title: Usefulness of plasma brain natriuretic peptide concentration for predicting subsequent left ventricular remodeling after coronary angioplasty in patients with acute myocardial infarction.
abstract: To determine the relation between plasma brain natriuretic peptide (BNP) and remodeling in terms of infarct-related artery (IRA) patency, 106 patients with a first anterior wall acute myocardial infarction with a patent IRA at 1 month were studied. The IRA reoccluded at 6 months in 17 patients (reoccluded IRA) and was patent in 89 patients (patent IRA). The 2 groups did not differ with respect to clinical characteristics, hemodynamic variables, and left ventricular function at 1 month, except for left ventricular end-diastolic and systolic volumes, which were significantly greater in the reoccluded IRA group. Plasma BNP concentration in the reoccluded IRA group (336 +/- 288 pg/ml) was significantly higher than that in the patent IRA group (116 +/- 106 pg/ml) at 1 month. BNP concentration decreased significantly at 6 months in the 2 groups (reoccluded IRA vs patent IRA 152 +/- 162 vs 44 +/- 58 pg/ml, p <0.05). The increase in left ventricular volume from 1 to 6 months was significantly correlated with plasma BNP concentration at 1 month in the patent IRA group (r = 0.314, p < 0.01) and the reoccluded group (r = 0.634, p < 0.01). Linear regression analysis showed that the correlation between the 2 parameters in the 2 groups was similar. Based on stepwise multivariate linear regression analysis, only plasma BNP concentration was significantly correlated with the increase in left ventricular volume from 1 to 6 months in the 2 groups. In conclusion, these results suggest that plasma BNP concentration predicts left ventricular dilation independently of IRA patency.
authors.affiliation: The Cardiovascular Division, Osaka Police Hospital, Osaka, Japan. ahirayama@oph.gr.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
authors.forename: Hideo
authors.initials: H
authors.lastname: Kusuoka
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sakata
authors.forename: Masanori
authors.initials: M
authors.lastname: Asakura
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Higuchi
authors.forename: Hiroya
authors.initials: H
authors.lastname: Mizuno
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kashiwase
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Ueda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Okuyama
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Kodama
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D015592:Immunoradiometric Assay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain