title: N-terminal pro-brain natriuretic peptide levels are elevated in patients with acute ischemic stroke.
abstract: Brain natriuretic peptide (BNP) is a counterregulatory hormone released by the ventricles of the heart. Its main actions are natriuresis and vasodilation. The authors studied N-terminal pro-brain natriuretic peptide (NT-proBNP) levels soon after an acute ischemic stroke. They compared plasma NT-proBNP concentrations in 30 patients with an acute ischemic stroke with those of 30 controls. The 2 groups were adjusted for age and gender, and there were no significant differences in vascular risk factors and left ventricular systolic and diastolic function. Venous samples were collected within the first 11.8 +/-1.2 hours after the onset of symptoms and again on day 6. Brain computed tomography/magnetic resonance imaging (CT/MRI) was performed on the same days (day 0 and day 6) in order to assess the site (carotid or vertebrobasilar), cause (atherothrombotic, cardioembolic, or lacunar), and size (large, medium, or small) of the brain infarct. NT-proBNP levels were elevated in patients with acute stroke (129.9 +/-9.9 fmol/mL) compared with the controls (90.8 +/-6.3 fmol/mL, p <0.05). These levels remained elevated at day 6 (113.5 +/-13.0 fmol/mL). NT-proBNP at admission was significantly higher in cardioembolic compared with atherothrombotic infarctions. There was no correlation between circulating NT-proBNP and stroke topography, infarct size, or severity as assessed by the National Institutes of Health Stroke Scale (NIHSS) at any of the 2 time points (admission and day 6). NT-proBNP levels were raised in patients with acute ischemic stroke; this effect persisted until day 6. The authors suggest that neurohumoral activation occurs in patients with acute ischemic stroke, either reflecting a counterbalancing vasodilating response to the cerebral ischemia or direct myocardial dysfunction.
authors.affiliation: First Department of Cardiology, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece. giannak@med.auth.gr
authors.forename: George
authors.initials: G
authors.lastname: Giannakoulas
authors.forename: Apostolos
authors.initials: A
authors.lastname: Hatzitolios
authors.forename: Haralambos
authors.initials: H
authors.lastname: Karvounis
authors.forename: George
authors.initials: G
authors.lastname: Koliakos
authors.forename: Aphrodite
authors.initials: A
authors.lastname: Charitandi
authors.forename: Theodoros
authors.initials: T
authors.lastname: Dimitroulas
authors.forename: Christos
authors.initials: C
authors.lastname: Savopoulos
authors.forename: Efrosini
authors.initials: E
authors.lastname: Tsirogianni
authors.forename: George
authors.initials: G
authors.lastname: Louridas
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000209:etiology / Q000473:pathology
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain