title: Amino-terminal pro-B-type brain natriuretic peptide: screening for cardiovascular disease in the setting of alcoholism.
abstract: OBJECTIVE
  N-terminal pro-BNP (NtBNP) has attracted attention as a biomarker for heart failure. The aims of our study are (a) to characterize the role of NtBNP as a biological marker in the setting of alcoholism; (b) to describe potential gender differences with respect to NtBNP; (c) to correlate NtBNP with other clinical and haemodynamic variables.
  
  
  METHODS
  We examined 83 alcohol-dependent patients according to International Classification of Disease 10th Revision (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV; 59 males and 24 females, age: 50 ± 10.5 years) referred to the department of psychiatry for alcohol withdrawal therapy. In these patients, we determined NtBNP, markers of alcohol abuse and transthoracic echocardiography to determine systolic left ventricular ejection fraction (EF). These measurements were repeated after alcohol withdrawal.
  
  
  RESULTS
  At Day 1 of alcohol withdrawal, 43 patients (52%; 27 males and 16 females) had elevated NtBNP levels (394.4 ± 438.7 pg/ml) despite normal EF (64.7 ± 6.2%). After withdrawal therapy (16.6 ± 7.8 days), NtBNP decreased significantly (228.6 ± 251.2 pg/ml; P < 0.01), despite unchanged EF (65.0 ± 5.8%; P = ns). This was the case in both males and females (328.9 ± 235.5 to 216.7 ± 194.3 pg/ml; P < 0.05 vs. 492.7 ± 635.7 to 246.6 ± 327.7 pg/ml; P < 0.05). Elevated NtBNP levels were related significantly to the history of arterial hypertension (P < 0.05).
  
  
  CONCLUSIONS
  This study highlights the fact that NtBNP can be elevated in the setting of alcoholism. The elevation in NtBNP is unrelated to EF and is reversible after alcohol withdrawal. We suggest a subclinical detrimental effect of alcohol abuse on cardiac function.
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. peter.hoefer@meduniwien.ac.at
authors.forename: Peter
authors.initials: P
authors.lastname: Höfer
authors.forename: Bonni
authors.initials: B
authors.lastname: Syeda
authors.forename: Jutta
authors.initials: J
authors.lastname: Bergler-Klein
authors.forename: Fabian
authors.initials: F
authors.lastname: Friedrich
authors.forename: Otto Michael
authors.initials: OM
authors.lastname: Lesch
authors.forename: Benjamin
authors.initials: B
authors.lastname: Vyssoki
authors.forename: Thomas
authors.initials: T
authors.lastname: Binder
authors.forename: Henriette
authors.initials: H
authors.lastname: Walter
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology* / Q000378:metabolism / Q000534:rehabilitation; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D002492:Central Nervous System Depressants / Q000009:adverse effects / Q000097:blood / Q000494:pharmacology; D015897:Comorbidity; D004452:Echocardiography; D000431:Ethanol / Q000009:adverse effects / Q000097:blood / Q000494:pharmacology; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood* / Q000502:physiology; D010446:Peptide Fragments / Q000097:blood* / Q000502:physiology; D011569:Psychiatric Status Rating Scales; D013318:Stroke Volume / Q000187:drug effects
chemical_list: D015415:Biomarkers; D002492:Central Nervous System Depressants; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D000431:Ethanol