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Natriuretic peptides as indicators of cardiac remodeling in hypertensive patients.

Magnusson, Martin LU ; Jovinge, Stefan LU ; Rydberg, Erik LU ; Dahlof, Bjorn; Hall, Christian; Nielsen, Olav; Grubb, Anders LU and Willenheimer, Ronnie LU (2009) In Blood Pressure 18. p.196-203
Abstract
Aims. This study was performed to evaluate the relationship between three different natriuretic peptides and left ventricular mass, function and diameter, and kidney function in patients with hypertension. Methods. One hundred and thirty-nine patients with moderate hypertension were consecutively included. N-terminal brain natriuretic peptide (Nt-BNP), brain natriuretic peptide (BNP) and N-terminal pro-atrial natriuretic peptide (Nt-ANP) were analyzed. Cardiac remodeling was assessed by echocardiography (UCG) and glomerular filtration was estimated by cystatin C. Results. Patients were stratified into four groups with regard to the extent of cardiac remodeling: (1) no remodeling; (2) one of left ventricular hypertrophy, left ventricular... (More)
Aims. This study was performed to evaluate the relationship between three different natriuretic peptides and left ventricular mass, function and diameter, and kidney function in patients with hypertension. Methods. One hundred and thirty-nine patients with moderate hypertension were consecutively included. N-terminal brain natriuretic peptide (Nt-BNP), brain natriuretic peptide (BNP) and N-terminal pro-atrial natriuretic peptide (Nt-ANP) were analyzed. Cardiac remodeling was assessed by echocardiography (UCG) and glomerular filtration was estimated by cystatin C. Results. Patients were stratified into four groups with regard to the extent of cardiac remodeling: (1) no remodeling; (2) one of left ventricular hypertrophy, left ventricular dysfunction or left ventricular dilatation; (3) two of above and (4) all three parameters. All peptides differed significantly between the groups (all p<0.001), with a continuous stepwise increase from groups 1 through 4. Receiver operating characteristic analysis showed equal diagnostic performances for the detection of any cardiac abnormalities for Nt-BNP [area under curve, AUC= 0.63 (0.52-0.75), p= 0.026] and BNP [AUC= 0.64 (0.53-0.76), p= 0.019], both, however superior to Nt-ANP [AUC=0.59 (0.47-0.70), p= 0.139]. In multivariable linear regression analysis, all three indicators of cardiac remodeling were independently correlated with ln Nt-BNP and ln BNP, whereas only left ventricular diameter was independently correlated with ln Nt-ANP. Conclusions. Natriuretic peptide levels increased with increasing number of markers of cardiac remodeling. Nt-BNP and BNP are useful to discriminate between patients with regard to cardiac remodeling and might be considered a screening tool in order select patients eligible for further examination with UCG examination. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Blood Pressure
volume
18
pages
196 - 203
publisher
Taylor & Francis
external identifiers
  • wos:000269389400006
  • pmid:19562575
  • scopus:70849097981
ISSN
0803-7051
DOI
10.1080/08037050903083298
language
English
LU publication?
yes
id
ec4247d6-824e-4742-b367-76c8cf9605bf (old id 1433778)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19562575?dopt=Abstract
date added to LUP
2009-07-06 11:28:15
date last changed
2017-01-01 07:36:48
@article{ec4247d6-824e-4742-b367-76c8cf9605bf,
  abstract     = {Aims. This study was performed to evaluate the relationship between three different natriuretic peptides and left ventricular mass, function and diameter, and kidney function in patients with hypertension. Methods. One hundred and thirty-nine patients with moderate hypertension were consecutively included. N-terminal brain natriuretic peptide (Nt-BNP), brain natriuretic peptide (BNP) and N-terminal pro-atrial natriuretic peptide (Nt-ANP) were analyzed. Cardiac remodeling was assessed by echocardiography (UCG) and glomerular filtration was estimated by cystatin C. Results. Patients were stratified into four groups with regard to the extent of cardiac remodeling: (1) no remodeling; (2) one of left ventricular hypertrophy, left ventricular dysfunction or left ventricular dilatation; (3) two of above and (4) all three parameters. All peptides differed significantly between the groups (all p&lt;0.001), with a continuous stepwise increase from groups 1 through 4. Receiver operating characteristic analysis showed equal diagnostic performances for the detection of any cardiac abnormalities for Nt-BNP [area under curve, AUC= 0.63 (0.52-0.75), p= 0.026] and BNP [AUC= 0.64 (0.53-0.76), p= 0.019], both, however superior to Nt-ANP [AUC=0.59 (0.47-0.70), p= 0.139]. In multivariable linear regression analysis, all three indicators of cardiac remodeling were independently correlated with ln Nt-BNP and ln BNP, whereas only left ventricular diameter was independently correlated with ln Nt-ANP. Conclusions. Natriuretic peptide levels increased with increasing number of markers of cardiac remodeling. Nt-BNP and BNP are useful to discriminate between patients with regard to cardiac remodeling and might be considered a screening tool in order select patients eligible for further examination with UCG examination.},
  author       = {Magnusson, Martin and Jovinge, Stefan and Rydberg, Erik and Dahlof, Bjorn and Hall, Christian and Nielsen, Olav and Grubb, Anders and Willenheimer, Ronnie},
  issn         = {0803-7051},
  language     = {eng},
  pages        = {196--203},
  publisher    = {Taylor & Francis},
  series       = {Blood Pressure},
  title        = {Natriuretic peptides as indicators of cardiac remodeling in hypertensive patients.},
  url          = {http://dx.doi.org/10.1080/08037050903083298},
  volume       = {18},
  year         = {2009},
}