title: Cardiac tamponade as an independent condition affecting the relationship between the plasma B-type natriuretic peptide levels and cardiac function.
abstract: Plasma B-type natriuretic peptide (BNP) is finely regulated by the cardiac function and several extracardiac factors. Therefore, the relationship between the plasma BNP levels and the severity of heart failure sometimes seems inconsistent. The purpose of the present study was to investigate the plasma BNP levels in patients with cardiac tamponade and their changes after pericardial drainage. This study included 14 patients with cardiac tamponade who underwent pericardiocentesis. The cardiac tamponade was due to malignant diseases in 13 patients and uremia in 1 patient. The plasma BNP levels were measured before and 24-48 h after drainage. Although the patients reported severe symptoms of heart failure, their plasma BNP levels were only 71.2 ± 11.1 pg/ml before drainage. After appropriate drainage, the plasma BNP levels increased to 186.0 ± 22.5 pg/ml, which was significantly higher than that before drainage (P = 0.0002). In patients with cardiac tamponade, the plasma BNP levels were low, probably because of impaired ventricular stretching, and the levels significantly increased in response to the primary condition after drainage. This study demonstrates an additional condition that affects the relationship between the plasma BNP levels and cardiac function. If inconsistency is seen in the relationship between the plasma BNP levels and clinical signs of heart failure, the presence of cardiac tamponade should therefore be considered.
authors.affiliation: Division of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Minai
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Komukai
authors.forename: Satoshi
authors.initials: S
authors.lastname: Arase
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Nagoshi
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Matsuo
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ogawa
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kayama
authors.forename: Keiichi
authors.initials: K
authors.lastname: Inada
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Tanigawa
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Takemoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sekiyama
authors.forename: Taro
authors.initials: T
authors.lastname: Date
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ogawa
authors.forename: Ikuo
authors.initials: I
authors.lastname: Taniguchi
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
mesh_terms: D015415:Biomarkers / Q000097:blood; D002305:Cardiac Tamponade / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D015536:Down-Regulation; D004322:Drainage / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009369:Neoplasms / Q000150:complications; D020519:Pericardiocentesis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014511:Uremia / Q000150:complications
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain