Plasma brain natriuretic peptide levels in patients with rheumatic heart disease

Abstract

Background: Brain natriuretic peptide (BNP) is a cardiac hormone secreted from the ventricular myocardium as a response to ventricular volume expansion and pressure overload. Rheumatic heart disease (RHD) is still an important cause of heart failure in developing countries. Aims: To measure BNP levels in patients with RHD and to determine whether BNP concentrations correlate with clinical and echocardiographic findings. Methods: Eighty-eight patients with rheumatic valve disease and 24 age-and sex-matched healthy subjects were entered in the study. BNP was measured using the Triage B-Type Natriuretic Peptide test (Biosite Diagnostics, San Diego, CA). Transthoracic echocardiography was performed in all patients to assess the severity of the valve disease and for the measurement of pulmonary artery pressure. Results: The plasma concentrations of BNP were significantly higher in patients with rheumatic heart disease than in control subjects (232 F 294 vs. 14 F 12 pg/ml, p < 0.0001). The plasma BNP level was significantly higher in NYHA class III + IV than in class II (463 F 399 vs. 192 F 243 pg/ml, p < 0.0001) and in NYHA class II than in class I (192 F 243 vs. 112 F 135 pg/ml, p < 0.001). The independent determinants of higher BNP levels were NYHA functional class and systolic pulmonary artery pressure in multivariate analysis. Conclusion: We found increased plasma BNP levels in patients with rheumatic heart disease compared with healthy subjects.

Serum N-Terminal Brain Natriuretic Peptide Indicates Exercise Induced Augmentation of Pulmonary Artery Pressure in Patients with Mitral Stenosis

“…This finding may be an indicator of NT pro‐BNP secretion from RV as a result of RV overload secondary to increased pulmonary artery systolic pressure and LA distention and enhanced pressure secondary to mitral stenosis may lead to augmented release of NT pro‐BNP from atrial granule. Previous studies suggest that NT pro‐BNP levels of MS patients with atrial fibrillation were found to be significantly higher than patients in sinus rhythm 20,25 . This may be due to LA enlargement, diminishing atrial contractility or hemodynamic impairment.…”

“…Previous studies suggest that NT pro-BNP levels of MS patients with atrial fibrillation were found to be significantly higher than patients in sinus rhythm. 20,25 This may be due to LA enlargement, diminishing atrial contractility or hemodynamic impairment. In this study, patients with atrial fibrillation had greater LA diameter and higher NT pro-BNP levels than patients with sinus rhythm.…”

Clinical and functional characterisation of rheumatic mitral regurgitation in children and adolescents including the brain natriuretic peptide

“…12,13,14 With regard to the use of brain natriuretic peptide as a marker of cardiac failure, in congenital and inflammatory diseases, only one study related to rheumatic cardiac disease was found by the authors. 15 Thus, the aim of the present study was to assess rheumatic mitral regurgitation in children and adolescents, addressing its clinical, electrocardiographic, and echocardiographic features, correlating these factors to each other and to the natriuretic peptide.…”

Hypermethylation of brain natriuretic peptide gene is associated with the risk of rheumatic heart disease

“…At present, several genes are reported to be associated with RHD pathogenesis including the brain natriuretic peptide ( BNP ), BMPR2 and GCK genes [18–20]. BNP is a cardiac hormone synthesized as a pre-propeptide, mainly expressed in the ventricle, when left ventricular function is insufficient.…”