Prognostic value of natriuretic peptides in Chagas' disease: a head-to-head comparison of the 3 natriuretic peptides.
To determine the diagnostic and prognostic value of natriuretic peptides in patients with Chagas' disease (CD), the authors first measured atrial (ANP), B-type (BNP), and C-type natriuretic peptide (CNP) and compared their diagnostic and prognostic capacity with that in other dilated cardiomyopathies (DCM). The CD and DCM patients were subdivided according to their New York Heart Association (NYHA) classification. Circulating ANP and more pronounced BNP, but not CNP, were increased in CD and DCM patients in relation to NYHA class. Importantly, ANP and BNP were already significantly elevated in CD patients without systolic ventricular dysfunction. All 3 natriuretic peptides were correlated with echocardiographic parameters in CD patients. While ANP and BNP have high predictive value for mortality and necessity for heart transplant in CD, CNP can not predict them. Thus, ANP and BNP rather than CNP could be used as valuable molecular markers to identify asymptomatic CD patients for early therapy and predict clinical outcomes.
Moreira
Maria da Consolação V
Mda C
Department of Internal Medicine, UFMG, Belo Horizonte, Brazil.
Wang
Yong
Y
Heringer-Walther
Silvia
S
Wessel
Niels
N
Walther
Thomas
T
D000328:Adult; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality; D002598:Chagas Cardiomyopathy / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D020098:Natriuretic Peptide, C-Type / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D013223:Statistics as Topic; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D020098:Natriuretic Peptide, C-Type; D009320:Atrial Natriuretic Factor