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

Schirmer, Henrik; Omland, Torbjørn

doi:10.1053/euhj.1998.1396

Cited by 37 publications

(18 citation statements)

References 41 publications

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“…After adjustment for age, gender, and pulse pressure, high serum Nt-proBNP was related to reduced LV systolic function, LV mass index, and UACR but not to PWV, indicating that the previously demonstrated relationship between high serum Nt-proBNP and LV hypertrophy 6 and albuminuria 7,8 do not just reflect parallel age-or load-related changes. This BP-independent relationship was especially clear in the older age group and may reflect subclinical coronary artery disease.…”

Section: Nt-probnp In Relation To Subclinical CV Damagementioning

confidence: 74%

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N-Terminal Pro Brain Natriuretic Peptide Is Inversely Related to Metabolic Cardiovascular Risk Factors and the Metabolic Syndrome

et al. 2005

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Abstract-We wanted to investigate the relationship of N-terminal pro brain natriuretic peptide (Nt-proBNP) The metabolic syndrome was associated with lower Nt-proBNP (35 pg/mL versus 48 pg/mL; PϽ0.001) and shifted the positive relationship between pulse pressure and Nt-proBNP to the right (ie, higher blood pressure for a given level of Nt-proBNP). The metabolic syndrome was associated with lower Nt-proBNP levels and shifted the positive relationship between Nt-proBNP and pulse pressure to the right, creating a possible link between the metabolic syndrome and hypertension. Key Words: risk factors Ⅲ albuminuria Ⅲ hypertrophy Ⅲ natriuretic peptides Ⅲ obesity B rain natriuretic peptide (BNP) is synthesized in myocardial cells as a response to increased wall stress 1 in relation to heart failure 2 or acute myocardial ischemia 3 as a prohormone that is cleaved into BNP and N-terminal proBNP (Nt-proBNP). High BNP as well as high NtproBNP are new promising cardiovascular (CV) risk markers 4 and have been associated with high blood pressure (BP), 5 left ventricular (LV) hypertrophy, 6 and albuminuria. 7,8 Because Nt-proBNP as well as BP, LV mass, and albuminuria increase with aging, it is unclear whether these associations merely rely on aging. Wang et al 9 demonstrated recently an inverse relationship between serum BNP and body mass index that could be a potential link between obesity and hypertension if obese patients have lower BNP levels at given levels of wall stress. However, others have not found this association, 10 and it has been suggested recently that the inverse relationship between BNP and body mass index may only reflect an increase in BNP and a decrease in body mass index with aging. 11 No studies of the effect of obesity or other elements of the metabolic syndrome on Nt-proBNP are available.Therefore, the aim of the present study was to evaluate the association of Nt-proBNP to metabolic and hemodynamic CV risk factors, including the metabolic syndrome, 24-hour ambulatory BP, LV hypertrophy, pulse wave velocity (PWV), and urine albumin/creatinine ratio (UACR) in 4 different age groups to control for age.

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Section: Nt-probnp In Relation To Subclinical CV Damagementioning

confidence: 74%

“…High BNP as well as high NtproBNP are new promising cardiovascular (CV) risk markers 4 and have been associated with high blood pressure (BP), 5 left ventricular (LV) hypertrophy, 6 and albuminuria. 7,8 Because Nt-proBNP as well as BP, LV mass, and albuminuria increase with aging, it is unclear whether these associations merely rely on aging.…”

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confidence: 99%

N-Terminal Pro Brain Natriuretic Peptide Is Inversely Related to Metabolic Cardiovascular Risk Factors and the Metabolic Syndrome

et al. 2005

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“…59 The functions of ANP are not only restricted to blood pressure homeostasis but also seem to involve the immune system. 60 Production of ANP and BNP is stimulated in pathologic conditions; plasma levels of these peptides are increased in subjects with left ventricular hypertrophy, 61 asymptomatic ventricular dysfunction, 62,63 and overt heart failure. 64,65 Considerable attention has been focused on the potential utility of plasma levels of these peptides to establish a diagnosis of heart failure or in identifying left ventricular dysfunction.…”

Section: Natriuretic Peptides Contribute To the Control Of Lipolysis mentioning

confidence: 99%

“…In subjects with congestive heart failure or ventricle hypertrophy, plasma levels of NPs (especially BNP) are very high. [61][62][63][64]112 Type 2 Diabetes Most patients with type 2 diabetes are overweight or obese. 113 They experience day-long elevations in plasma NEFA concentration which escape to the normal suppression by meals or glucose load.…”

