title: B-type natriuretic Peptide predicts clinical presentations and ventricular overloading in patients with heart failure.
abstract: Brain natriuretic peptide (BNP), a neurohormone secreted from the ventricular myocardium in response to hemodynamic load/wall stress, in congestive heart failure (CHF). This study was performed to evaluate the correlation between BNP level and clinical presentations and hemodynamic parameters obtained by echo-Doppler (echo-Doppler) analysis, and its relation with disease severity and ventricular load/wall stress. CHF patients (n=246) were subgrouped by clinical presentations and echo-Doppler findings into 4 groups: diastolic HF only, chronic HF, acute HF, and chronic HF with acute exacerbation. A BNP level of 81.2 pg/ml showed a sensitivity/ specificity of 53.3%/98.4% for detecting CHF (AUC, 0.882; p < 0.0001), and was found to be closely related with the NYHA classification (p < 0.0001). Log BNP was related with LVEF (r2=0.3015, p < 0.0001) and the Meridional wall stress index (r2=0.4052, p < 0.0001). The difference between the BNP levels of the subgroups and BNP control was significant (p < 0.0001), except between the HF group and the controls; control (n=114, 20.9 +/- 31.4 pg/ml), only diastolic HF (n=84, 89.8 +/- 117.6 pg/ml), chronic HF (n=60, 208.2 +/- 210.2 pg/ml), acute HF (n=28, 477.9 +/- 498.4 pg/ml), chronic HF with acute exacerbation (n= 74, 754.1 +/- 419.2 pg/ml). The BNP level was significantly higher in the only diastolic HF group than in the asymptomatic control group with diastolic dysfunction (89.8 +/- 12.8 vs. 22.8 +/- 5.1 pg/ml, p < 0.0001). BNP may be a good indicator for the differential diagnosis of a broad spectrum of heart failures. And, elevated BNP might help to diagnose diastolic HF in patients with diastolic dysfunction.
authors.affiliation: Cardiology Division, Department of Internal Medicine, Yongdong Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok- dong, Kangnam-gu, Seoul 135-720, Korea.
authors.forename: Bo Young
authors.initials: BY
authors.lastname: Joung
authors.forename: Byung-Eun
authors.initials: BE
authors.lastname: Park
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Kim
authors.forename: Bum Kee
authors.initials: BK
authors.lastname: Hong
authors.forename: Dong-Yeon
authors.initials: DY
authors.lastname: Kim
authors.forename: Yun-Hyeong
authors.initials: YH
authors.lastname: Cho
authors.forename: Sang Hak
authors.initials: SH
authors.lastname: Lee
authors.forename: Young Won
authors.initials: YW
authors.lastname: Yoon
authors.forename: Hyun-Seung
authors.initials: HS
authors.lastname: Kim
authors.forename: Jeong-Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyuck Moon
authors.initials: HM
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain; D011379:Prognosis; D018754:Ventricular Dysfunction / Q000209:etiology*
chemical_list: D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor