Plasma brain natriuretic peptide as a biochemical marker of high left ventricular end-diastolic pressure in patients with symptomatic left ventricular dysfunction☆,☆☆,★,★★
Section snippets
Patients
Seventy-two patients with left ventricular dysfunction (LVEF <50%) undergoing right and left heart catheterization for clinically indicated purposes were studied continually from December 1994 until March 1997 in our institution. Informed consent was obtained from all patients for participation in the study according to a protocol approved by the Committee on Human Investigation at our institution. The 53 men and 19 women ranged in age from 20 to 80 years (mean age 61 years). Fifty-one patients
Hemodynamic data
Cardiac catheterization data are shown in Table I.Empty Cell Mild CHF (n = 57) Severe CHF (n = 15) NYHA (functional class) 1.74 ± 0.44 3.53 ± 0.52* Age (yr) 60.6 ± 13.1 64.1 ± 13.1 ANP (pg/ml) 67.1 ± 48.3 152.7 ± 96.9* BNP (pg/ml) 86.8 ± 82.6 690.6 ± 491.1* ET-1 (pg/ml) 2.21 ± 0.67 3.56 ± 1.67* NE (pg/ml) 260 ± 218 1032 ± 1042* HR (beats/min) 68 ± 17 91 ± 8.7* RAP (mm Hg) 2.9 ± 1.9 5.6 ± 4.1* MPAP (mm Hg) 13.7 ± 5.6 24.7 ± 11.9* PCWP (mm Hg) 6.8 ± 4.2 15.1 ± 6.8*
Discussion
Previous studies reported the correlation between hemodynamics and neurohumoral factors such as plasma cardiac natriuretic peptides, and plasma levels of ANP were thought to be a hemodynamic predictor in patients with CHF.10, 13 In fact, we previously reported a close correlation between the LVEDP and plasma ANP in patients with left ventricular dysfunction.17 However, it remained unknown as to which cardiac natriuretic peptide, ANP, mainly from the atrium, or BNP, mainly from the ventricle, is
Acknowledgements
We thank Ms. Ikuko Sakaguchi for excellent technical assistance.
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From the First Department of Internal Medicine, Shiga University of Medical Science.
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Supported in part by a Grant-in-Aid for Scientific Research (C) in Japan.
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Reprint requests: Takayoshi Tsutamoto, MD, First Department of Internal Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu 520-2192, Japan.
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