Copyright © 1999 by the European Society of Cardiology.
Plasma brain natriuretic peptide level as a biochemical marker of morbidity and mortality in patients with asymptomatic or minimally symptomatic left ventricular dysfunction. Comparison with plasma angiotensin II and endothelin-1
First Department of Internal Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Japan
revised April 14, 1999; accepted May 19, 1999
Abstract
Aims To evaluate the level of plasma brain natriuretic peptide as a predictor of morbidity and mortality in patients with asymptomatic or minimally symptomatic left ventricular dysfunction.
Methods We measured plasma levels of atrial natriuretic peptide, brain natriuretic peptide, norepinephrine, angiotensin II, and endothelin-1 and monitored haemodynamic parameters in 290 consecutive patients with asymptomatic or minimally and newly symptomatic left ventricular dysfunction (functional classes I–II, mean left ventricular ejection fraction=37%). All patients were followed up for a median period of 812 days. The Cox proportional hazards model was used to assess the association of variables with mortality and morbidity.
Results At the end of the follow-up, 24 patients had suffered cardiac death and 25 had been hospitalized for worsening heart failure during the follow-up period. Among 21 variables such as clinical characteristics, treatment, haemodynamics, and neurohumoral factors, high levels of plasma brain natriuretic peptide (P<0·0001), norepinephrine (P=0·042), left ventricular end-diastolic volume index (P=0·0035), and left ventricular end-diastolic pressure (P=0·033) were shown to be independent predictors of mortality and morbidity by stepwise multivariate analysis. Moreover, only a high level of plasma brain natriuretic peptide (P<0·0001) was shown to be an independent predictor of mortality in these patients.
Conclusions These results indicate that a high plasma brain natriuretic peptide level provides information about mortality and morbidity in patients with asymptomatic or minimally symptomatic left ventricular dysfunction.
Key Words: Brain natriuretic peptide, asymptomatic left ventricular dysfunction, mortality, morbidity, angiotensin II
f1 Correspondence: Takayoshi Tsutamoto, MD, First Department of Internal Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu 520-2192, Japan.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R. S. Gardner, K. S. Chong, E. O'Meara, A. Jardine, I. Ford, and T. A. McDonagh Renal dysfunction, as measured by the modification of diet in renal disease equations, and outcome in patients with advanced heart failure Eur. Heart J., December 2, 2007; 28(24): 3027 - 3033. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Ring, H. Persson, M. Mejhert, and M. Edner Post-systolic motion in patients with heart failure - A marker of left ventricular dyssynchrony? Eur J Echocardiogr, October 1, 2007; 8(5): 352 - 359. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Rienstra, I. C. Van Gelder, M. P. Van den Berg, F. Boomsma, and D. J. Van Veldhuisen Natriuretic peptides in patients with atrial fibrillation and advanced chronic heart failure: determinants and prognostic value of (NT-)ANP and (NT-pro)BNP Europace, July 1, 2006; 8(7): 482 - 487. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. R. Goldberg and M. Jessup Stage B Heart Failure: Management of Asymptomatic Left Ventricular Systolic Dysfunction Circulation, June 20, 2006; 113(24): 2851 - 2860. [Full Text] [PDF]
|
|
|
|
 |
|
 G A Wright and A D Struthers Natriuretic peptides as a prognostic marker and therapeutic target in heart failure Heart, February 1, 2006; 92(2): 149 - 151. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Norozi, R. Buchhorn, C. Kaiser, G. Hess, R. W. Grunewald, L. Binder, and A. Wessel Plasma N-Terminal Pro-Brain Natriuretic Peptide as a Marker of Right Ventricular Dysfunction in Patients With Tetralogy of Fallot After Surgical Repair Chest, October 1, 2005; 128(4): 2563 - 2570. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Kistorp, J. Faber, S. Galatius, F. Gustafsson, J. Frystyk, A. Flyvbjerg, and P. Hildebrandt Plasma Adiponectin, Body Mass Index, and Mortality in Patients With Chronic Heart Failure Circulation, September 20, 2005; 112(12): 1756 - 1762. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. T. Sandri, M. Salvatici, D. Cardinale, L. Zorzino, R. Passerini, P. Lentati, M. Leon, M. Civelli, G. Martinelli, and C. M. Cipolla N-Terminal Pro-B-Type Natriuretic Peptide after High-Dose Chemotherapy: A Marker Predictive of Cardiac Dysfunction? Clin. Chem., August 1, 2005; 51(8): 1405 - 1410. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Luchner, C. Hengstenberg, H. Lowel, G. A.J. Riegger, H. Schunkert, and S. Holmer Effect of Compensated Renal Dysfunction on Approved Heart Failure Markers: Direct Comparison of Brain Natriuretic Peptide (BNP) and N-Terminal Pro-BNP Hypertension, July 1, 2005; 46(1): 118 - 123. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A D Gavin and A D Struthers Allopurinol reduces B-type natriuretic peptide concentrations and haemoglobin but does not alter exercise capacity in chronic heart failure Heart, June 1, 2005; 91(6): 749 - 753. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A Doust, E. Pietrzak, A. Dobson, and P. Glasziou How well does B-type natriuretic peptide predict death and cardiac events in patients with heart failure: systematic review BMJ, March 19, 2005; 330(7492): 625. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Jarai, N. Iordanova, R. Jarai, A. Raffetseder, W. Woloszczuk, M. Gyongyosi, G. Geyer, J. Wojta, and K. Huber Risk assessment in patients with unstable angina/non-ST-elevation myocardial infarction and normal N-terminal pro-brain natriuretic peptide levels by N-terminal pro-atrial natriuretic peptide Eur. Heart J., February 1, 2005; 26(3): 250 - 256. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G I W Galasko, S Basu, A Lahiri, and R Senior Is echocardiography a valid tool to screen for left ventricular systolic dysfunction in chronic survivors of acute myocardial infarction? A comparison with radionuclide ventriculography Heart, December 1, 2004; 90(12): 1422 - 1426. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. F. Hernandez, L. K. Newby, and C. M. O'Connor Preoperative Evaluation for Major Noncardiac Surgery: Focusing on Heart Failure Arch Intern Med, September 13, 2004; 164(16): 1729 - 1736. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Menezes Falcao, F. Pinto, L. Ravara, and P. A. van Zwieten BNP and ANP as diagnostic and predictive markers in heart failure with left ventricular systolic dysfunction Journal of Renin-Angiotensin-Aldosterone System, September 1, 2004; 5(3): 121 - 129. [Abstract] [PDF]
|
|
|
|
 |
|
 Y.J. Akashi, H. Musha, K. Nakazawa, and F. Miyake Plasma brain natriuretic peptide in takotsubo cardiomyopathy QJM, September 1, 2004; 97(9): 599 - 607. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J E Macdonald, N Kennedy, and A D Struthers Effects of spironolactone on endothelial function, vascular angiotensin converting enzyme activity, and other prognostic markers in patients with mild heart failure already taking optimal treatment Heart, July 1, 2004; 90(7): 765 - 770. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Clerico and M. Emdin Diagnostic Accuracy and Prognostic Relevance of the Measurement of Cardiac Natriuretic Peptides: A Review Clin. Chem., January 1, 2004; 50(1): 33 - 50. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.R Cowie, P Jourdain, A Maisel, U Dahlstrom, F Follath, R Isnard, A Luchner, T McDonagh, J Mair, M Nieminen, et al. Clinical applications of B-type natriuretic peptide (BNP) testing Eur. Heart J., October 1, 2003; 24(19): 1710 - 1718. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R.S. Gardner, F. Ozalp, A.J. Murday, S.D. Robb, and T.A. McDonagh N-terminal pro-brain natriuretic peptide: A new gold standard in predicting mortality in patients with advanced heart failure Eur. Heart J., October 1, 2003; 24(19): 1735 - 1743. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. J. Wang, D. Levy, E. J. Benjamin, and R. S. Vasan The Epidemiology of "Asymptomatic" Left Ventricular Systolic Dysfunction: Implications for Screening Ann Intern Med, June 3, 2003; 138(11): 907 - 916. