Natriuretic peptides as markers of preclinical cardiac disease in obesity.
BACKGROUND
Aim of the study was to evaluate the role of atrial (ANP) and brain natriuretic peptides (BNP) as markers of preclinical cardiac disease in obesity.


METHODS
We selected 26 obese (BMI > 29 kg m(-2)) never-treated hypertensives (24-h BP > 140 and/or 90 mmHg), 26 obese normotensives (24-h BP < 130/80 mmHg) and 25 lean (BMI < or = 25 kg m(-2)) never-treated hypertensives. Each subject underwent measurements of ANP and BNP plasma levels, 24-h ambulatory blood pressure (BP) monitoring, digitized M-mode and Doppler echocardiography.


RESULTS
Mean values of ANP and BNP were similar among the three groups. All the subjects had normal left ventricular (LV) systolic function. Within each group ANP levels were higher in patients with LV diastolic dysfunction than in patients with normal diastolic function, and BNP levels were higher in patients with LV hypertrophy and in patients with LV diastolic dysfunction. Within each group, ANP levels were inversely correlated with LV diastolic indices, whereas BNP levels were directly correlated with LV mass index and inversely correlated with LV diastolic indices. ANP and BNP levels were not correlated with other echocardiographic parameters, age, BMI or 24-h BP values.


CONCLUSIONS
In normotensive and hypertensive obese subjects the relationships of ANP and BNP levels with LV morpho-functional characteristics follow the same trend as in lean hypertensives, with ANP mainly influenced by diastolic dysfunction and BNP influenced by both LV hypertrophy and LV diastolic dysfunction. Therefore ANP and BNP can be considered useful markers of preclinical cardiac disease in obesity.
Grandi
A M
AM
University of Insubria, Varese, Italy. amgrandi@libero.it
Laurita
E
E
Selva
E
E
Piantanida
E
E
Imperiale
D
D
Giovanella
L
L
Guasti
L
L
Venco
A
A
D000328:Adult; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D045265:Natriuretic Peptides / Q000097:blood*; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000473:pathology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology
D015415:Biomarkers; D045265:Natriuretic Peptides; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor