Increased Plasma Levels of Brain Natriuretic Peptide in Hypertrophic Cardiomyopathy

Yoshibayashi, Muneo; Kamiya, Tetsuro; Saito, Yoshihiko; Matsuo, Hisayuki

doi:10.1056/nejm199308053290614

Cited by 39 publications

(19 citation statements)

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“…Electrocardiography indicated no sign of left ventricular hypertrophy. Plasma levels of ANP and, especially, BNP were elevated in patients with hypertrophic cardiomyopathy (19). Although the plasma BNP level in patient 3 was slightly elevated, all patients' levels of both ANP and BNP were almost within normal range.…”

Section: Resultsmentioning

confidence: 79%

Gene and Phenotype Analysis of Congenital Generalized Lipodystrophy in Japanese: A Novel Homozygous Nonsense Mutation in Seipin Gene

Ebihara

Kusakabe

Masuzaki

et al. 2004

The Journal of Clinical Endocrinology & Metabolism

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Congenital generalized lipodystrophy (CGL), BerardinelliSeip syndrome, is a rare metabolic disorder characterized by a near total lack of adipose tissue from birth or early infancy. Recently, seipin, encoding a 398-amino acid protein of unknown function, and AGPAT2, encoding 1-acyl-sn-glycerol-3-phosphate acyltransferase 2, were identified as causative genes for CGL. Seipin mutations were found in patients from families originating from Europe and the Middle East. AGPAT2 mutations were found predominantly in African ancestry. However, no information is available on these genes in the pathogenesis of CGL in Asian ancestry. We examined the sequences of the entire coding region of seipin and AGPAT2 in four Japanese CGL patients from independent families. Their average body fat content was 4.7 ؎ 0.5%, and the plasma leptin level was 1.15 ؎ 0.14 ng/ml. We identified a novel nonsense mutation of seipin at codon 275 (R275X). Of four CGL patients, three were homozygous for R275X. No seipin mutation was found in any exon in one patient. We did not find any AGPAT2 mutations in our Japanese patients, suggesting that AGPAT2 is a minor causative gene, if any, for CGL in Japanese. This is the first report on gene and phenotype analysis of CGL in

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Section: Resultsmentioning

confidence: 79%

Gene and Phenotype Analysis of Congenital Generalized Lipodystrophy in Japanese: A Novel Homozygous Nonsense Mutation in Seipin Gene

Ebihara

Kusakabe

Masuzaki

et al. 2004

The Journal of Clinical Endocrinology & Metabolism

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“…The natriuretic peptides, especially BNP, are reported to have high predictive characteristics as a diagnostic test for heart disease 28 and we found that their concentrations were remarkably increased in the patients with HCM compared with the HHD patients and controls, which is consistent with the previous studies. [12][13][14][15] The increase in the plasma concentrations of ANP and BNP is the most significant difference in the neurohumoral profile of HCM patients compared with that of the HHD patients, and we were able to use these results to diagnose HCM. Thus, the plasma concentrations of natriuretic peptides, especially BNP, could serve as noninvasive markers of HCM.…”

Section: Discussionmentioning

confidence: 93%

“…9 With regard to HCM patients, it has been reported that plasma concentrations of catecholamines 10 and endothelin-1 11 are increased, as well as those of ANP and brain natriuretic peptide (BNP). [12][13][14][15][16] However, there are no data on the differences in the neurohumoral profiles of HCM and HHD patients.Thus, in the present study we measured the plasma concentrations of catecholamines (epinephrine and norepinephrine), angiotensin II, endothelin-1 and natriuretic peptides (ANP and BNP) in patients with HCM and HHD without LV dysfunction to clarify the neurohumoral profile of HCM and its clinical implications. …”

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confidence: 99%

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Neurohumoral Profiles in Patients With Hypertrophic Cardiomyopathy-Differences to Hypertensive Left Ventricular Hypertrophy-

Oginö¹,

Ogura²,

Kuboi

et al. 2004

Circ J

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ypertrophic cardiomyopathy (HCM) characteristically has severe myocardial hypertrophy, predominantly involving the interventricular septum of the nondilated left ventricle. Echocardiography is useful for the differential diagnosis of HCM, but it can be difficult to distinguish HCM from hypertensive heart disease (HHD) with left ventricular (LV) hypertrophy. Although concentric LV hypertrophy is observed in patients with HCM 1 and sometimes HCM patients present with hypertension as a complication, asymmetrical interventricular hypertrophy (ASH) is also observed in HHD. 2,3 Recently, ultrasonic myocardial tissue characterization by integrated backscatter has provided additional information about the pathological changes; however, it is still unable to completely differentiate HCM from HHD. 4 It has been reported that various neurohumoral systems are accelerated in patients with HHD or HCM. In HHD, the plasma concentrations of epinephrine and norepinephrine are increased, 5,6 and other trophic neurohumoral factors, such as angiotensin II 7 and endothelin-1, 8 are also increased. Moreover, it has been reported that atrial natriuretic peptide (ANP) is increased in patients with hypertension. 9 With regard to HCM patients, it has been reported that plasma concentrations of catecholamines 10 and endothelin-1 11 are increased, as well as those of ANP and brain natriuretic peptide (BNP). [12][13][14][15][16] However, there are no data on the differences in the neurohumoral profiles of HCM and HHD patients.Thus, in the present study we measured the plasma concentrations of catecholamines (epinephrine and norepinephrine), angiotensin II, endothelin-1 and natriuretic peptides (ANP and BNP) in patients with HCM and HHD without LV dysfunction to clarify the neurohumoral profile of HCM and its clinical implications. Methods SubjectsWe studied 40 patients with HCM, 35 with HHD and 15 healthy normal controls (Protocol 1). All patients were clinically evaluated and carefully diagnosed based on their family history, history of hypertension, echocardiography (UCG) and cardiac catheterization. 17,18 Patients with angina pectoris, low LV ejection fraction (LVEF: <50%), valvular heart disease, liver injury or renal dysfunction were excluded because all of these factors have effects on the Circ J 2004; 68: 444 -450 (Received November 28, 2003; revised manuscript received February 6, 2004; accepted February 13, 2004 Background Patients with hypertrophic cardiomyopathy (HCM) or hypertensive heart disease (HHD) have increased concentrations of various neurohumoral factors. Thus, the aim of the present study was to evaluate the differences in the neurohumoral profiles of HCM and HHD. Methods and Results Plasma concentrations of epinephrine, norepinephrine, atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), angiotensin II and endothelin-1 were measured in 40 patients with HCM, 35 with HHD, and 15 controls. Additionally, the concentrations of these neurohumoral factors in the coronary sinus and aortic root were measured in...

