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Plasma concentrations of N-terminal atrial natriuretic peptide are raised in asymptomatic relatives of dilated cardiomyopathy patients with left ventricular enlargement
  1. J Grzybowski1,
  2. Z T Bilinska1,
  3. J Janas2,
  4. E Michalak3,
  5. W Ruzyllo1
  1. 1Department of General Cardiology, Institute of Cardiology, Warsaw, Poland
  2. 2Department of Clinical Biochemistry, Institute of Cardiology, Warsaw
  3. 3Department of Noninvasive Diagnostics, Institute of Cardiology, Warsaw
  1. Correspondence to:
    Dr J Grzybowski, Department of General Cardiology, Institute of Cardiology, Alpejska 42, 04628, Warsaw, Poland

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The prognosis among patients with dilated cardiomyopathy (DCM) who present to a referral centre for heart failure management is poor, as the disease is usually well advanced by the time it is diagnosed.1 There is established evidence of the favourable effects of angiotensin converting enzyme (ACE) inhibitors in patients with asymptomatic left ventricular (LV) dysfunction; therefore, identification of patients at an earlier stage of the disease would hopefully have a positive impact on prognosis.

Prospective family screening has identified a subset of asymptomatic relatives with LV enlargement (LVE) that may represent early disease.2 A recent study found that overt DCM developed in 27% of patients with LVE during a three year follow up.3 Nevertheless we do not know which relatives are at highest risk of developing overt DCM.

N-terminal atrial natriuretic peptide (N-ANP) is known to be a sensitive marker of LV dysfunction in the general population.4 These findings strongly support a possible role for N-ANP as an important additional marker for the diagnosis of patients with symptomless LV dysfunction in the setting of possible early disease in familial DCM. We hypothesised that …

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