Direct comparison of transcardiac difference between brain natriuretic peptide (BNP) and N-terminal pro-BNP in patients with chronic heart failure.
BACKGROUND
Direct comparison of transcardiac increase in brain natriuretic peptide (BNP) and NT-pro-BNP has not been performed previously.


OBJECTIVE
To evaluate the relation between BNP and NT-pro-BNP secretion, plasma levels and renal function.


METHODS
We measured the plasma levels of BNP and NT-pro-BNP in the aortic root and coronary sinus in 326 consecutive patients with chronic heart failure (CHF). Patients were divided into two groups [group I: estimated glomerular filtration rate (eGFR)>or=60 mL/min and group II: eGFR<60 mL/min].


RESULTS
The molar level of the transcardiac increase in NT-pro-BNP is lower than that of BNP. There were no differences in haemodynamics or the transcardiac gradient of BNP and NT-pro-BNP between group I and group II. The molar ratio of the plasma NT-pro-BNP to BNP was significantly higher in group II than in group I. By stepwise multivariate analyses, not only the left ventricular (LV) ejection fraction and LV end-diastolic pressure, but also eGFR, LV mass index (LVMI) and haemoglobin were independent predictors of plasma NT-pro-BNP and BNP.


CONCLUSIONS
The molar level of the transcardiac increase in NT-pro-BNP is lower than that of BNP; however, the influence of renal function on plasma NT-pro-BNP is greater than that on BNP.
Tsutamoto
Takayoshi
T
Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu 520-2192, Japan. tutamoto@belle.shiga-med.ac.jp <tutamoto@belle.shiga-med.ac.jp>
Sakai
Hiroshi
H
Ishikawa
Chitose
C
Fujii
Masanori
M
Tanaka
Toshinari
T
Yamamoto
Takashi
T
Takashima
Hiroyuki
H
Ohnishi
Masato
M
Wada
Atsuyuki
A
Horie
Minoru
M
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D006328:Cardiac Catheterization; D002302:Cardiac Output / Q000502:physiology; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain