Relation of B-type natriuretic peptide (BNP) and infarct size as assessed by contrast-enhanced MRI

Bruder, Oliver; Jensen, Christoph J; Jochims, Markus; Farazandeh, Mani; Barkhausen, Joerg; Schlosser, Thomas; Sabin, Georg; Hunold, Peter

doi:10.1016/j.ijcard.2009.03.139

Cited by 21 publications

(15 citation statements)

References 57 publications

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“…Microcirculatory obstruction may occur via distal embolisation, and infarct expansion during PCI may affect the elevation of plasma BNP levels 20. Post-PCI plasma BNP level was consistently higher than pre-PCI plasma BNP level in patients with STEMI, and those who showed elevated post-PCI plasma BNP levels were expected to undergo PMIR or cardiac death 21…”

Section: Discussionmentioning

confidence: 99%

The optimal time of B-type natriuretic peptide sampling associated with post-myocardial infarction remodelling after primary percutaneous coronary intervention : cardiovascular topics

Choi¹,

Yoo²,

Doh³

et al. 2013

CVJA

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AimsTo find the optimal time to evaluate plasma B-type natriuretic peptide (BNP), which is related to post-myocardial infarction remodelling (PMIR), we measured serial plasma BNP levels according to time protocols after primary percutaneous coronary intervention (PCI).BackgroundIt has been established that plasma BNP levels can predict the development of PMIR in patients with ST-elevation myocardial infarction (STEMI). However, the time of plasma BNP sampling associated with PMIR is still controversial.MethodsWe analysed 42 patients who were diagnosed as PMIR on six-month follow-up echocardiography among 131 patients with STEMI. We then compared clinical variables including plasma BNP between the remodelling group and the non-remodelling group. The plasma BNP level was obtained on hospital admission (acute phase), at two to five days (early phase), three to four weeks (late phase) and at the six-month follow up (long term).ResultsEarly-phase and long-term BNP levels were higher in the remodelling group. The serial plasma BNP levels, according to study protocols, showed a biphasic pattern of elevation. In multiple logistic regression analyses, early-phase BNP [odds ratio (OR): 1.013, p < 0.01] and acute-phase BNP levels (OR: 1.007, p = 0.02) were independent predictors of PMIR. However, early-phase BNP level was statistically a more powerful predictor of PMIR during follow up.ConclusionConsecutive BNP levels after primary PCI showed a biphasic peak elevation during follow up. Earlyphase plasma BNP level was an independent predictor of PMIR in patients with STEMI.

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Section: Discussionmentioning

confidence: 99%

The optimal time of B-type natriuretic peptide sampling associated with post-myocardial infarction remodelling after primary percutaneous coronary intervention : cardiovascular topics

Choi¹,

Yoo²,

Doh³

et al. 2013

CVJA

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“…In line with these findings, there are many studies, performed with isolated myocytes, heart muscle strips and animals, which clearly provide evidence that there is a hypoxia sensitive component in the release mechanism of the natriuretic peptide system. When the blood flow in the coronaries of the pig heart was surgically blocked, the BNP mRNA increased significantly in the wall area that had become hypoxic [10] and the plasma levels of NT-proBNP were associated with the extent of myocardial damage and microvascular obstruction in patients, as assessed by contrast-enhanced cardiac magnetic resonance imaging [11] . Stockmann et al [12] studied the effects of oxygenation in the hypertrophied heart ventricular of the rat and showed that when normoxic conditions were restored, the ANP content decreased to control levels despite the persisting hypertrophy.…”

Section: Physiology Of Natriuretic Peptidesmentioning

confidence: 99%

Physiology of natriuretic peptides: The volume overload hypothesis revisited

Arjamaa¹

2014

WJC

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The discovery of the natriuretic peptide system in the early 1980s aroused great interest among clinical cardiologists. The heart was not a mechanical pump alone, but also an endocrine organ that had powerful effects on blood circulation. Natriuretic peptides caused both natriuresis and diuresis, and they responded to a volume overload which caused either stretch or pressure on the heart. As a result, the findings led to the conclusion that the human body had a hormone with effects similar to those of a drug which treats high blood pressure. Later, it became evident that the volume contraction was fortified by extrarenal plasma shift. Here, a hypothesis is presented in which the role of natriuretic peptides is to regulate oxygen transport as the volume contraction leads to hemoconcentration with an increased oxygen-carrying capacity. Wall stress, either chemical or mechanical, changes the oxygen gradient of the myocardium and affects the diffusion of oxygen within a myocyte. In support of this hypothesis, hypoxia-response elements have been found in both the atrial natriuretic peptide and the brain natriuretic peptide genes.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Natriuretic peptides; Hypoxia; Hemoglobin concentration; Volume overload Core tip: A new concept is suggested for the understanding of the physiology of natriuretic peptides. Both chemical and physical challenges will ultimately increase the oxygen consumption of the heart which is the factor regulating the release of natriuretic peptides. Diuresis, natriuresis and plasma shift lead to hemoconcentration and the oxygen transport in human body will be enhanced.Arjamaa O. Physiology of natriuretic peptides: The volume overload hypothesis revisited.

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“…Previous studies have also found that BNP levels at admission could serve as predictor of short and long term mortality after STEMI, worse outcome as well as ''no reflow'' phenomenon and impaired reperfusion (10,(12)(13)(14). Also the relation between the level of BNP is associated with the infarct size and infarct mass assessed with cardiac MR and echocardiography (15)(16)(17). Although all our patients had single vessel disease and angiographycally successful reperfusion, it is possible that patients who had elevated BNP levels after 7 days had impaired or delayed reperfusion and, therefore, higher risk of left ventricular remodeling and developing left ventricular systolic dysfunction.…”

Section: Discussionmentioning

confidence: 96%

B-type Natriuretic Peptide as Predictor of Heart Failure in Patients with Acute ST Elevation Myocardial Infarction, Single-vessel Disease, and Complete Revascularization: Follow-up Study

Manola¹,

Pavlović²,

Radeljić³

et al. 2009

Croat Med J

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Relation of B-type natriuretic peptide (BNP) and infarct size as assessed by contrast-enhanced MRI

Cited by 21 publications

References 57 publications

The optimal time of B-type natriuretic peptide sampling associated with post-myocardial infarction remodelling after primary percutaneous coronary intervention : cardiovascular topics

The optimal time of B-type natriuretic peptide sampling associated with post-myocardial infarction remodelling after primary percutaneous coronary intervention : cardiovascular topics

Physiology of natriuretic peptides: The volume overload hypothesis revisited

B-type Natriuretic Peptide as Predictor of Heart Failure in Patients with Acute ST Elevation Myocardial Infarction, Single-vessel Disease, and Complete Revascularization: Follow-up Study

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