Section: ␤-Ar Antagonist Treatmentmentioning

confidence: 99%

An Unsuspected Metabolic Role for Atrial Natriuretic Peptides

Lafontan

Moro

Sengenès

et al. 2005

ATVB

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Abstract-In normal and obese humans, lipid mobilization and systemic nonesterified fatty acid levels are thought to be acutely controlled by catecholamines (ie, epinephrine and norepinephrine) and insulin. Natriuretic peptides (NPs) are known to play a key role in the regulation of salt and water balance and blood pressure homeostasis. They are involved in the pathophysiology of hypertension and heart failure. (ATP III). The NCEP definition of the metabolic syndrome includes 3 or more of the following: abdominal obesity, defined as waist circumference Ն102 cm in men and Ͼ88 cm in women; elevated triglyceride concentration Ն150 mg/dL, low HDL cholesterol (Ͻ40 mg/dL in men and Ͻ50 mg/dL in women); elevated fasting plasma glucose level (Ն110 mg/dL); and elevated blood pressure (Ն130/85 mm Hg). 1 The presence of abdominal obesity is more closely associated with the metabolic risk factors than body mass index. The prevalence of the metabolic syndrome increases with age. Obesity interferes with many metabolic pathways which underlie numerous potential risk factors. It is very difficult to differentiate between the major and minor factors, and some remain to be discovered. 2 This complexity leaves the area open and challenges basic and clinical researchers to uncover novel metabolic pathways. The discovery that cardiac natriuretic peptides (NPs) control human fat cell function is a provocative observation which reveals an unsuspected link between heart and adipose tissue. NPs exert potent lipolytic effects (eg, stimulation of hydrolysis of triacylglycerols stored in adipocytes) in isolated human fat cells. 3 When administered intravenously, they potently increase plasma glycerol and nonesterified fatty acid (NEFA) levels; in other words they stimulate lipid mobilization. 4 Before the discovery of the NP pathway, catecholamines and insulin were considered to be the major acute regulators of lipid mobilization in humans: they both act through a cAMP-dependent regulation of lipolysis. In contrast, NPs activate a 3Ј, 5Ј-cyclic guanosine monophosphate (cGMP)-dependent pathway that is completely independent from the cAMP-dependent pathway. 5 The NPs may represent a promising new pathway contributing to the control of lipid mobilization in humans in physiological and pathological conditions. The introductory section

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“…In adult hemodialysis patients, ANP-N correlated with the decrement in relative blood volume [41], and even better with LVH and LV dysfunction than ANP-C [42,43,44]. In pediatric patients with congenital heart disease, Holmstrom et al [9] reported significantly higher mean ANP-N values than in controls (1.06 vs. 0.42 nmol/l), and a positive correlation between ANP-N and atrial pressure.…”

Section: Discussionmentioning

confidence: 99%

Hypertension, cardiac state, and the role of volume overload during peritoneal dialysis

Hölttä

Happonen

Rönnholm

et al. 2001

Pediatric Nephrology

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The cardiac state and the prevalence of high blood pressure (BP) were analyzed in 21 pediatric patients (mean age 5.3 +/- 5.3 years) on chronic peritoneal dialysis (CPD), the aim being to specify the impact of hypervolemia in the etiology of hypertension. C- and N-terminal atrial natriuretic peptide (ANP-C, ANP-N) were measured as possible additional markers of hypervolemia. Baseline investigations were carried out 0.2 years after initiation of PD, and repeated after 0.9 +/- 0.2 years. Fifty-two percent of the patients had high BP, and in 40% the nocturnal BP decline was decreased. Left ventricular hypertrophy was present in 45%, but the systolic and diastolic functions of the heart were not impaired. Left ventricular mass correlated significantly with the severity of hypertension and with ANP-N (r = 0.79, P < 0.01 and r = 0.66, P < 0.01, Spearman rank correlation). Significant correlations were also found between the severity of hypertension and ANP-N and ANP-C (r = 0.82, P < 0.01 and r = 0.66, P < 0.01, Spearman rank correlation). High BP and cardiac impairment were more frequent in the younger and nephrectomized patients in whom volume overload seemed to be the most-important etiological factor. Our results suggest further that an ANP-N over 3.0 nmol/l combined with hypertension is strongly indicative of volume overload in patients on PD.

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

Cited by 37 publications

References 41 publications

N-Terminal Pro Brain Natriuretic Peptide Is Inversely Related to Metabolic Cardiovascular Risk Factors and the Metabolic Syndrome

N-Terminal Pro Brain Natriuretic Peptide Is Inversely Related to Metabolic Cardiovascular Risk Factors and the Metabolic Syndrome

An Unsuspected Metabolic Role for Atrial Natriuretic Peptides

Hypertension, cardiac state, and the role of volume overload during peritoneal dialysis

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