/ml (0.9-2.0) in those alive at four years (p < 0.0001). Subjects with an LVEF < 40% also had a significant mortality rate of 17% if they also had a BNP concentration > 17.9 pg/ml compared with 6.8% if their BNP was below this concentration (p = 0.013). Multivariate analysis revealed the independent predictors of four year all cause mortality to be increasing age (p < 0.001), a BNP concentration > 17.9 pg/ml (p = 0.006), the presence of ischaemic heart disease (p = 0.03), and male sex (p = 0.04). Conclusions-LVD is associated with a considerable mortality rate in this population. BNP also independently predicts outcome. In addition to its role as a diagnostic aid in chronic heart failure and LVD, it provides prognostic information and clarifies the meaning of a given degree of LVD.

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Section: Discussionsupporting

confidence: 82%

Left ventricular dysfunction, natriuretic peptides, and mortality in an urban population

McDonagh

Cunningham²,

Morrison³

et al. 2001

Heart

229

142

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“…Although plasma ANP and BNP levels have previously been reported to be elevated in patients with essential hypertension [6,7], NT-proBNP has recently been shown to be normal unless systolic dysfunction develops [9]. Plasma BNP level was dependent on left ventricular mass as reported previously for ANP [7], NT-proANP [10,11] and BNP [6]. The stronger correlation for BNP than for ANP is in agreement with its origin from the ventricular muscle in contrast to ANP secreted by both atria and ventricles [4].…”

Section: Discussionsupporting

confidence: 58%

“…Their increase in hypertension seems to be related to the degree of left ventricular hypertrophy [6][7][8], although no correlation between left ventricular mass and NT-proBNP was found in a recent study [9]. Plasma NT-proANP level is also correlated with left ventricular mass in the general population [10,11]. Plasma concentrations of natriuretic peptides may also increase in hypertension without left ventricular hypertrophy [12,13] and patients with diastolic dysfunction [14 -16].…”

Section: Introductionmentioning

confidence: 99%

Plasma B-type natriuretic peptide reflects left ventricular hypertrophy and diastolic function in hypertension

Uusimaa

Tokola

Ylitalo

et al. 2004

International Journal of Cardiology

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“…Several early studies found increased peptide concentrations in patients with mitral regurgitation but none of these distinguished patients with ischaemic regurgitation from those with non-ischaemic regurgitation. [25][26][27] In a population based study of elderly people living in Finland, N-terminal ANP was significantly increased in those with moderate or severe mitral regurgitation. 25 A study of patients with suspected LV dysfunction also found an association between NT-proBNP and the severity of mitral regurgitation.…”

mentioning

confidence: 99%

Natriuretic peptides in heart valve disease

Ray

2006

Heart

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Synthesis and release of B-type natriuretic peptide (BNP) are increased in heart failure, and plasma concentrations provide important therapeutic and prognostic information. Recent studies have shown that BNP concentrations are also increased with disease of the mitral and aortic valves. The extent of the increase is broadly related to the severity of the valve abnormality and the degree of consequent cardiac remodelling. BNP concentrations appear to relate to prognosis in these patients and might have a role in identifying suitable candidates for cardiac surgery. This paper reviews the current literature and identifies areas where further research is required if assessment of BNP is to be of practical use.

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Associations between atrial natriuretic peptides, echocardiographic findings and mortality in an elderly population sample

Cited by 22 publications

References 39 publications

Left ventricular dysfunction, natriuretic peptides, and mortality in an urban population

Left ventricular dysfunction, natriuretic peptides, and mortality in an urban population

Plasma B-type natriuretic peptide reflects left ventricular hypertrophy and diastolic function in hypertension

Natriuretic peptides in heart valve disease

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