European Heart Journal Advance Access originally published online on October 17, 2007
European Heart Journal 2007 28(22):2726-2731; doi:10.1093/eurheartj/ehm396
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Altered sodium intake affects plasma concentrations of BNP but not proBNP in healthy individuals and patients with compensated heart failure
1 Division of Aviation Medicine, Medical Department B, Rigshospitalet, Copenhagen DK-2100, Denmark
2 Department of Cardiovascular Medicine, Bispebjerg Hospital, Bispebjerg Bakke 23,Copenhagen DK-2400 NV, Denmark
3 Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
4 Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
5 Department of Medicine, Køge Sygehus, Copenhagen, Denmark
Received 13 June 2006; revised 14 August 2007; accepted 24 August 2007; online publish-ahead-of-print 17 October 2007.
* Corresponding author. Tel: +45 35 45 76 97; fax: +45 35 45 76 27. E-mail address: mdamgaard{at}dadlnet.dk
Aims: Plasma B-type natriuretic peptide (BNP) and proBNP are promising markers for treatment of heart failure (HF), but the intra-individual biological variation is high. We investigated whether changes in sodium intake and posture contribute to this variation.
Methods and results: A total of 12 healthy individuals and 12 patients with medically treated compensated HF were examined after 1 week of low (70 mmol [1.61 g] per day) and 1 week of high (250 mmol [5.75 g] per day) sodium intake. Plasma volume and plasma concentrations of BNP and proBNP were determined after 1 h in seated and 1 h in supine position. In healthy individuals, the plasma BNP concentration increased significantly on high sodium intake with a ratio (high sodium/low sodium) of 2.00 (1.32–3.03, P = 0.004). The corresponding values for HF patients were 1.69 (1.25–2.29, P = 0.003). The plasma BNP concentration changed modestly by a posture change, with a plasma BNP ratio (supine/seated) of 1.15 (1.07–1.14, P = 0.001) and 1.06 (0.99–1.24, P = 0.088) in healthy subjects and HF patients, respectively. Plasma proBNP concentrations were neither significantly affected by posture nor by sodium intake.
Conclusion: Sodium intake has a considerable effect on plasma BNP and therefore contributes to the intra-individual variability. We suggest dietary sodium intake to be standardized at least 3 days prior to blood sampling for the determination of plasma BNP.
Key Words: Plasma volume • Posture • Variability
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