Increased cardiac BNP expression associated with myocardial ischemia

Abstract

Congestive heart failure is accompanied by increased cardiac brain natriuretic peptide (BNP) gene expression with elevated plasma concentrations of BNP and its precursor, proBNP. We investigated if myocardial ischemia in the absence of overt heart failure may be another mechanism for increased myocardial BNP expression. The BNP expression was examined in hypoxic myocardium of patients undergoing coronary bypass grafting surgery, in patients with coronary artery disease and normal left ventricular function undergoing percutaneous transluminal intervention therapy, and in heart failure patients without coronary artery disease. BNP mRNA was quantified by real-time PCR, and plasma BNP and proBNP concentrations were measured with radioimmunoassays. Quantitative analysis of BNP mRNA in atrial and ventricular biopsies from coronary bypass grafting patients revealed close associations of plasma BNP and proBNP concentrations to ventricular, but not atrial, BNP mRNA levels. Plasma BNP and proBNP concentrations were markedly increased in patients with coronary artery disease but without concomitant left ventricular dysfunction. These results are compatible with the notion that myocardial ischemia, even in the absence of left ventricular dysfunction, augments cardiac BNP gene expression and increases plasma BNP and proBNP concentrations. Thus, elevated BNP and proBNP concentrations do not necessarily reflect heart failure but may also result from cardiac ischemia.

The Role of N terminal pro-BNP in assessing severity of Coronary Artery Disease: a prospective study

“…Toth et al (25) have found evidence that tissue hypoxia alone triggers release of BNP in absence of LV dysfunction. These results were confirmed by a recent physiological study showing that ventricular BNP gene expression is up-regulated by myocardial hypoxia resulting in augmented plasma concentrations of BNP and NT-proBNP (26). The association of elevations of BNP with a greater severity and extent of ischemia may explain, atleast in part, the adverse clinical outcomes of such elevation.…”

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“…Correlation analysis and stepwise regression analysis revealed that AVI was positively related to age, PP, SBP and BNP. Advanced age, increased PP and SBP are well documented risk factors for cardiovascular events (Darne et al 1989;Tokitsu et al 2015), while increased BNP level is a strong predictor of cardiac dysfunction (Goetze et al 2003;McLean et al 2003). In this sense, AVI may be an integrated embodiment of several indicators of cardiovascular disorders.…”

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