Brain natriuretic peptide (BNP) level is closely related to the extent of left ventricular sympathetic overactivity in chronic ischemic heart failure.
OBJECTIVE
Both brain natriuretic peptide (BNP) and cardiac sympathetic activity are useful surrogate markers of congestive heart failure. BNP is known to be secreted in response to sympathetic tone. This study examined the relationship between the cardiac sympathetic system and BNP.


METHODS
Sixty patients with chronic ischemic heart failure (mean age,72 years-old; 46 males and 14 females) who had undergone cardiac catheterization and were classified as NYHA II underwent resting (99m)Tc-sestamibi quantitative gated imaging (MIBI) and (123)I-metaiodobenzylguanidine imaging (MIBG). MIBI was used to obtain left ventricular (LV) dimension. MIBG was used to obtain the washout rate and the H/M ratios as well as the extent of LV washout rate abnormality (RSNA), which was defined as the number of regions with a regional washout rate of more than mean+2SD of 15 normal subjects on a two-dimensional polar map divided into 20 regions. Blood samples were obtained to measure neurohormones such as BNP, renin activity, noradrenaline, and angiotensin II.


RESULTS
Simple linear regression analysis showed that BNP had significant correlations to age, LVEF, LV end diastolic volume, LV end systolic volume, RSNA, global washout rate, myocardial ischemia, and LV end diastolic pressure. Among them, multiple linear regression analysis showed that only RSNA (partial regression coefficient =0.618, p<0.002) had a significant positive correlation with BNP.


CONCLUSIONS
This study suggested that the extent of cardiac sympathetic overactivity in the LV could enhance BNP release.
Sakata
Kazuyuki
K
Division of Cardiology, Shizuoka Cancer Center Hospital, Shizuoka. k.sakata@scchr.jp
Iida
Kei
K
Mochiduki
Nao
N
Nakaya
Yoshihiro
Y
D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods; D002851:Chromatography, High Pressure Liquid; D018450:Disease Progression; D004562:Electrocardiography; D004837:Epinephrine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000294:innervation* / Q000503:physiopathology; D006801:Humans; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009638:Norepinephrine / Q000097:blood; D011863:Radioimmunoassay; D012083:Renin / Q000097:blood; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D013564:Sympathetic Nervous System / Q000378:metabolism / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000150:complications / Q000503:physiopathology*
D020097:Natriuretic Peptide, Brain; D012083:Renin; D009638:Norepinephrine; D004837:Epinephrine