title: Elevated plasma N-terminal pro-brain natriuretic peptide levels in acute ischemic stroke.
abstract: BACKGROUND
  B-type natriuretic peptide (BNP) is a neurohormone secreted mainly in the cardiac ventricles in response to volume expansion and pressure overload. The aim of this study was to assess plasma N-terminal proBNP (NT-proBNP) changes in acute ischemic stroke (AIS).
  
  
  METHODS
  The study group consisted of 57 (37 women aged 64 +/- 12 years) patients who had their first AIS and no history or signs of cardiovascular disease. An age-matched control group was also included (n = 57, 36 women aged 61 +/- 6 years). NT-proBNP, troponin I (TnI), and creatine kinase-MB were evaluated. A thorough cardiovascular and neurological investigation, including imaging techniques and lesion size determination, was also performed.
  
  
  RESULTS
  The log NT-proBNP peak levels, TnI, and creatine kinase-MB levels were significantly higher in AIS compared with controls (7.25 +/- 1.77 vs 3.48 +/- 0.76 pg/mL, P < .0001; 0.76 +/- 0.54 vs 0.5 +/- 0.0 ng/mL, P < .001; 57 +/- 37 vs 13 +/- 4 U/L, P < .001, respectively). The log NT-proBNP correlated positively with TnI (r = 0.29, P = .03) and heart rate (r = 0.41, P = .002), and negatively with left ventricular ejection fraction (r = -0.67, P < .0001). Patients with signs of marked myocardial ischemia and patients with insular cortex involvement had even higher NT-proBNP levels. After adjustment for relevant factors, the relation between the log NT-proBNP and AIS as well as insular cortex involvement was observed to be insignificant (P > .05 for both).
  
  
  CONCLUSIONS
  Our results show that NT-proBNP plasma levels are significantly elevated in AIS and might be of clinical importance as a supplementary tool for the assessment of cardiovascular function in patients with AIS.
authors.affiliation: Department of Cardiology, Dicle University Medical Faculty, Diyarbakir, Turkey. kencan@dicle.edu.tr
authors.forename: Kenan
authors.initials: K
authors.lastname: Iltumur
authors.forename: A
authors.initials: A
authors.lastname: Yavavli
authors.forename: Aziz
authors.initials: A
authors.lastname: Karabulut
authors.forename: Ismail
authors.initials: I
authors.lastname: Apak
authors.forename: Ufuk
authors.initials: U
authors.lastname: Aluclu
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Ariturk
authors.forename: Nizamettin
authors.initials: N
authors.lastname: Toprak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications*; D016022:Case-Control Studies; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain