Different secretion patterns of atrial natriuretic peptide and brain natriuretic peptide in patients with congestive heart failure.

Yoshimura, Michihiro; Yasue, Hirofumi; Okumura, Ken; Ogawa, Hisao; Jougasaki, Michihisa; Mukoyama, Masashi; Nakao, Kazuwa; Imura, Hiroo

doi:10.1161/01.cir.87.2.464

Cited by 565 publications

(358 citation statements)

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“…In addition, the clinical signs of heart failure and physical examination in the dogs with experimental MR were evaluated to be divided into the heart failure classes according to the New York Heart Association (NYHA) Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are cardiac hormones responsible for the regulation of body fluid homeostasis and blood pressure [18]. The synthesis and secretion of ANP and BNP have demonstrated to augment in human abnormal heart conditions [19,21]. Plasma ANP and BNP concentrations are therefore good indicators for the severity, the prognosis and the left ventricular (LV) dysfunction in human acute myocardial infarction (AMI) and congestive heart failure (CHF) [12,19].…”

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confidence: 99%

Plasma Atrial and Brain Natriuretic Peptide Levels in Dogs with Congestive Heart Failure.

et al. 1999

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ABSTRACT. Plasma concentrations of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were measured in 6 dogs with experimental mitral regurgitation (MR) and 19 canine patients with asymptomatic and symptomatic congestive heart failure (CHF). In dogs with experimental MR, ANP and BNP concentrations were significantly correlated with pulmonary capillary wedge pressure (PCWP) (ANP; r=0.852, P=0.0004, BNP; r=0.832, P=0.0008). ANP level was shown to have a predominant effect on PCWP in comparison with BNP using multiple regression analysis. In canine patients with asymptomatic and symptomatic CHF, ANP and BNP concentrations were significantly different among the heart failure classes according to the New York Heart Association functional classification (ANP; P=0.0165, BNP; P=0.0005). In addition, ANP and BNP levels in dogs with decompensated heart failure (n=10) significantly increased in comparison with those in dogs with compensated heart failure (n=9). There was however no correlation between ANP and BNP levels in each heart failure class. In conclusion, plasma ANP and BNP levels may become predictors of PCWP and the severity of heart failure in dogs with MR, although further investigations on ANP and BNP levels in more clinical cases are required. -KEY WORDS: atrial natriuretic peptide, brain natriuretic peptide, canine, heart failure, pulmonary capillary wedge pressure.J. Vet. Med. Sci. 61 (5): [523][524][525][526][527][528][529] 1999 MATERIALS AND METHODS Relationship between PCWP and plasma levels of ANP and BNP in dogs with experimental MRAnimals: Six healthy mongrel dogs, 5 males and 1 female, weighing between 6.5 and 12.0 kg, were used for the surgical creation of MR.Methods: Anesthesia was induced with sodium thiopental (25 mg/kg, IV) and maintained with isoflurane (1.3%) and oxygen (1.0 l/min). A 5-Fr balloon catheter was introduced into a 6-Fr sheath placed in the jugular vein and advanced into the pulmonary artery. PCWP was recorded by a polygraph (Bedside Monitor BSM-8502; Nihon Kohden Co., Tokyo, Japan). A 6-Fr 28 cm-long sheath was introduced into the exposed carotid artery and placed into the LV. A bioptome was inserted into the long sheath, and the mitral valvular chordae tendineae was then cut by it to cause significant MR under transesophageal echocardiographic and fluoroscopic guidance, and the surgical site was closed. One week after the operation, a second operation was repeated similarly to the first operation. Postoperative antibiotic (ampicillin 20 mg/kg, PO, BID, for 3 days), and when needed, diuretic (furosemide 2.0-4.0 mg/kg, PO, BID) were given. Two weeks after the second operation, PCWP was recorded in each dog under the general anesthesia as mentioned above.Blood samples were collected from the dogs before the first operation and 2 weeks after the second operation. In addition, the clinical signs of heart failure and physical examination in the dogs with experimental MR were evaluated to be divided into the heart failure classes according to the New York Heart A...

