Serum N-Terminal-pro-B-Type Natriuretic Peptide (NT-pro-BNP) Levels in Hyperthyroidism and Hypothyroidism

Özmen, Bilgin; Özmen, Dilek; Parildar, Zuhal; Mutaf, Isil; Bayındır, Oya

doi:10.1080/07435800701670047

Cited by 34 publications

(28 citation statements)

References 22 publications

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“…The increased serum NT-proBNP levels in GD patients found in this study were in accordance with previous findings [21,31]. Thyroid hormone can directly stimulate [20,22,32].…”

Section: Discussionsupporting

confidence: 93%

Relationships between serum levels of thyroid hormones and serum concentrations of asymmetric dimethylarginine (ADMA) and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) in patients with Graves’ disease

Zhao

Zhu

et al. 2011

Endocr

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Endothelial dysfunction as well as abnormal thyroid hormone levels may be responsible for increased cardiovascular risk in Graves' disease (GD). Asymmetric dimethylarginine (ADMA) and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) are new markers of endothelial and myocardial dysfunction, respectively. The purpose of this study was to investigate the relationship among the serum levels of ADMA, NT-proBNP, and thyroid hormones in GD patients. This was a cross-sectional investigation conducted in a university teaching hospital. Two hundred and thirty-nine GD (Female: 182, Male: 57) patients and 81 normal controls were enrolled in this study. Serum levels of ADMA were positively related with FT3 (r = 0.584, P < 0.001), FT4 (r = 0.551, P < 0.001), and TRAb levels (r = 0.502, P < 0.001). Serum NT-proBNP levels were positively associated with FT3 (r = 0.243, P < 0.001) and FT4 levels (r = 0.274, P < 0.001), as well as heart rate (r = 0.271, P < 0.03). The elevation of serum ADMA and NT-proBNP levels were also observed in patients with controlled hyperthyroidism. It is thus concluded that serum ADMA and NT-proBNP levels were increased in GD patients. Future studies may determine the usefulness of these two biomarkers to detect early signs of endothelial dysfunction, vascular stiffness, and fluid volume in GD patients.

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“…The increased serum NT-proBNP levels in GD patients found in this study were in accordance with previous findings [21,31]. Thyroid hormone can directly stimulate [20,22,32].…”

Section: Discussionsupporting

confidence: 93%

Relationships between serum levels of thyroid hormones and serum concentrations of asymmetric dimethylarginine (ADMA) and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) in patients with Graves’ disease

Zhao

Zhu

et al. 2011

Endocr

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“…There are only a few studies investigating the influence of thyroid dysfunction on BNP measurements [4][5][6]. However there are controversial issues in this field.…”

mentioning

confidence: 99%

Decreasing Brain Natriuretic Peptide Levels after Treatment for Hyperthyroidism

et al. 2009

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Brain natriuretic peptide (BNP) belongs to the family of natriuretic peptides which counterbalances the renin-angiotensin-aldosterone system. BNP are produced in ventricular cardiomyocytes, and secreted in response to volume expansion or pressure overload. The BNP test can be used to detect preclinical heart disease or to confirm the cardiac etiology in symptomatic patients. Brain natriuretic peptide was investigated in several extra-cardiac conditions such as rheumatic diseases, pulmonary diseases [1,2].Hyperthyroidism can manifest with overt clinical symptoms of heart failure. The increase in pulse rate and cardiac output seen in untreated hyperthyroid patients also represents a situation of increased cardiac abstract. BNP are produced in ventricular cardiomyocytes, and secreted in response to volume expansion or pressure overload. The purpose of this study was to assess BNP levels in patients with hyperthyroidism before specific treatment for hyperthyroidism and after euthyroidism was achieved. The study was performed in a prospective design. The study population consisted of 48 consecutive newly diagnosed untreated overt hyperthyroid patients who had not been treated any anti-thyroid medications before. all subjects underwent transthoracic echocardiography. levels of fT3, fT4, TsH and BNP were measured before the onset of the treatment and after euthyroidism was achieved. A significant decrease in BNP (102.5 (6.7-1769) ng/l vs. 5.0 (0.1-87.0) ng/l p< 0.001) levels were observed, after euthyroidism was achieved. The decrease in BNP levels was positively correlated with the decrease in fT3 (r=0.298; p=0.049) and fT4 (r=0.313; p=0.030).There was no correlation between BNP levels and TsH levels (p=Ns). We conclude that hyperthyroidism may cause high BNP measurements which can lead to misdiagnosis of congestive heart failure. We suggest that thyroid hormones should be checked in patients with high levels of BNP.Key words: Hyperthyroidism, BNP, echocardiography, Heart failure (Endocrine Journal 56: [1043][1044][1045][1046][1047][1048] 2009) stretch, which theoretically could influence the secretion of BNP [3]. There are only a few studies investigating the influence of thyroid dysfunction on BNP measurements [4][5][6]. However there are controversial issues in this field. The purpose of this study was to assess BNP levels in patients with hyperthyroidism before specific treatment for hyperthyroidism and after euthyroidism was achieved. MethodsThe study was performed in a prospective design. The study population consisted of 48 consecutive newly diagnosed untreated overt hyperthyroid patients who had not been treated any anti-thyroid medications before. Overt hyperthyroidism was diagnosed when patients simultaneously showed high serum concentra-

