Brain natriuretic peptide and other cardiac markers predicting left ventricular remodeling and function two years after myocardial infarction.
BACKGROUND
Left ventricular remodeling is a complex pathologic process of progressive left ventricular dilatation, leading to dysfunction and heart failure in patients after myocardial infarction.


OBJECTIVE
To evaluate biochemical markers, reflecting cardiac remodeling process after first myocardial infarction and compare those markers with clinical characteristics of left ventricular remodeling.


METHODS
Brain natriuretic peptide, troponin I, creatine kinase, creatine kinase MB mass, lactate dehydrogenase levels were measured in 30 patients with acute myocardial infarction on days 1, 2, 3-7 . Brain natriuretic peptide was measured at 3 months, 6 months, and 2 years after myocardial infarction. Echocardiographic parameters of left ventricular remodeling were determined in acute phase (day 1-3), at 3 months, 6 months, and 2 years after MI.


RESULTS
In acute phase, brain natriuretic peptide level progressively increased according to worsening of left ventricular geometry: in normal left ventricle geometry group, brain natriuretic peptide level was 84.1 (58.7-121) pg/mL, in concentric remodeling group - 125 (69.2-165) pg/mL, in concentric hypertrophy group - 128 (74-368) pg/mL, and in eccentric hypertrophy group - 470 (459-494) pg/mL, P=0.02. Patients who had increased left ventricular end diastolic diameter index during 2-year period had higher brain natriuretic peptide level in the acute phase (584 (249-865) pg/mL vs. 120 (67-202) pg/mL, P=0.04) and also higher peak lactate dehydrogenase and troponin I levels.


CONCLUSIONS
Brain natriuretic peptide level in acute phase of myocardial infarction is strongly associated with the markers of myocardial injury and related to left ventricular geometry changes and remodeling. Brain natriuretic peptide together with troponin I levels in acute phase of myocardial infarction might be useful in predicting subsequent cardiac function.
Grybauskiene
Regina
R
Institute of Cardiology, Kaunas University of Medicine, Sukileliu 17, 50161 Kaunas, Lithuania. reggryb@med.kmu.lt
Karciauskaite
Dovile
D
Brazdzionyte
Julija
J
Janenaite
Jūrate
J
Bertasiene
Zita
Z
Grybauskas
Pranas
P
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers; D003627:Data Interpretation, Statistical; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D013997:Time Factors; D019210:Troponin I / Q000097:blood; D020257:Ventricular Remodeling
D015415:Biomarkers; D019210:Troponin I; D020097:Natriuretic Peptide, Brain