TY - JOUR
T1 - Circulating natriuretic peptide concentrations in patients with end-stage renal disease
T2 - Role of brain natriuretic peptide as a biomarker for ventricular remodeling
AU - Cataliotti, Alessandro
AU - Malatino, Lorenzo S.
AU - Jougasaki, Michihisa
AU - Zoccali, Carmine
AU - Castellino, Pietro
AU - Giacone, Giuseppe
AU - Bellanuova, Ignazio
AU - Tripepi, Rocco
AU - Seminara, Giuseppe
AU - Parlongo, Saverio
AU - Stancanelli, Benedetta
AU - Bonanno, Grazia
AU - Fatuzzo, Pasquale
AU - Rapisarda, Francesco
AU - Belluardo, Paola
AU - Signorelli, Salvatore S.
AU - Heublein, Denise M.
AU - Lainchbury, John G.
AU - Leskinen, Hanna K.
AU - Bailey, Kent R.
AU - Redfield, Margaret M.
AU - Burnett, John C.
N1 - Funding Information:
This study was supported in part by grants from the National Institutes of Health (HL 36634), Miami Heart Research Institute, Mayo Foundation, the Bruce and Ruth Rappaport Program in Vascular Biology, and the Ministero dell'Università e della Ricerca Scientifica e Tecnologica.
PY - 2001
Y1 - 2001
N2 - Objectives: To determine levels of natriuretic peptides (NPs) in patients with end-stage renal disease (ESRD) and to examine the relationship of these cardiovascular peptides to left ventricular hypertrophy (LVH) and to cardiac mortality. Patients and Methods: One hundred twelve dialysis patients without clinical evidence of congestive heart failure underwent plasma measurement of NP concentrations and echocardiographic investigation for left ventricular mass index (LVMI). Results: Plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) concentrations correlated positively with LVMI and inversely with left ventricular ejection fraction, whereas C-type NP and Dendroaspis NP levels did not correlate with LVMI. In dialysis patients with LVH (LVMI > 125 g/m2), plasma ANP and BNP concentrations were increased compared with those in dialysis patients without LVH (both P<.001). In a subset of 15 dialysis patients without LVH or other concomitant diseases, plasma BNP concentrations were not significantly increased compared with those in 35 controls (mean ± SD, 20.1±13.4 vs 13.5±9.6 pg/mL; P=.06), demonstrating that the BNP concentration was not increased by renal dysfunction alone. Furthermore, the BNP level was significantly higher in the 16 patients who died from cardiovascular causes compared with survivors (mean±SD, 129±13 vs 57±7 pg/mL; P<.003) and was significantly associated with greater risk of cardiovascular death in Cox regression analysis (P<.001), as was the ANP level (P=.002). Conclusions: Elevation of the plasma BNP concentration is more specifically related to LVH compared with the other NP levels in patients with ESRD independent of congestive heart failure. Thus, BNP serves as an important plasma biomarker for ventricular hypertrophy in dialysis patients with ESRD.
AB - Objectives: To determine levels of natriuretic peptides (NPs) in patients with end-stage renal disease (ESRD) and to examine the relationship of these cardiovascular peptides to left ventricular hypertrophy (LVH) and to cardiac mortality. Patients and Methods: One hundred twelve dialysis patients without clinical evidence of congestive heart failure underwent plasma measurement of NP concentrations and echocardiographic investigation for left ventricular mass index (LVMI). Results: Plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) concentrations correlated positively with LVMI and inversely with left ventricular ejection fraction, whereas C-type NP and Dendroaspis NP levels did not correlate with LVMI. In dialysis patients with LVH (LVMI > 125 g/m2), plasma ANP and BNP concentrations were increased compared with those in dialysis patients without LVH (both P<.001). In a subset of 15 dialysis patients without LVH or other concomitant diseases, plasma BNP concentrations were not significantly increased compared with those in 35 controls (mean ± SD, 20.1±13.4 vs 13.5±9.6 pg/mL; P=.06), demonstrating that the BNP concentration was not increased by renal dysfunction alone. Furthermore, the BNP level was significantly higher in the 16 patients who died from cardiovascular causes compared with survivors (mean±SD, 129±13 vs 57±7 pg/mL; P<.003) and was significantly associated with greater risk of cardiovascular death in Cox regression analysis (P<.001), as was the ANP level (P=.002). Conclusions: Elevation of the plasma BNP concentration is more specifically related to LVH compared with the other NP levels in patients with ESRD independent of congestive heart failure. Thus, BNP serves as an important plasma biomarker for ventricular hypertrophy in dialysis patients with ESRD.
KW - ANP = atrial natriuretic peptide
KW - AUC = area under the curve
KW - BNP = brain natriuretic peptide
KW - CAD = coronary artery disease
KW - CHF = congestive heart failure
KW - CNP = C-type natriuretic peptide
KW - DNP = Dendroaspis natriuretic peptide
KW - DNP-LI = DNP-like immunoreactivity
KW - ESRD = end-stage renal disease
KW - IVST = intraventricular septum thickness
KW - Kt/V = fractional urea clearance rate
KW - LVD = left ventricular systolic dysfunction
KW - LVEF = left ventricular ejection fraction
KW - LVH = left ventricular hypertrophy
KW - LVMI = left ventricular mass index
KW - MI = myocardial infarction
KW - NP = natriuretic peptide
KW - PWT = posterior wall thickness
KW - ROC = receiver operating characteristic
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U2 - 10.4065/76.11.1111
DO - 10.4065/76.11.1111
M3 - Article
C2 - 11702899
AN - SCOPUS:0034765282
SN - 0025-6196
VL - 76
SP - 1111
EP - 1119
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 11
ER -