title: Cardiac natriuretic peptides are related to left ventricular mass and function and predict mortality in dialysis patients.
abstract: This study was designed to investigate the relationship among brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) and left ventricular mass (LVM), ejection fraction, and LV geometry in a large cohort of dialysis patients without heart failure (n = 246) and to test the prediction power of these peptides for total and cardiovascular mortality. In separate multivariate models of LVM, BNP and ANP were the strongest independent correlates of the LVM index. In these models, the predictive power of BNP was slightly stronger than that of ANP. Both natriuretic peptides also were the strongest independent predictors of ejection fraction, and again BNP was a slightly better predictor of ejection fraction than ANP. In separate multivariate Cox models, the relative risk of death was significantly higher in patients of the third tertile of the distribution of BNP and ANP than in those of the first tertile (BNP, 7.14 [95% confidence interval (CI), 2.83 to 18.01, P = 0.00001]; ANP, 4.22 [95% CI, 1.79 to 9.92, P = 0.001]), and a similar difference was found for cardiovascular death (BNP, 6.72 [95% CI, 2.44 to 18.54, P = 0.0002]; ANP, 3.80 [95% CI, 1.44 to 10.03, P = 0.007]). BNP but not ANP remained as an independent predictor of death in a Cox's model including LVM and ejection fraction. Cardiac natriuretic peptides are linked independently to LVM and function in dialysis patients and predict overall and cardiovascular mortality. The measurement of the plasma concentration of BNP and ANP may be useful for risk stratification in these patients.
authors: Centro di Fisiologia Clinica del CNR e Divisione di Nefrologia, Reggio Calabria, Italy.
authors: Carmine
authors: C
authors: Zoccali
authors: Centro di Fisiologia Clinica del CNR e Divisione di Nefrologia, Reggio Calabria, Italy.
authors: Francesca
authors: F
authors: Mallamaci
authors: Servizio di Cardiologia Ospedale Morelli, Reggio Calabria, Italy.
authors: Francesco Antonio
authors: FA
authors: Benedetto
authors: Centro di Fisiologia Clinica del CNR e Divisione di Nefrologia, Reggio Calabria, Italy.
authors: Giovanni
authors: G
authors: Tripepi
authors: Centro di Fisiologia Clinica del CNR e Divisione di Nefrologia, Reggio Calabria, Italy.
authors: Saverio
authors: S
authors: Parlongo
authors: Istituto di Clinica Medica "L. Condorelli," Università di Catania, Catania, Italy.
authors: Alessandro
authors: A
authors: Cataliotti
authors: Centro di Fisiologia Clinica del CNR e Divisione di Nefrologia, Reggio Calabria, Italy.
authors: Sebastiano
authors: S
authors: Cutrupi
authors: Istituto di Clinica Medica "L. Condorelli," Università di Catania, Catania, Italy.
authors: Giuseppe
authors: G
authors: Giacone
authors: Istituto di Clinica Medica "L. Condorelli," Università di Catania, Catania, Italy.
authors: Ignazio
authors: I
authors: Bellanuova
authors: Istituto di Clinica Medica "L. Condorelli," Università di Catania, Catania, Italy.
authors: Emilio
authors: E
authors: Cottini
authors: Istituto di Clinica Medica "L. Condorelli," Università di Catania, Catania, Italy.
authors: Lorenzo Salvatore
authors: LS
authors: Malatino
mesh_terms: D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood; D019208:Brain-Derived Neurotrophic Factor / Q000378:metabolism; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000378:metabolism*; D045283:Natriuretic Agents / Q000378:metabolism*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011379:Prognosis; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D017582:Renal Replacement Therapy; D013318:Stroke Volume; D016277:Ventricular Function, Left
chemical_list: D019208:Brain-Derived Neurotrophic Factor; D045283:Natriuretic Agents; D009320:Atrial Natriuretic Factor