Brain natriuretic peptide increases acutely and much more prominently than atrial natriuretic peptide during coronary angioplasty

Abstract

SummaryBackground: Increased levels of plasma brain natriuretic peptide (BNP) are observed in patients with congestive heart failure, hypertension, left ventricular hypertrophy, and acute myocardial infarction. However, there are no data on serial changes in plasma levels of BNP in patients undergoing coronary angioplasty.Hypothesis: The study was undertaken to examine plasma concentrations of BNP together with those of atrial natriuretic peptide (ANP) in patients undergoing percutaneous transluminal coronary angioplasty (PTCA).Methods: Plasma concentrations of BNP and ANP were examined in 13 patients with stable anginapectoris and good left ventricular function undergoing PTCA. Blood samples were taken from the femoral vein at baseline, after the first balloon inflation, after the end of the procedure, and 4 h thereafter.Results: Plasma BNP levels were 14 k 4 at baseline, 22 2 10 after the first balloon inflation, 28 f 12 at the end of the procedure, and 15+4pgr/ml4hthereafter(F= 13.05,p<O.ooOo1).

N -Terminal Pro–Brain Natriuretic Peptide and Other Risk Markers for the Separate Prediction of Mortality and Subsequent Myocardial Infarction in Patients With Unstable Coronary Artery Disease

“…19 Moreover, our study demonstrated that ongoing myocardial damage (ie, minimal troponin elevation), time since start of myocardial ischemia and damage, and the inflammatory response (ie, CRP elevation) were related to the magnitude of elevation of NTproBNP, further supporting the concept of BNP as a sensitive and rapid marker of reduced cardiac performance. This is in accordance with the recent report that BNP levels increase as a result of temporary occlusion of a coronary artery in conjunction with a coronary intervention, 20 even when intracardiac filling pressures remain unchanged. 21 …”

B-Type Natriuretic Peptide as a Marker of Resuscitation in Patients With Cardiac Arrest Outside the Hospital

“…Although the level of expression of the BNP gene in the left ventricle tripled within 4 h of a coronary ligation in an animal model, 22 the BNP concentration increased rapidly and transiently after exercise testing in patients with stable angina, after uncomplicated percutaneous transluminal coronary angioplasty, and after the onset of unstable angina. [23][24][25][26] We measured the BNP concentration once, within approximately 1 h of the cardiac arrest, and it is not possible to determine whether BNP is reflective of sudden cardiac arrest or of a pre-existing ventricular dysfunction from a single measurement. Half of the patients who die of acute myocardial infarction do so before reaching a hospital and in most of these deaths the presenting rhythm is ventricular fibrillation.…”

N-Terminal Pro-Brain Natriuretic Peptide on Admission Has Prognostic Value Across the Whole Spectrum of Acute Coronary Syndromes

“…CK-MB measurements were performed by local laboratories in each participating center, using commercial assays, at baseline and at 8,16, and 24 hours after admission.…”

“…11 Moreover, the magnitude of the increase may reflect the extent of the ischemic injury, elevations being detected soon after the onset of myocardial ischemia. 15,16 We measured NT-proBNP at a median time of 3 hours after the onset of ischemic symptoms. Such early increases may reflect the amount of the ischemic insult to the myocardium rather than the actual extent of myocardial necrosis.…”