Head-to-head comparison of N-terminal pro-brain natriuretic peptide, brain natriuretic peptide and N-terminal pro-atrial natriuretic peptide in diagnosing left ventricular dysfunction

Hammerer-Lercher, Angelika; Neubauer, Elke; Müller, Silvana; Pachinger, Otmar; Puschendorf, Bernd; Mair, Johannes

doi:10.1016/s0009-8981(01)00578-2

Cited by 181 publications

(116 citation statements)

References 20 publications

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“…Tested by a ROC curve, the diagnostic capacities of NT-proBNP were better compared to ANP, and no additional information was obtained by combining NT-proBNP with ANP. Similar to our findings, in earlier studies with a direct comparison between atrial and brain natriuretic peptides, an advantage for brain natriuretic peptides was convincingly proved with no increased predictive power by addition of ANP to BNP determination (Davidson et al, 1996;Cowie et al, 1997;McDonagh et al, 1998;Hammerer-Lercher et al, 2001). Natriuretic peptides are mainly produced and excreted in the atria of the heart in response to increased wall tension.…”

Section: Discussionsupporting

confidence: 91%

“…2003), but is in accordance with studies performed in a population with a higher chance of cardiac dysfunction (Cowie et al, 1997;Hammerer-Lercher et al, 2001;Maisel et al, 2002). In our carcinoid population, ANP was less reliable.…”

Section: Discussionsupporting

confidence: 90%

“…In patients with the suspicion of heart failure several other studies showed natriuretic peptides to be useful indicators for the detection of heart failure (Lerman et al, 1993;Davidson et al, 1996;Cowie et al, 1997;Hammerer-Lercher et al, 2001;Maisel et al, 2002Maisel et al, , 2003. In the follow-up of patients with an acute cardiac event levels of natriuretic peptides were proved to be of prognostic value for outcome (Hall et al, 1994;Omland et al, 1996;de Lemos et al, 2001;Koglin et al, 2001;Richards et al, 2003).…”

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confidence: 99%

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Role of natriuretic peptides in the diagnosis and treatment of patients with carcinoid heart disease

et al. 2004

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Carcinoid heart disease (CHD) occurs in 20 -70% of the patients with metastatic well-differentiated neuroendocrine tumours (NET). We evaluated whether natriuretic peptides (ANP or NT-proBNP) are useful in early detection of CHD. Blood samples from 32 patients with NET were compared with cardiac ultrasound follow-up. CHD was defined as thickening of the tricuspid valve in the presence of grade III -IV/IV tricuspid valve regurgitation. CHD was found in nine out of 32 patients (28%), all with symptoms of the carcinoid syndrome compared to 65% in the 23 patients without CHD (P ¼ 0.04). Median levels of NT-proBNP and 5-HIAA were significantly higher in patients with CHD (894 ng l À1 and 815 mmol 24 h À1 ) compared to those without (89 and 206 ng l À1 , Po0.001 and P ¼ 0.007). No significant differences were detected in ANP levels (P ¼ 0.11). Dilatation of the right atrium and ventricle as well as thickening of the tricuspid valve and degree of regurgitation were statistically significant correlated with NT-proBNP levels. The accuracy of NT-proBNP in the diagnosis of CHD was higher than that of ANP. A significantly better survival was observed in case of normal NT-proBNP values. In conclusion, NT-proBNP is helpful as a simple marker in the diagnosis of CHD. Survival is better in patients with normal levels of NT-proBNP.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

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confidence: 99%

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Role of natriuretic peptides in the diagnosis and treatment of patients with carcinoid heart disease

et al. 2004

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“…[1][2][3] In several studies, plasma ANP and BNP concentrations have been found to be decreased in obese subjects. [4][5][6][7] Additionally, an increase in natriuretic peptides (NPs) has been reported to parallel an increase in blood pressure.…”

Section: Introductionmentioning

confidence: 99%

The association of brain natriuretic peptide and insulin resistance in obesity-related hypertension