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“…Hipotirodili hastalarla kontrol grubunun NT-proBNP düzeyleri arasında anlamlı farklılık bulunmamış, serum NTproBNP düzeyi ile tiroid hormon düzeyi arasında pozitif bir korelasyon saptanmıştır (23,24).…”

Section: Discussionunclassified

Tiroid Fonksiyon Bozukluğu Bulunan Hastalarda Erken Dönem Kardiyak Disfonksiyonu Belirlemede N-Terminal Pro-B-Tip Natriüretik Peptid

Ulusoy¹,

Gerek²,

Yiğit³

et al. 2013

haseki

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ÖzetAmaç:Bu çalışmanın amacı hipotiroidi ve hipertiroidi tanısı almış, ekokardiyografik ve klinik olarak herhangi bir kardiyak problemi bulunmayan hastalarda NT-proBNP düzeyinin erken dönem kardiyak disfonksiyonunun belirteci olarak kullanımını araştırmaktır. Yöntem: Hastanemizin İç Hastalıkları polikliniklerine başvuran tiroid hastalığı konmuş 13'ü erkek, 40'ı kadın toplam 53 hasta ile 40 sağlıklı kontrol çalışmaya dahil edildi. Çalışmaya alınan hastaların daha öncesine ait bilinen bir hastalık öyküsü yoktu ve yeni tanı almış aşikar hipotiroidi ve hipertiroidi hastalarıydı. Hasta ve kontrol gruplarının kan örneklerinde rutin biyokimyasal parametrelere, tiroid fonksiyon testlerine ve NT-proBNP düzeylerine bakıldı, elektrokardiyogram çekildi ve ekokardiyografi yapıldı. Bulgular: Çalışmaya alınan hastaların 28'inde hipotiroidi, 25'inde hipertiroidi mevcuttu. Hipotiroid grubun yaş ortalaması daha yüksekti. Hipertiroidi ve hipotiroidili hasta grubunda NTproBNP ortalaması kontrol grubuna göre anlamlı derecede yüksekti (p=0.019). Bu iki hasta grubu ayrı ayrı kontrol grubu ile karşılaştırıldığında NT-proBNP düzeyi hipotiroidili (p=0.0096) ve hipertiroidili (p=0.0415) hastalarda kontrol grubuna göre anlamlı olarak yüksek bulundu. Sonuç:Artmış NT-proBNP düzeyi kalp yetersizliği ve koroner arter hastalığında kötü prognozu gösteren önemli bir belirteçtir. Bu nedenle artmış NT-proBNP düzeyi aşikar hipotiroidi ve hipertiroidisi olan hastalarda erken dönem kardiyak disfonksiyonu belirlemede değerli bir belirteç olabilir. Abs tractAim: The aim of this study was to investigate N-terminal probrain natriuretic peptide (NT-proBNP) as a marker of early cardiac dysfunction in patients with hypothyroidism or hyperthyroidism without any clinical and echocardiographic cardiac problem. Methods:A total of 53 patients (13 male and 40 female), who were newly diagnosed with thyroid disease and 40 healthy controls who attended our internal medicine outpatient clinic, were included in the study. The patients had no history of any disease and, all of them were with newly diagnosed overt hypothyroidism or hyperthyroidism. Routine biochemical tests, and thyroid function tests were done and NT-proBNP levels were measured. Electrocardiograms and echocardiograms were performed. Results: There were 28 patients with hypothyroidsm and 25 patients with hyperthyroidism in the study group. The mean age of hypothyroidism group was higher than that of hyperthyroidism group. The mean NT-proBNP levels were significantly higher in the patient group when compared to the control group (p=0.019). When the two groups of patients were compared with the control group separately, the level of NT-proBNP was significantly higher in hypothyroidism group (p=0.0096) and hyperthyroidism group (p=0.0415). Conclusion: Elevated NT-proBNP levels are an important marker that suggests worse prognosis in heart failure and coronary artery disease. Elevated serum NT-proBNP levels might be a valuable marker to detect early cardiac dysfunction in patients with overt hypothyroidism ...

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Serum N-Terminal-pro-B-Type Natriuretic Peptide (NT-pro-BNP) Levels in Hyperthyroidism and Hypothyroidism

Cited by 34 publications

References 22 publications

Relationships between serum levels of thyroid hormones and serum concentrations of asymmetric dimethylarginine (ADMA) and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) in patients with Graves’ disease

Relationships between serum levels of thyroid hormones and serum concentrations of asymmetric dimethylarginine (ADMA) and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) in patients with Graves’ disease

Decreasing Brain Natriuretic Peptide Levels after Treatment for Hyperthyroidism

Tiroid Fonksiyon Bozukluğu Bulunan Hastalarda Erken Dönem Kardiyak Disfonksiyonu Belirlemede N-Terminal Pro-B-Tip Natriüretik Peptid

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