title: Elevated levels of brain natriuretic peptide as a predictor of impaired coronary endothelial function in patients with left ventricular remodeling.
abstract: BACKGROUND
  Plasma levels of brain natriuretic peptide (BNP) correlate with left ventricular remodeling, but the relationship between BNP induction and coronary function remains unclear.
  
  
  OBJECTIVE
  The present study assessed BNP production in response to left ventricular enlargement and investigated the relationship between BNP production and coronary vasodilating function in patients with left ventricular remodeling.
  
  
  METHODS
  Patients (n = 63) with normal or mildly diseased coronary arteries underwent Doppler flow study of the left anterior descending coronary artery. Vascular reactivity was examined using intracoronary acetylcholine, papaverine and nitroglycerin using a Doppler guidewire.
  
  
  RESULTS
  Left ventricular end-diastolic dimension was positively correlated with BNP (r = 0.45, p < 0.001) in all patients. BNP was significantly and inversely correlated with percentage change in coronary artery diameter induced by acetylcholine (r = -0.56, p < 0.001) but not by nitroglycerin (r = -0.20, p = 0.28) in patients with left ventricular end-diastolic dimension > or = 55 mm (n = 32). By contrast, BNP was not significantly correlated with percentage change in coronary artery diameter induced by either acetylcholine or nitroglycerin in patients with left ventricular end-diastolic dimension < 55 mm (n = 31). Further, BNP was not correlated with the percentage change in coronary blood flow induced by acetylcholine or by papaverine in patients with or without left ventricular remodeling.
  
  
  CONCLUSIONS
  The elevation in plasma BNP levels that occurs in association with left ventricular enlargement is a predictor of impaired endothelium-dependent vasodilation in conductance coronary arteries.
authors.affiliation: Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ninomiya
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hamasaki
authors.forename: Sanemasa
authors.initials: S
authors.lastname: Ishida
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kataoka
authors.forename: Keishi
authors.initials: K
authors.lastname: Saihara
authors.forename: Hideki
authors.initials: H
authors.lastname: Okui
authors.forename: Koji
authors.initials: K
authors.lastname: Orihara
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Fukudome
authors.forename: Takuro
authors.initials: T
authors.lastname: Shinsato
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ichiki
authors.forename: Etsuko
authors.initials: E
authors.lastname: Mizoguchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Otsuji
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology*; D003331:Coronary Vessels / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D014664:Vasodilation; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain