Left ventricular remodelling and brain natriuretic peptide after first myocardial infarction.
OBJECTIVE
To investigate the relation between brain natriuretic peptide (BNP) concentrations and left ventricular remodelling characteristics after acute myocardial infarction.


METHODS
Consecutive sample prospective cohort study.


METHODS
District general hospital coronary care unit in the north of England.


METHODS
133 initial survivors of a first myocardial infarction who received thrombolytic treatment.


METHODS
Patients had transthoracic echocardiography and BNP concentrations measured at three to seven days (early) and two months (late).


METHODS
Wall motion index </= 1.2, end systolic left ventricular volume index and mortality at one year.


RESULTS
Patients with an early wall motion index of </= 1.2 had higher early and late BNP concentrations (early BNP mean (SEM) 629 (76.2) pg/ml v 334 (20.8) pg/ml, p = 0.001 and late BNP 584 (79.5) pg/ml v 343 (25.0) pg/ml, p = 0.001). Patients with an increase in end systolic left ventricular volume index of > 10% also had higher early and late BNP concentrations (early BNP p = 0.034 and late BNP p = 0.001). Early BNP was significantly associated with one year mortality (p = 0.003).


CONCLUSIONS
Higher BNP concentrations early after first myocardial infarction are associated with adverse left ventricular remodelling characteristics. This may help explain why BNP is such a strong predictor of outcome after myocardial infarction.
Crilley
J G
JG
Department of Cardiology, Ward B22 Office, Sunderland Royal Hospital, Sunderland SR4 7TP, UK. j.g.crilley@ncl.ac.uk
Farrer
M
M
D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000378:metabolism* / Q000503:physiopathology; D015425:Myocardial Reperfusion / Q000379:methods; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000378:metabolism; D020257:Ventricular Remodeling / Q000502:physiology*
D020097:Natriuretic Peptide, Brain