title: Increased brain natriuretic peptide secretion is a marker of disease progression in nonobstructive hypertrophic cardiomyopathy.
abstract: BACKGROUND
  Hypertrophic cardiomyopathy (HCM) is associated with increased plasma brain natriuretic peptide (BNP), but sequential plasma and myocardial BNP assessment in stable and dilated HCM has never been performed.
  
  
  RESULTS
  Forty consecutive HCM patients (42 +/- 8 years, 25 males) underwent cardiac catheterization, angiography, and left ventricular (LV) endomyocardial biopsy. During follow-up (70.5 +/- 6.7 months), 30 patients (Group 1) remained stable whereas 10 patients (Group 2) progressed to dilated phase. Group 2 patients underwent a second invasive study with LV biopsy. BNP plasma levels were measured at baseline and at follow-up in all patients. All biopsies were processed for histology and immunohistochemistry with anti-BNP antibodies. BNP plasma levels remained unchanged in Group 1, whereas it significantly increased in all Group 2 patients who exhibited an elevation of LV and right ventricular end-diastolic pressure. Immunohistochemistry showed an increase of BNP-positive myocytes in follow-up biopsies when compared with baseline (75.0 +/- 15.0 % versus 29.8 +/- 10.0 %; P = .005) with a significant correlation with LV end-diastolic pressure (r = 0.78, P < .001) and plasma BNP (r = 0.83, P < .001).
  
  
  CONCLUSIONS
  Progression to end-stage of HCM is characterized by further increase of myocardial and plasma BNP. Serial assessment of plasma BNP may provide noninvasive recognition of hemodynamic deterioration, allowing prompt institution of heart failure therapy.
authors.affiliation: Cardiology Department, Catholic University, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pieroni
authors.forename: Fulvio
authors.initials: F
authors.lastname: Bellocci
authors.forename: Tommaso
authors.initials: T
authors.lastname: Sanna
authors.forename: Romina
authors.initials: R
authors.lastname: Verardo
authors.forename: Carolina
authors.initials: C
authors.lastname: Ierardi
authors.forename: Attilio
authors.initials: A
authors.lastname: Maseri
authors.forename: Andrea
authors.initials: A
authors.lastname: Frustaci
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000000981:diagnostic imaging; D018450:Disease Progression; D005260:Female; D006352:Heart Ventricles / Q000737:chemistry; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000737:chemistry; D020097:Natriuretic Peptide, Brain / Q000097:blood / Q000378:metabolism*; D011379:Prognosis; D014463:Ultrasonography
chemical_list: D020097:Natriuretic Peptide, Brain