B Type natriuretic peptide: a good omen in myocardial ischaemia?

D’Souza, Savio

doi:10.1136/heart.89.7.707

Cited by 49 publications

(38 citation statements)

References 20 publications

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“…In humans, elevated concentrations of plasma BNP were detected following unstable angina [32]. These reports suggest that BNP has additional, tissue protecting effects beyond its natriuretic and cardiac unloading properties [33]. In addition, BNP exerts potent actions on cell growth and proliferation of fibroblasts, vascular smooth muscle cells and cardiac myocytes [34 -37].…”

Section: Discussionmentioning

confidence: 98%

Impact of cardiac surgery on plasma levels of B-type natriuretic peptide in children with congenital heart disease

Koch

Kitzsteiner

Zink

et al. 2007

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 98%

Impact of cardiac surgery on plasma levels of B-type natriuretic peptide in children with congenital heart disease

Koch

Kitzsteiner

Zink

et al. 2007

International Journal of Cardiology

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“…The responsible mechanisms still remain to be fully elucidated, but both experimental and clinical myocardial infarction is associated with gradual and sustained elevation of circulating BNP levels [29] and cardiac BNP expression as verified by cardiac biopsies of hypoxic ventricular areas is of the same magnitude in patients with CAD and with normal left ventricular function as in patients with congestive heart failure but no myocardial ischemia [29]. Furthermore, NT-proBNP has emerged as a potential tool in the diagnosis and therapy of CVD besides heart failure [13], [15], [30].…”

Section: Discussionmentioning

confidence: 99%

NT-proBNP and Circulating Inflammation Markers in Prediction of a Normal Myocardial Scintigraphy in Patients with Symptoms of Coronary Artery Disease

et al. 2010

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BackgroundMyocardial perfusion imaging (MPI) can detect myocardial perfusion abnormalities but many examinations are without pathological findings. This study examines whether circulating biomarkers can be used as screening modality prior to MPI.Methodology/Principal Findings243 patients with an intermediate risk of CAD or with known CAD with renewed suspicion of ischemia were referred to MPI. Blood samples were analyzed for N-terminal fragment of the prohormone brain natriuretic peptide (NT-proBNP), YKL-40, IL-6, matrix metalloproteinase 9 (MMP-9) and high sensitive C-reactive protein (hsCRP). Patients with myocardial perfusion defects had elevated levels of NT-proBNP (p<0.0001), YKL-40 (p = 0.03) and IL-6 (p = 0.03) but not of hsCRP (p = 0.58) nor of MMP-9 (p = 0.14). The NT-proBNP increase was observed in both genders (p<0.0001), whereas YKL-40 (p = 0.005) and IL-6 (p = 0.02) were elevated only in men. A NT-proBNP cut off-concentration at 25 ng/l predicted a normal MPI with a negative predictive value >95% regardless of existing CAD.Conclusions20-25% of patients suspected of CAD could have been spared a MPI by using a NT-proBNP cut-off concentration at 25 ng/l with a negative predictive value >95%. NT-proBNP has the potential use of being a screening marker of CAD before referral of the patient to MPI.

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“…Recent human data also suggest that BNP is overexpressed in ischemic myocardium (39). These observations have raised the possibility that early activation of natriuretic peptides, by exerting cytoprotective actions, may represent an important physiological response to myocardial ischemia (40).…”

Section: Bnp and Myocardial Ischemia: Potential Mechanismsmentioning

confidence: 98%

Clinical and Laboratory Diagnostics of Cardiovascular Disease: Focus on Natriuretic Peptides and Cardiac Ischemia

Omland

2005

Scandinavian Journal of Clinical and Laboratory Investigation

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Chest pain is the most common clinical presentation of acute ischemic heart disease, but only one third of these patients are ultimately found to have an acute coronary syndrome. Initial assessment of the patient presenting with chest pain includes a careful history, physical examination, an initial electrocardiogram (ECG) and measurement of biochemical markers of myocardial injury. The natriuretic peptide system is activated in a broad spectrum of cardiovascular diseases, including acute coronary syndromes and stable coronary disease. A strong relation between plasma levels of B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) obtained in the subacute phase, and long-term, all-cause mortality, as well as the rate of re-admissions for heart failure after myocardial infarction, has been documented. Persistently elevated NT-proBNP levels during the first 72 hours following admission for an acute coronary syndrome have recently been associated with the presence of refractory ischemia and high risk of short-term recurrent ischemic events. Patients with signs of exercise-induced ischemia by dobutamine stress echocardiography have been reported to have higher baseline BNP values. Moreover, BNP and NT-proBNP levels are increased acutely in proportion to the magnitude of the inducible perfusion defect observed during stress testing, suggesting that BNP and NT-proBNP are markers of acute ischemia. Recently, a relationship between circulating levels of BNP and NT-proBNP and long-term all cause mortality in patients with stable coronary artery disease has been documented.

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B Type natriuretic peptide: a good omen in myocardial ischaemia?

Cited by 49 publications

References 20 publications

Impact of cardiac surgery on plasma levels of B-type natriuretic peptide in children with congenital heart disease

Impact of cardiac surgery on plasma levels of B-type natriuretic peptide in children with congenital heart disease

NT-proBNP and Circulating Inflammation Markers in Prediction of a Normal Myocardial Scintigraphy in Patients with Symptoms of Coronary Artery Disease

Clinical and Laboratory Diagnostics of Cardiovascular Disease: Focus on Natriuretic Peptides and Cardiac Ischemia

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