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“…The natriuretic peptides play an important role in HF compensation and can delay progression of the disease. Heart hypertrophy (usually appears with HF) stimulates production of ANP and BNP, and stretching of atria and ventricles stimulates release of these hormones (3)(4)(5)(6). The mechanism of increased production of natriuretic peptides can be explained by chronic central hypervolemia with elevated ventricle filling pressure (7,8).…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Different Therapy Protocols for Heart Failure in Patients with Heart Failure and Increased Natriuretic Peptide Level

Kovačević¹,

Mirić²

2009

Journal of Medical Biochemistry

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Kratak sadr`aj: Natriuretski peptidi mogu imati klini~ki zna~aj u pra}enju terapijskih efekata kod pacijenata sa sr~anom insuficijencijom. Cilj ove randomizovane studije bio je da se ispita efikasnost razli~itih terapijskih protokola za sr~anu insuficijenciju kod pacijenata sa sr~anom insuficijenci jom na osnovu nivoa BNP-a u plazmi pre i posle terapije.[ezdeset dva pacijenta sa sr~anom insuficijencijom i povi{enim nivoom BNP-a, dobi 55,82±9,09 god, sa II-III NYHA funkcionalnom klasom, ejekcionom frakcijom (EF) <45%, primali su 12 nedelja tradicionalnu farmakolo{ku terapiju za sr~anu insuficijenciju, i to: ACE inhibitore i b blokatore (1. grupa); ACE inhibitore i angiotenzin II receptor blokatore (ARBs) (2. grupa); ß blokatore i ARBs (3. grupa); ACE inhibitore, ß blokatore i ARBs (4. grupa). Ispitivali smo nivo BNPa u plazmi, hemodinamske parametre (pritisak u plu}nim kapilarima (PCWP), cardiac output (CO), EF i du`inu trajanja opte re}enja. Nivo BNP-a u plazmi se zna~ajno snizio u 4. grupi pacijenata, koji su bili na ACE inhibitorima, ß blokatorima i ARBs, u odnosu na ostale grupe. Tako|e je prime}en zna~ajan pozitivan uticaj na hemodinamske parametre i trajanje optere}enja u toj grupi pacijenata, u pore|enju sa ostalim ispitanicima. Mo`e se zaklju~iti da terapijski protokol koji uklju~uje ACE inhibitore, ß blokatore i ARBs kod pacijenata sa sr~a nom insuficijencijom i povi{enim BNP-om zna~ajno pobolj {a va kvalitet `ivota, funkciju leve komore, vrednosti hemodi namskih parametara i du`inu trajanja optere }enja. Sve te promene su udru`ene sa sni`enjem nivoa BNP-a u plazmi.Klju~ne re~i: B-tip natriuretskog peptida, sr~ana insu ficijencija, terapijski protokoli Summary: Natriuretic peptide BNP might be clinically useful for monitoring treatment effects in patients with heart failure (HF). In order to investigate the pharmacological effects of different therapy protocols for patients with HF based on the BNP level before and after therapy, we performed an open randomized comparative trial. Sixty-two HF patients with increased natriuretic peptide level, aged 55.82±9.09, II-III NYHA functional classes, ejection fraction (EF) <45%, received a 12-week treatment with either traditional pharmacotherapy for HF with ACE inhibitors and b-blockers (1 st group), or ACE inhibitors and angiotensin II receptor blo ckers (ARBs) (2 nd group), or b-blockers and ARBs (3 rd group), and ACE inhi bitors, b-blockers and ARBs (4 th group). We evaluated the BNP plasma level, hemodynamic state (pulmonary capillary wedge pressure (PCWP), cardiac output (CO), EF and exercise capacity. The BNP plasma level decreased significantly in the 4 th group of patients who received ACE inhibitors, b-blockers and ARBs, in comparison to other groups. A beneficial influ ence on hemodynamic and exercise capacity was significantly pronounced in this group, compared to the other therapy regimes. In conclusion, the therapeutic protocol: ACE inhibitors, b-blockers and ARBs in HF patients with increased natriuretic peptide level significantly improves the qual...

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Increased Plasma Levels of Brain Natriuretic Peptide in Hypertrophic Cardiomyopathy

Cited by 39 publications

References 5 publications

Gene and Phenotype Analysis of Congenital Generalized Lipodystrophy in Japanese: A Novel Homozygous Nonsense Mutation in Seipin Gene

Gene and Phenotype Analysis of Congenital Generalized Lipodystrophy in Japanese: A Novel Homozygous Nonsense Mutation in Seipin Gene

Neurohumoral Profiles in Patients With Hypertrophic Cardiomyopathy-Differences to Hypertensive Left Ventricular Hypertrophy-

The Efficacy of Different Therapy Protocols for Heart Failure in Patients with Heart Failure and Increased Natriuretic Peptide Level

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