[Left ventricular dysfunction without brain natriuretic peptide elevation: two case reports].
Brain natriuretic peptide (BNP) is an useful marker for the differential diagnosis of dyspnea and pleural effusion of unknown origin. BNP elevation indicates myocardial overload. Two patients were admitted to our hospital with abnormal electrocardiogram or dyspnea. Left ventricular ejection fractions were below 40% and BNP levels were below 2.0 pg/ml in both patients. The diagnoses were dilated cardiomyopathy (DCM) based on coronary angiography, and pathological examination and suspected secretion insufficiency of BNP. Immunohistochemistry for BNP showed no significant difference in BNP expression in the myocardium between patients with DCM and elevated BNP and the present patients. We recommend that patients with intractable dyspnea undergo echocardiography at least once even if their BNP level is low.
Togane
Yuko
Y
Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Omori Medical Center, Omori-nishi 6-11-1, Ohta-ku, Tokyo 143-8541. ytogane@med.toho-u.ac.jp
Nakano
Hajime
H
Kawase
Tomoharu
T
Yamagishi
Yasumichi
Y
Suzuki
Takeya
T
Kiuchi
Shunsuke
S
Yamashina
Shohei
S
Nanjo
Shuji
S
Yamazaki
Junichi
J
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology
D020097:Natriuretic Peptide, Brain