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confidence: 99%

Plasma Atrial and Brain Natriuretic Peptide Levels in Dogs with Congestive Heart Failure.

et al. 1999

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“…In valvular disorders, ANP and BNP levels are affected by the site of valve damage (mitral, aortic, etc), the form of damage (regurgitation, stenosis), the severity of valve dysfunction (regurgitant fraction, effective orifice area), as well as ventricular and atrial function (9)(10)(11)(12)(13). Chronic LV volume overload as a result of MR leads to compensatory dilation of the LV.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of the brain natriuretic peptide to atrial natriuretic peptide ratio in determining the severity of mitral regurgitation

Shimamoto

Kusumoto

Sakai

et al. 2007

Canadian Journal of Cardiology

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I n chronic mitral regurgitation (MR), increased preload and reduced afterload due to unloading from the left ventricle (LV) into the left atrium (LA) leads to compensatory dilation of the LV and facilitates LV ejection. Although this response initially maintains cardiac output, myocardial decompensation eventually results in heart failure symptoms and an increased risk of sudden death. In addition, backflow into the LA results in enlargement of the LA, atrial fibrillation and elevated pulmonary pressures. In some patients, LV contractility is irreversibly impaired in the absence of symptoms (1-3). Thus, deferring surgical intervention often leads to irreversible postoperative LV dysfunction. Valve replacement or valvuloplasty is essential before the myocardial damage becomes irreversible.Early valvuloplasty conducted when heart failure is mild has been reported to improve prognosis (4). In clinical practice, however, it remains difficult to decide the timing of surgery defined by mild heart failure symptoms and preserved cardiac function.Some reports have shown that preoperative LV function (LV end-diastolic diameter [LVDd], LV end-systolic diameter BACKGROUND: Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) levels were characterized in subjects with mitral regurgitation (MR). METHODS: Sixty-two cases of moderate or severe chronic MR were studied. The blood levels of neurohormonal factors were stratified by the known MR prognostic factors of New York Heart Association (NYHA) functional class, left ventricular end-diastolic diameters, left ventricular end-systolic diameter (LVDs), ejection fraction (EF), left atrial diameter and presence of atrial fibrillation (AF). RESULTS: ANP levels were higher in NYHA class II and lower in classes I and III/IV (P=0.0206). BNP levels were higher in NYHA class II than class I (P=0.0355). The BNP/ANP ratio was significantly higher in NYHA classes II and III/IV than in class I (P=0.0007). To differentiate between NYHA classes I/II and III/IV, a cut-off BNP/ANP ratio of 2.97 produced a sensitivity of 78% and specificity of 87%. Compared with subjects in sinus rhythm, patients with AF had an enlarged left atrium and lower ANP levels. The BNP/ANP ratio correlated significantly with left atrial diameter, LVDs and EF (r=0.429, P=0.0017; r=0.351, P=0.0117; and r=-0.349, P=0.0122; respectively), and was significantly higher among all the known operative indications for MR tested (LVDs 45 mm or more, EF 60% or less, NYHA class II or greater and AF; P=0.0073, P=0.003, P=0.0102 and P=0.0149, respectively). CONCLUSIONS: In chronic MR, levels of ANP and BNP, and the BNP/ANP ratio are potential indicators of disease severity.

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“…Early studies demonstrated a correlation of the plasma BNP level with ventricular dilation in patients with dilated cardiomyopathy (23). Studies in adult patients found plasma BNP to be an accurate predictor of the presence of congestive heart failure (24,25) as well as providing predictive information for use in risk stratification in patients with acute coronary syndromes (26) and chronic heart failure (27).…”

Section: B-type Natriuretic Peptide (Bnp)mentioning

confidence: 99%

Design of a large cross-sectional study to facilitate future clinical trials in children with the Fontan palliation

Sleeper

Anderson

Hsu

et al. 2006

American Heart Journal

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Background-Clinical trials in children with congenital heart disease are often limited by the absence of: 1) a primary outcome that can be observed in a reasonable period of time; 2) information regarding health-related quality of life; 3) knowledge of the correlation between health status and ventricular function and exercise performance; 4) a sufficient number of children at a single institution to provide adequate statistical power; and 5) procedural and management differences between and within institutions.

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Different secretion patterns of atrial natriuretic peptide and brain natriuretic peptide in patients with congestive heart failure.

Abstract: We conclude that plasma levels of BNP mainly reflect the degree of ventricular overload and that the secretion patterns of ANP and BNP vary with underlying cardiac disorders of CHF with different degrees of overload in atria and ventricles.

Cited by 565 publications

References 35 publications

Plasma Atrial and Brain Natriuretic Peptide Levels in Dogs with Congestive Heart Failure.

Plasma Atrial and Brain Natriuretic Peptide Levels in Dogs with Congestive Heart Failure.

Usefulness of the brain natriuretic peptide to atrial natriuretic peptide ratio in determining the severity of mitral regurgitation

Design of a large cross-sectional study to facilitate future clinical trials in children with the Fontan palliation

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