BRAIN NATRIURETIC PEPTIDE AS BIOCHEMICAL MARKER FOR STRUCTURAL AND FUNCTIONAL HEART DISORDERS IN ARTERIAL HYPERTENSION
https://doi.org/10.15829/1560-4071-2015-12-56-62
Abstract
Aim. Assessment of structural and functional condition of the left and right heart chambers related to the level of NT-proBNP and clinical signs of CHD in AH patients.
Material and methods. Totally, 137 AH patients studied (45 men, 92 women) with sinus rhythm and EF LV ≥50%. All patients underwent standard investigations, 6-minute walking test, two-dimension EchoCG, transvalvular and tissue Dopplergraphy, treadmill-test, NT-proBNP concentration in plasma. Assessment of structural and functional heart condition was done in three defined groups according to NT-proBNP level (norm, “grey” zone, elevated NT-proBNP).
Results. The level of NT-proBNP is related to the age, sex, therapy intake regularity and does not relate to body mass, BP level, heart rate. The relation revealed for NTproBNP level and diastolic dysfunction of the LV by the data of transmitral and tissue Doppler-graphy. Modified Tei index, obtained during impulse-wave tissue Dopplergraphy, was the most informative marker of LV dysfunction, relevant of NT-proBNP levels. The increase of NT-proBNP followed by significant increase of RV wall thickness. Evaluation of NT-proBNP together with EchoCG led to revelation of asympthomatic LV dysfunction in 13,1% of patients.
Conclusion. Interpretation of NT-proBNP level in hypertensive must complex, taking into consideration clinical factors as risk factors, gender and age. Evaluation of NT-proBNP with echocardiography helps to identify groups of patients of higher cardiovascular risk and to optimize further treatment.
About the Authors
S. V. Ivanova
A.I. Evdokimov Moscow State University of Medicine and Dentistry (MSUMD)
Russian Federation
Moscow
Russian Federation
Moscow
Yu. A. Vasyuk
A.I. Evdokimov Moscow State University of Medicine and Dentistry (MSUMD)
Russian Federation
Moscow
Russian Federation
Moscow
E. Yu. Shupenina
A.I. Evdokimov Moscow State University of Medicine and Dentistry (MSUMD)
Russian Federation
Moscow
Russian Federation
Moscow
P. V. Krikunov
A.I. Evdokimov Moscow State University of Medicine and Dentistry (MSUMD)
Russian Federation
Moscow
Russian Federation
Moscow
I. A. Sadulaeva
A.I. Evdokimov Moscow State University of Medicine and Dentistry (MSUMD)
Russian Federation
Moscow
Russian Federation
Moscow
References
1. Betti I, Castelli G, Barchielli A, et al. The Role of N-terminal PRO-Brain Natriuretic Peptide and Echocardiography for Screening Asymptomatic Left Ventricular Dysfunction in a Population at High Risk for Heart Failure. The PROBE-HF Study. Journal of Cardiac Failure. 2009; 15 (5): 377-83.
2. Bower JK, Lazo M, Matsushita K, et al. N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Risk of Hypertension in the Atherosclerosis Risk in Communities (ARIC) Study. American Journal of Hypertension. 2015; 28(10): 1262-6.
3. Chazova IE, Zhernakova YuV, Oshchepkova EV, et al. Prevalence of risk factors for cardiovascular disease in the Russian population of patients with hypertension. Cardiology 2014; 10: 4-12. Russian (Чазова И.Е., Жернакова Ю.В., Ощепкова Е.В., и др. Распространенность факторов риска сердечно-сосудистых заболеваний в российской популяции больных артериальной гипертонией. Кардиология 2014; 10: 4-12.
4. Diagnosis and treatment of hypertension. RMOAG /GFCF Russian recommendations (fourth revision). J System Hypertension 2010; 3: 5-26. Russian (Диагностика и лечение артериальной гипертензии. РМОАГ/ВНОК Российские рекомендации, (четвертый пересмотр). Системные гипертензии 2010; 3: 5-26).
5. Hu W, Zhou PH, Zhang XB, et al. Plasma concentrations of adrenomedullin and natriuretic peptides in patients with essential hypertension. Exp Ther Med. 2015; 9 (5): 1901-8. Published online 2015 Mar 11.doi 10.3892/etm.2015.2345.
6. Galasko GIW, Lahiri A, Barnes SC, et al. What is the normal range for N-terminal pro-brain natriuretic peptide? How well does this normal range screen for cardiovascular disease? Eur Heart J 2005;26:2269-76.
7. Lee KH, Kim JY, Koh SB, et al. N-Terminal Pro-B-type Natriuretic Peptide Levels in the Korean General Population. Korean Circ J. 2010; 40 (12): 645-50. Published online 2010 Dec 31.doi:10.4070/kcj.2010.40.12.645
8. Asferg CL, Nielsen SJ, Andersen UB, et al. Relative atrial natriuretic peptide deficiency and inadequate renin and angiotensin II suppression in obese hypertensive men. Hypertension. 2013; 62: 147-53. doi:10.1161/Hypertens. 111.00791 PMID: 23670298
9. Fox ER, Musani SK, Bidulescu A, et al. Relation of obesity to circulating B-type natriuretic peptide concentrations in blacks: the Jackson Heart Study. Circulation. 2011; 124: 1021-7. doi: 10.1161/Circulationaha.110.991943 PMID: 21824924 (5).
10. Seven E, Husemoen LLN, Ibsen H, et al. Higher Serum Concentrations of N-Terminal ProBType Natriuretic Peptide Associate with Prevalent Hypertension whereas Lower Associate with Incident Hypertension. PLoS ONE. 2015; 10 (2): e0117864. doi:10.1371/journal.pone.0117864.
11. Macheret F, Heublein D, Costello-Boerrigter LC, et al. Human hypertension is characterized by a lack of activation of the antihypertensive cardiachormones ANP and BNP. J Am Coll Cardiol. 2012; 60: 1558-65. doi: 10.1016/j.jacc.2012.05.049 PMID: 23058313.
12. Jeppesen JL, Nielsen SJ, Torp-Pedersen C, et al. Genetic variation in the natriuretic peptide system, circulating natriuretic peptide levels, and blood pressure: an ambulatory blood pressure study. Am J Hypertens. 2012; 25: 1095-1000. doi: 10.1038/ajh.2012.96 PMID: 22785411.
Review
For citations:
Ivanova S.V., Vasyuk Yu.A., Shupenina E.Yu., Krikunov P.V., Sadulaeva I.A. BRAIN NATRIURETIC PEPTIDE AS BIOCHEMICAL MARKER FOR STRUCTURAL AND FUNCTIONAL HEART DISORDERS IN ARTERIAL HYPERTENSION. Russian Journal of Cardiology. 2015;(12):56-62. (In Russ.) https://doi.org/10.15829/1560-4071-2015-12-56-62
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