Cikim

2007

J Hum Hypertens

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Hypertension is frequently associated with obesity and natriuretic peptide levels are reported to decrease in obese subjects. Both the lower brain natriuretic peptide (BNP) concentration and insulin resistance are suggested to be associated with hypertension. However, their involvement in obesity-related hypertension has not been clearly defined. Forty-four obese women (21 normotensive and 23 hypertensive) and 25 healthy women matched for age were included in the study. Anthropometrical parameters were determined. Serum BNP, fasting insulin and glucose concentrations, and lipid parameters were evaluated. Insulin resistance was calculated using Homeostasis Model Assessment (HOMA) and Quantative Insulin Sensitivity Check Index (QUICKI) formulations. Within the obese groups, HOMA and QUICKI reflected the increased insulin resistance in hypertensive obese subjects with a significant correlation to blood pressure. The decrease in BNP in the obese groups was in favour of the hypertensive obese subjects (31.4376.43; 26.3674.29; and 17.5173.08 pg/ ml, respectively) with a fractional statistical significance between the hypertensive obese group and the controls (P ¼ 0.047). Only for the obese hypertensive group, fasting glucose, HOMA and QUICKI were significantly correlated with BNP. Moreover, fasting plasma glucose (R 2 ¼ 0.22, P ¼ 0.007) and fasting plasma insulin (R 2 ¼ 0.39, P ¼ 0.03) were independently correlated with BNP only for the obese hypertensive group. It can be concluded that the decrease in BNP concentrations in the obese hypertensive subjects seem to be well correlated with the insulin resistance.

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“…The role of BNP as a prognostic risk marker for CVD has been investigated in patients with chronic heart failure and acute myocardial infarction, showing increased risk of future CVD morbidity or mortality with elevated plasma levels of BNP. Measurement of plasma NT-proBNP seems to provide the same information as that of plasma BNP [3].…”

Section: Introductionmentioning

confidence: 94%

Plasma N-terminal pro-brain natriuretic peptide as a major risk marker for cardiovascular disease in patients with type 2 diabetes and microalbuminuria

et al. 2004

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Aims/hypothesis: We examined whether plasma N-terminal probrain natriuretic peptide (NT-proBNP) predicts cardiovascular outcome in patients with type 2 diabetes. Methods: A total of 160 microalbuminuric type 2 diabetic patients (mean age 55.1 years [SD 7.2], 119 men) were enrolled in the Steno-2 Study examining the effect of multifactorial treatment, and were divided into two groups according to baseline levels of plasma NTproBNP below or above the median for the cohort, which was followed for an average of 7.8 years. Cardiovascular outcome was a composite of cardiovascular mortality, myocardial infarction, stroke, revascularisation procedures in the heart or legs, and amputations. Results: In the whole group, plasma NT-proBNP being above the median was associated with an increased risk of cardiovascular disease during follow-up, with an unadjusted hazard ratio of 4.4 (95% CI 2.3-8.4; p<0.0001). A decrease in plasma NT-proBNP of 10 pg/ml during the first 2 years of intervention was associated with a 1% relative reduction in the primary endpoint (p<0.001). Despite polypharmacological treatment targeting cardiovascular disease, the mean plasma NT-proBNP level increased during followup. Conclusions/interpretation: We conclude that high plasma NT-proBNP is a major risk marker for cardiovascular disease in patients with type 2 diabetes and microalbuminuria.

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Head-to-head comparison of N-terminal pro-brain natriuretic peptide, brain natriuretic peptide and N-terminal pro-atrial natriuretic peptide in diagnosing left ventricular dysfunction

Cited by 181 publications

References 20 publications

Role of natriuretic peptides in the diagnosis and treatment of patients with carcinoid heart disease

Role of natriuretic peptides in the diagnosis and treatment of patients with carcinoid heart disease

The association of brain natriuretic peptide and insulin resistance in obesity-related hypertension

Plasma N-terminal pro-brain natriuretic peptide as a major risk marker for cardiovascular disease in patients with type 2 diabetes and microalbuminuria

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