Correlation Between Levels of N-terminal Pro-B-Type Natriuretic Peptide and Degrees of Heart Failure

Abstract

BackgroundThe N-terminal fragment of pro Brain Natriuretic Peptide (NT-pro BNP) is a neuro-hormone synthesized in the cardiac ventricles in response to increased wall tension. The purpose of this study was to assess the correlation between the NT-pro BNP levels and the New York Heart Association function class (NYHA Fc) of dyspnea and echocardiographic findings for the patients who visited our cardiology departments.MethodsFrom October, 2002 to April, 2003, serum NT-pro BNP levels were measured in 348 patients who visited the Samsung Medical Center and the Jong Koo Lee Heart Clinic.ResultsThe NT-pro BNP levels were increased with the progression of NYHA Fc of dyspnea (p<0.001 by ANOVA), the increase in the systolic left ventricular internal dimension (p<0.05), and the decrease in the ejection fraction (p<0.01). For the NYHA Fc I patients, the NT-pro BNP levels were positively correlated with age (p<0.001) and left atrial size (p<0.001). For the patients with ischemic heart disease, the NT-pro BNP levels were also positively correlated with the NYHA Fc (p<0.001 by ANOVA). The NT-pro BNP levels were increased with the increase in the systolic (p<0.001) and diastolic pressure (p=0.017), the left ventricular internal dimension as well as the decrease in the ejection fraction (p<0.001). The area under the receiver operating characteristic (ROC) curve for the NT-pro BNP levels was 0.994 (95% confidence interval, 0.979-0.999), and the most reliable cut-off level for the NT-pro BNP was 293.6 pg/mL.ConclusionThe NT-pro BNP levels were positively correlated with the NYHA Fc of dyspnea and the systolic dysfunction for the patients who visited our cardiology departments. A 300 pg/mL value for the NT-pro BNP cut-off point appears to be a sensitive level to differentiate dyspnea originating from an ailing heart or not for the patients who visited our cardiology departments.

N-terminal pro b-type natriuretic peptide (NT-pro-BNP) –based score can predict in-hospital mortality in patients with heart failure

“…All adult hospitalized patients were eligible for this study once they met the following criteria: (1) had serum NT-pro BNP drawn within 24 hours upon hospitalization, which had reached the predefined age-specific cut-points; (2) had undergone echocardiography during the hospitalization; and (3) had final diagnosis of HF with International Classification of Diseases (ICD)-9 code of 428, 428.0, 428.1, and 428.9 at their discharge. The age-specific serum NT-pro BNP cut-points which had been proven to identify acute HF patients were as follows: (1) >1800 pg/ml in patients over 75 years; (2) >900 pg/ml in patients aged 50–75 years; and (3) >450 pg/ml in patients below 50 years 32 33 34 35 36 37 38 . The exclusion criteria included patients less than 18 years of age, along with those who had severe chronic pulmonary diseases (i.e.…”

Integrated Transcriptome Map Highlights Structural and Functional Aspects of the Normal Human Heart

“…NPPA and NPPB belong to the natriuretic peptide family and are synthesized as precursor proteins, which undergo intracellular modification (cleavage events) to produce cardiac hormones involved in the cardiovascular homeostasis. Both are expressed in cardiac tissue and are used as diagnostic tools in cardiovascular disease (de Lemos et al, ; Song et al, ). MFN2 is a mitochondrial membrane protein, whose expression is dysregulated in vascular proliferative disorders (Sorianello et al, ).…”

Novel and potential future biomarkers for assessment of the severity and prognosis of chronic heart failure

“…NT-proBNP has been studied as a biomarker of severity and prognosis of CHF in small studies [8][9][10][11] and shown to be very reliable. In the multicenter Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial of patients with class IV heart failure who were taking carvedilol or placebo, levels of NT-proBNP remained elevated despite clinical euvolemia.…”