title: Does the C-type natriuretic peptide have prognostic value in chagas disease and other dilated cardiomyopathies?
abstract: Atrial natriuretic peptides (ANP) and brain natriuretic peptides (BNP) are powerful neurohormonal indicators of left-ventricular function and prognosis in heart failure (HF). Chagas disease (CD) caused by the protozoan Trypanosoma cruzi remains a major cause of HF in Latin America. We assessed whether the plasma concentration of the third natriuretic peptide, C-type natriuretic peptide (CNP), also has diagnostic and prognostic properties in patients with CD or other dilated cardiomyopathies (DCM). Blood samples were obtained from 66 patients with CD, 50 patients with DCM from other causes, and 30 gender- and age-matched healthy subjects. Patients were subdivided according to the New York Heart Association (NYHA) class. The CNP concentration was determined by radioimmunoassay (Immundiagnostik, Bensheim, Germany). The main duration of follow-up was 31.4 months (range 13 to 54 months); 19 patients had died and 11 patients received a heart transplant. CNP concentrations were only significantly altered in patients with DCM or CD of the NYHA classes III and IV (P < 0.05). The Pearson correlation of echocardiographic data with CNP revealed an association only with the left-ventricular end systolic volume (P = 0.03) in patients with DCM. Furthermore, CNP did not predict mortality or the necessity for heart transplant. Our data are the first to demonstrate the raised levels of the third natriuretic peptide CNP in CD and other DCM. Whereas ANP and BNP have a high predictive value for mortality in both diseases, CNP is without any predictive potency.
authors.affiliation: Department of Cardiology and Pneumology, CUM, Campus Benjamin Franklin (CBF), Berlin, Germany.
authors.forename: Silvia
authors.initials: S
authors.lastname: Heringer-Walther
authors.forename: Maria da Consolação V
authors.initials: Mda C
authors.lastname: Moreira
authors.forename: Niels
authors.initials: N
authors.lastname: Wessel
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.forename: Tiago Moreira
authors.initials: TM
authors.lastname: Ventura
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Schultheiss
authors.forename: Thomas
authors.initials: T
authors.lastname: Walther
mesh_terms: D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002227:Carbazoles / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D000077261:Carvedilol; D014355:Chagas Disease / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D020098:Natriuretic Peptide, C-Type / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D011412:Propanolamines / Q000627:therapeutic use; D013318:Stroke Volume / Q000187:drug effects; D016019:Survival Analysis; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000503:physiopathology / Q000628:therapy
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D020098:Natriuretic Peptide, C-Type