Plasma B-type natriuretic peptide reflects left ventricular hypertrophy and diastolic function in hypertension.
BACKGROUND
Hypertension is associated with changes in concentrations of vasoactive peptides and procollagen propeptides, but their relationships with left ventricular hypertrophy and cardiac function are unclear.


METHODS
We measured plasma levels of atrial natriuretic peptide (ANP), its amino terminal propeptide (NT-proANP), B-type natriuretic peptide (BNP), endothelin-1 (ET-1), and serum levels of the aminoterminal propeptide of type I procollagen (PINP) and the aminoterminal propeptide of type III procollagen (PIIINP) and echocardiographic parameters in 97 patients with hypertension in the Anglo-Scandinavian Cardiac Outcomes Trial.


RESULTS
Median values (reference values) of the peptides were: ANP 11.2 (6.9-14.9) pmol/l, NT-proANP 351 (143-311) pmol/l, BNP 1.1 (0.4-7.2) pmol/l, ET-1 8.7 (1.2-5.0) pmol/l, PIIINP 2.8 (1.7-4.2) microg/l and PINP 29 (19-84) microg/l. Plasma BNP levels in patients with left ventricular hypertrophy (1.2 pmol/l) and patients with echocardiographic signs of diastolic dysfunction (1.5 pmol/l) were greater than those in patients without hypertrophy (0.7 pmol/l) and normal diastolic parameters (0.9 pmol/l) (p<0.05). BNP was the only biochemical parameter that independently predicted interventricular septal diastolic diameter (p<0.05), left ventricular mass index (p<0.01) and ratio of the velocity-time integrals of the E and A waves of the mitral inflow in a stepwise logistic regression analysis (p<0.05).


CONCLUSIONS
The results show that BNP reflects the remodelling process in hypertension.
Uusimaa
Paavo
P
Department of Internal Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland. paavo.uusimaa@oulu.fi
Tokola
Heikki
H
Ylitalo
Antti
A
Vuolteenaho
Olli
O
Ruskoaho
Heikki
H
Risteli
Juha
J
Linnaluoto
Markku
M
Peuhkurinen
Keijo
K
D000328:Adult; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003971:Diastole / Q000502:physiology; D019332:Endothelin-1 / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D017379:Hypertrophy, Left Ventricular / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D011498:Protein Precursors / Q000097:blood; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging
D015415:Biomarkers; D019332:Endothelin-1; C099254:N-terminal proatrial natriuretic peptide; D010446:Peptide Fragments; D011347:Procollagen; D011498:Protein Precursors; C047202:procollagen Type I N-terminal peptide; C041876:procollagen Type III-N-terminal peptide; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor