Atrial natriuretic peptides predict mortality in the elderly

Wallén, Thomas; Landahl, Sten; Hedner, Thomas; Hall, Christian; Saito, Yoshihiko; Nakao, Kazuwa

doi:10.1046/j.1365-2796.1997.128149000.x

Cited by 26 publications

(12 citation statements)

References 19 publications

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“…The repeated measurement of ANS activity along with other conditions associated with ANS activity levels, such as physical activity [62,63] , diseases including hypertension [64][65][66][67] , orthostatic hypotension [68][69][70] , and its biological markers [71] , sleep-related breathing disorders, diabetes mellitus, obesity, and the inflammatory status will provide a unique opportunity to describe the chronology of predictors and events. Consequently, the assessment of the inflammatory status is of particular importance as it may be a major factor of ANS activity alteration as neural control of inflammation is reflexive, directly interconnected and controllable [72] .…”

Section: Discussionmentioning

confidence: 99%

Autonomic Nervous System Activity and Decline as Prognostic Indicators of Cardiovascular and Cerebrovascular Events: The ‘PROOF’ Study

Barthélémy

Pichot

Dauphinot³

et al. 2007

Neuroepidemiology

110

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Background: Transversal studies have underlined the association between the decline in autonomic nervous system (ANS) activity and all-cause mortality. However, the predictive value of ANS has never been prospectively assessed in a general population-based cohort. Method: The PROOF (PROgnostic indicator OF cardiovascular and cerebrovascular events) cohort study was designed to prospectively assess the predictive value of ANS activity level in the general population, with regard to cardiovascular and cerebrovascular events, and death. This predictive power will be compared with the usual and newly discovered risk factors for the purposes of developing a risk model. Results: A prospective cohort of elderly subjects aged 65 years upon study entry were recruited from the electoral list of the city of Saint-Etienne, France. Three initial 2-year examination programs were scheduled for 7 years (2001–2007), followed by late events monitoring. At each examination, ANS activity was assessed along with clinical and biological cardiovascular risk factors, brain MRI, neuropsychological evaluation, physical activity profile, and sleep-related breathing disorders. The main study outcomes are stroke, myocardial infarction and death from any cause. A cohort consisting of 1,011 subjects aged 65.6 (0.8) years was constituted. Conclusion: Despite other selective characteristics, the associations between ANS activity and events will be applicable to other populations.

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Section: Discussionmentioning

confidence: 99%

Autonomic Nervous System Activity and Decline as Prognostic Indicators of Cardiovascular and Cerebrovascular Events: The ‘PROOF’ Study

Barthélémy

Pichot

Dauphinot³

et al. 2007

Neuroepidemiology

110

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“…Raised plasma levels of ANP, and of N-terminal proANP, have also been associated with increased mortality in elderly people [85]. Interestingly, this could not be explained entirely by overt heart disease at the time of sampling, suggesting increased peptide levels even in those with intrinsic asymptomatic cardiac disease.…”

Section: Prognostic Significancementioning

confidence: 99%

“…Indeed, knowledge of renal function (or plasma creatinine at least) is essential to eliminate renal failure as a possible cause of raised plasma levels. Moreover, the measurement of plasma BNP to discriminate whether in patients admitted with dyspnoea, the dyspnoea is due to acute lung disease or to heart [84,85] failure [91], should be used with caution as raised levels of BNP have also been found in patients with primary obstructive airway disease [92]. Despite these limitations, knowledge of plasma levels of natriuretic peptides may provide useful information about cardiac structure and function in several situations ( Table 2).…”

Section: Perspectivesmentioning

confidence: 99%

Measurement and significance of circulating natriuretic peptides in cardiovascular disease

1998

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1. The major cardiovascular and renal actions of alpha-atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) and the fact that the heart is strategically located to sense changes in intravascular volume indicate the importance of these peptides in the overall control of the extracellular fluid volume under normal and pathophysiological conditions.2. This review examines the clinical and diagnostic significance of the measurement of plasma natriuretic peptides in diseases of the cardiovascular system with particular emphasis on the assessment of patients with heart failure. 3. Raised plasma levels of ANP and BNP have repeatedly been found in patients with heart disease originating from diverse causes including tachycardias, valvular stenosis or ventricular dysfunction. The raised circulating levels of natriuretic peptide (ANP, N-terminal proANP and BNP in particular) are associated with (i) raised atrial and pulmonary wedge pressures; (ii) reduced ventricular systolic and diastolic function; (iii) presence (and possibly geometric form) of left ventricular hypertrophy; and (iv) severe myocardial infarction. Although both plasma ANP and BNP are raised in the presence of left ventricular hypertrophy, BNP appears to be a better index of left ventricular hypertrophy.4. Several situations where the measurement of natriuretic peptides may be of benefit in the overall assessment of heart disease are discussed. However, it is emphasized that the measurement of plasma natriuretic peptides alone appears to be of limited value as a specific diagnostic tool, given that raised levels are a consequence of haemodynamic and structural abnormalities arising from diverse pathological processes. Despite these limitations, the major value of plasma natriuretic peptides in the examination of patients with suspected heart disease rests on the premise that: (i) a normal value would not be consistent with cardiac disease; (ii) the presence of markedly raised levels may help to target those for subsequent detailed assessment of underlying cardiac dysfunction; and (iii) markedly raised levels of plasma natriuretic peptides after myocardial infarction can identify those at high risk of death.

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“…It has already been documented that natriuretic peptides are powerful prognostic indicators in patients with chronic heart failure and myocardial infarction [36][37][38] . A recent population-based study in octogenarians also suggested that natriuretic peptides may provide prognostic information in an unselected population of elderly subjects [39] . The ability of natriuretic peptides to integrate information concerning ventricular mass and systolic function, both strong markers of cardiovascular risk, indicates that natriuretic peptide measurements may be strongly associated with cardiovascular mortality in the general population as well.…”

Section: Prediction Of Ventricular Hypertrophy By N-anp 759mentioning

confidence: 99%

Circulating N-terminal pro-atrial natriuretic peptide is an independent predictor of left ventricular hypertrophy in the general population The Tromsø Study

Schirmer

Omland²

1999

European Heart Journal

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Purpose The purpose of this study was to determine whether circulating N-terminal pro-atrial natriuretic peptide (N-ANP) levels predict left ventricular hypertrophy in the general population after adjustment for relevant risk factors. Method and ResultsIn a population-based sample of 3287 subjects aged 25-85 years, circulating N-ANP was measured in a subgroup of 389 subjects. Left ventricular mass and ejection fraction were determined by twodimensional guided M-mode echocardiography. Left ventricular hypertrophy was defined as height adjusted mass above 145·5 g . m 1 and 125·4 g . m 1, in men and women, respectively. Fifty-one subjects with left ventricular hypertrophy had significantly higher N-ANP levels than controls (1075 vs 763 pmol . l 1 ; P<0·0001). A gradually increasing prevalence of left ventricular hypertrophy over increasing 500 pmol . l 1 intervals of N-ANP was observed (1·8 to 64·3%; (Chi-squared P for trend <0·001). N-ANP was an independent predictor of left ventricular hypertrophy after adjustment for ejection fraction, body mass index, hypertension, valvular disease, a history of myocardial infarction, gender, and age. The adjusted odds ratio for left ventricular hypertrophy was 1·79 (95% CI 1·04-3·07) for a 500 pmol . l

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Atrial natriuretic peptides predict mortality in the elderly

Abstract: Abstract. Walle! n T,

Cited by 26 publications

References 19 publications

Autonomic Nervous System Activity and Decline as Prognostic Indicators of Cardiovascular and Cerebrovascular Events: The ‘PROOF’ Study

Autonomic Nervous System Activity and Decline as Prognostic Indicators of Cardiovascular and Cerebrovascular Events: The ‘PROOF’ Study

Measurement and significance of circulating natriuretic peptides in cardiovascular disease

Circulating N-terminal pro-atrial natriuretic peptide is an independent predictor of left ventricular hypertrophy in the general population The Tromsø Study

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