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J G J Neffke, I I Tulevski, E E van der Wall, A A M Wilde, D J van Veldhuisen, A Dodge-Khatami, and B J M Mulder ECG determinants in adult patients with chronic right ventricular pressure overload caused by congenital heart disease: relation with plasma neurohormones and MRI parameters Heart, September 1, 2002; 88(3): 266 - 270. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Kruger, J.u. Graf, D. Kunz, T. Stickel, P. Hanrath, and U. Janssens brain natriuretic peptide levels predict functional capacity in patients with chronic heart failure J. Am. Coll. Cardiol., August 21, 2002; 40(4): 718 - 722. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Hulsmann, R. Berger, B. Sturm, A. Bojic, W. Woloszczuk, J. Bergler-Klein, and R. Pacher Prediction of outcome by neurohumoral activation, the six-minute walk test and the Minnesota Living with Heart Failure Questionnaire in an outpatient cohort with congestive heart failure Eur. Heart J., June 1, 2002; 23(11): 886 - 891. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Tsutsui, T. Tsutamoto, A. Wada, K. Maeda, N. Mabuchi, M. Hayashi, M. Ohnishi, and M. Kinoshita Plasma oxidized low-density lipoprotein as a prognostic predictor in patients with chronic congestive heart failure J. Am. Coll. Cardiol., March 20, 2002; 39(6): 957 - 962. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Hunt, D. W. Baker, M. H. Chin, M. P. Cinquegrani, A. M. Feldmanmd, G. S. Francis, T. G. Ganiats, S. Goldstein, G. Gregoratos, M. L. Jessup, et al. ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure) Circulation, December 11, 2001; 104(24): 2996 - 3007. [Full Text] [PDF]
|
|
|
|
|
|
S. A. Hunt, D. W. Baker, M. H. Chin, M. P. Cinquegrani, A. M. Feldman, G. S. Francis, T. G. Ganiats, S. Goldstein, G. Gregoratos, M. L. Jessup, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary: A report of the american college of cardiology/american heart association task force on practice guidelines (committee to revise the 1995 guidelines for the evaluation and management of heart failure) developed in collaboration with the international society for heart and lung transplantation endorsed by the heart failure society of america J. Am. Coll. Cardiol., December 1, 2001; 38(7): 2101 - 2113. [Full Text] [PDF]
|
|
|
|
|
|
Task Force for the Diagnosis and Treatment of Chro, W. J. Remme, and K. Swedberg Guidelines for the diagnosis and treatment of chronic heart failure Eur. Heart J., September 1, 2001; 22(17): 1527 - 1560. [PDF]
|
|
|
|
 |
|
 P. R Kalra, S. D Anker, and A. J.S Coats Water and sodium regulation in chronic heart failure: the role of natriuretic peptides and vasopressin Cardiovasc Res, August 15, 2001; 51(3): 495 - 509. [Full Text] [PDF]
|
|
|
|
|
|
I I Tulevski, M Groenink, E E van der Wall, D J van Veldhuisen, F Boomsma, J Stoker, A Hirsch, J S Lemkes, and B J M Mulder Increased brain and atrial natriuretic peptides in patients with chronic right ventricular pressure overload: correlation between plasma neurohormones and right ventricular dysfunction Heart, July 1, 2001; 86(1): 27 - 30. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Tsutamoto, A. Wada, K. Maeda, N. Mabuchi, M. Hayashi, T. Tsutsui, M. Ohnishi, M. Sawaki, M. Fujii, T. Matsumoto, et al. Effect of spironolactone on plasma brain natriuretic peptide and left ventricular remodeling in patients with congestive heart failure J. Am. Coll. Cardiol., April 1, 2001; 37(5): 1228 - 1233. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Fischer, K. Filzmaier, H. Stiegler, J. Graf, S. Fuhs, A. Franke, U. Janssens, and A. M. Gressner Evaluation of a New, Rapid Bedside Test for Quantitative Determination of B-Type Natriuretic Peptide Clin. Chem., March 1, 2001; 47(3): 591 - 594. [Full Text] [PDF]
|
|
|
|
|
|
K. Maeda, T. Tsutamoto, A. Wada, N. Mabuchi, M. Hayashi, T. Tsutsui, M. Ohnishi, M. Sawaki, M. Fujii, T. Matsumoto, et al. High levels of plasma brain natriuretic peptide and interleukin-6 after optimized treatment for heart failure are independent risk factors for morbidity and mortality in patients with congestive heart failure J. Am. Coll. Cardiol., November 1, 2000; 36(5): 1587 - 1593. [Abstract] [Full Text] [PDF]
|
|