N-Terminal Pro-B-Type Natriuretic Peptide in Patients with Hypertensive Heart Disease

Open access

N-Terminal Pro-B-Type Natriuretic Peptide in Patients with Hypertensive Heart Disease

Patients with hypertensive heart disease have elevated concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP). The aim of our study was to evaluate NT-proBNP in patients with long-standing hypertension and in patients with signs of hypertensive cardiomyopathy. The study included three groups of 50 subjects: healthy persons (Control Group), patients with hypertension and normal left ventricular systolic function (Group 1) and patients with longstanding hypertension and signs of hyper tensive cardiomyopathy with impaired left ventricular systolic function (Group 2). Our results show a very good correlation (Pearson's test) between NT-proBNP in Group 1 and Group 2 and C-reactive protein (Group 1: r = 0.8424; Group 2: r = 0.6650), systolic blood pressure (Group 1: r = 0.7213; Group 2: r = 0.4856), diastolic blood pressure (Group 1: r = 0.4282; Group 2: r = 0.3989) and ejection fraction (Group 1: r = -0.7390; Group 2: r = 0.9111). ROC analysis revealed that the AUC between the Control Group and Group 1 for NT-proBNP (0.912) was not significantly different (p>0.05) from the AUC for systolic (0.924) and diastolic pressure (0.937). A cut-off value for NT-proBNP of 5.89 pmol/L can be used to reliably distinguish patients of Group 1 from the Control Group, and a cut-off value of 21.67 pmol/L reliably separates patients from Group 1 and Group 2 (in both cases, the AUC is 1.000). Patients in Group 2 who belonged to the II and III New York Heart Association (NYHA) class had significantly higher levels of NT-proBNP than those in NYHA class I (ANOVA test, p=0.001). These data suggest that NT-proBNP is a useful biomarker for distin guishing patients with long-standing hypertension who are at risk of heart failure, allowing optimization and proper treatment of these patients.

Moe GW, Howlett J, Januzzi JL, Zowall H. N-terminal pro-B-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation 2007; 115: 3103-10.

Tang WH, Francis GS. The year in heart failure. J Am Coll Cardiol 2007; 50: 2344-51.

Jonsson A, Edner M, Alehagen U, Dahlström U. Heart failure registry: a valuable tool for improving the management of patients with heart failure. Eur J Heart Fail 2010; 12: 25-31.

Maisel AS, Krishnaswamy P, Nowak RM, McCord J, Hollander JE, Duc P, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 2002; 347: 161-7.

Ogino K, Ogura K, Kinugawa T, Osaki S, Kato M, Furuse Y, et al. Neurohumoral profiles in patients with hypertrophic cardiomyopathy: differences to hypertensive left ventricular hypertrophy. Circ J 2004; 68: 444-50.

Nakamura M, Endo H, Nasu M, Arakawa N, Segawa T, Hiramori K. Value of plasma B type natriuretic peptide measurement for heart disease screening in a Japanese population. Heart 2002; 87: 131-5.

Seino Y, Ogawa A, Yamashita T, Fukushima M, Ogata K, Fukumoto H, et al. Application of NT-proBNP and BNP measurements in cardiac care: a more discerning marker for the detection and evaluation of heart failure. Eur J Heart Fail 2004; 6: 295-300.

Braunwald E. Congestive heart failure: a half century perspective. Eur Heart J 2001; 22: 825-36.

Cowie MR, Jourdain P, Maisel A, Dahlstrom U, Follath F, Isnard R, et al. Clinical applications of B-type natriuretic peptide (BNP) testing [Review]. Eur Heart J 2003; 24: 1710-8.

Clerico A, Del Ry S, Giannessi D. Measurement of cardiac natriuretic hormones (atrial natriuretic peptide, brain natriuretic peptide, and related peptide) in clinical practice: the need for a new generation of immuno assay methods [Review]. Clin Chem 2000; 46: 1529-34.

Mair J. Role of cardiac natriuretic peptide testing in heart failure [Editorial]. Clin Chem 2002; 48: 977-8.

Dajak M, Ignjatović S, Majkić-Singh N. Značaj određivanja srčanih natriuretičnih peptida u srčanoj insuficijenciji. Jugoslov Med Biohem 2003; 22: 311-7.

Tang WH, Francis GS, Morrow DA, Newby LK, Cannon CP, Jesse RL, et al; NACB Committee. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: clinical utilization of cardiac biomarker testing in heart failure. Clin Biochem 2008; 41: 210-21.

Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJ, Ponikowski P, Poole-Wilson PA, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology: developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur J Heart Fail 2008; 10: 933-89.

Muller T, Gegenhuber A, Poelz W, Haltmayer M. Head-to-head comparison of the diagnostic utility of BNP and NT-proBNP in symptomatic and asymptomatic structural heart disease. Clin Chim Acta 2004; 341: 41-8.

Richards M, Troughton RW. NT-proBNP in heart failure: therapy decisions and monitoring. Eur J Heart Fail 2004; 6: 351-4.

Yamamoto K, Burnett JC Jr, Jougasaki M, Nishimura RA, Bailey KR, Saito Y, et al. Superiority of brain natriuretic peptide as a hormonal marker of ventricular systolic and diastolic dysfunction and ventricular hypertrophy. Hypertension 1996; 28: 988-94.

Yasumoto K, Takata M, Ueno H, Tomita S, Tomoda F, Inoue H. Relation of plasma brain and atrial natriuretic peptides to left ventricular geometric patterns in essential hypertension. Am J Hypertens 1999; 12: 921-4.

Fruhwald FM, Fahrleitner A, Watzinger N, Fruhwald S, Dobnig H, Schumacher M, et al. Natriuretic peptides in patients with diastolic dysfunction due to idiopathic dilated cardiomyopathy. Eur Heart J 1999; 20: 1415-23.

Windram JD, Loh PH, Rigby AS, Hanning I, Clark AL, Cleland JG. Relationship of high-sensitivity C-reactive protein to prognosis and other prognostic markers in outpatients with heart failure. Am Heart J 2007; 153: 1048-55.

Journal of Medical Biochemistry

The Journal of Society of Medical Biochemists of Serbia

Journal Information


IMPACT FACTOR 2017: 1.378
5-year IMPACT FACTOR: 0.704



CiteScore 2017: 1.05

SCImago Journal Rank (SJR) 2017: 0.307
Source Normalized Impact per Paper (SNIP) 2017: 0.532

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 114 114 9
PDF Downloads 41 41 6