Effect of renal failure on N-terminal Pro-Brain natriuretic peptide in patients admitted to emergency department with acute dyspnea
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Preexisting renal failure diminishes the excretion of N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP), therefore limits the diagnostic value of this peptide for concomitant heart failure. The aim of this study was to evaluate the association between NT-proBNP and the stages of renal dysfunction in a typical population attended to emergency department with acute dyspnea.In this cross-sectional study, all consecutive patients with acute dyspnea underwent clinical evaluation, laboratory assessment of NT-proBNP, and echocardiographic examinations. Among subjects, 54.5% were diagnosed as heart failure. Grouping variables according to renal function capacity and ejection fraction, independent variables were compared with Kruskal-Wallis or ANOVA with posthoc tests. Correlation and linear regression analysis were done to analyze the variables associated with NT-proBNP. The diagnostic performance of NT-proBNP was evaluated by receiver-operating characteristic (ROC) curve.Serum median NT-proBNP level in patients with severe renal impairment was significantly higher than moderate and mildly decreased renal functions (p=0.001). In patients with moderate and severe left ventricular failure, NT-proBNP was significantly higher compared with normal subjects (LVEF>50%) (p=0.040, and 0.017, respectively). Renal dysfunction was associated in 56% of patients with heart failure. The area under the ROC curve of NT-proBNP for identifying left ventricular failure in patients with renal failure (eGFR<90 mL/min/1.73 m2) was 0.649 and reached significant difference (95% CI:0.548-0.749, p=0.005).In addition to NT-proBNP measurement in clinical judgement of heart failure, renal functions have to be taken into consideration to avoid misdiagnosis.Keywords:
Brain natriuretic peptide
Brain natriuretic peptide
Atrial natriuretic peptide
NPR1
NPR2
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Objective To observe the evaluation of effect on left heart function between plasma brain natriuretic peptide(BNP) level and left ventricular ejection fraction(LVEF),analyze the cause of common error.Methods Collect 320 patients of different cardiac function level,They were assigned separately to groups according to BNP and LVEF.Using Biosite company brain natriuretic meal kits and Triage BNP tester for BNP detection.Results In BNP(ng/L) group,BNP level in each group,the differences were statistically significant(P0.05);BNP≥ 100ng/L group and the other group LVEF value,the difference was statistically significant(P0.05).LVEF(%) group,the levels of BNP in all groups,LVEF,LVEDd,the differences were statistically significant(P0.05);where LVEF≥50% in 270 cases,BNP400ng/L in 247 cases(91.5%).Conclusion All kinds of detecting techniques should be comprehensive analysis,Clinical doctors can′t overly dependent on a certain detection.
Brain natriuretic peptide
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To determine age-related concentrations of brain-type natriuretic peptide in preterm infants using bedside Triage brain-type natriuretic peptide test and correlate it to the presence or absence of the patent ductus arteriosus and ventilatory support.Serum brain-type natriuretic peptide levels were measured in infants who were born at <32 weeks' gestation from birth to 2 months of age. Serial echocardiograms were performed, until closure of the patent ductus arteriosus, or until discharge. Brain-type natriuretic peptide levels were correlated to the day of life, gestational age, presence or absence of the patent ductus arteriosus, and the degree of ventilatory support. Nineteen preterm infants (gestational age: 24-31 weeks; birth weight: 645-1670 g) were enrolled prospectively during the first 2 weeks of life. Serum brain-type natriuretic peptide levels (pg/mL) were determined in 177 blood samples, and 87 paired echocardiograms were performed.Significant negative correlation was found between brain-type natriuretic peptide levels and the day of life and remained significant when the patients were stratified by gestational age (< or =28 weeks and >28 weeks). Higher brain-type natriuretic peptide levels correlated with increasing grade of the patent ductus arteriosus. Significant differences in brain-type natriuretic peptide levels were seen with increasing ventilatory support. Comparisons between the size of patent ductus arteriosus and the degree of ventilatory support to brain-type natriuretic peptide levels revealed that the size of the patent ductus arteriosus was the major determinant of both brain-type natriuretic peptide levels and the degree of ventilatory support.Similar to term infants, brain-type natriuretic peptide levels of preterm infants are related to the chronological age and decline during the first month of life. Rapid bedside Triage brain-type natriuretic peptide is a potentially valuable and practical assay in determining the hemodynamic changes in preterm infants.
Ductus arteriosus
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Brain natriuretic peptide
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THE AIM of the study was to assess the brain natriuretic peptide (BNP) plasma concentrations in patients with CAD and to evaluate the relationships between BNP levels and such parameters of the left ventricular (LV) systolic function as ejection fraction (LVEF) and peak LV emptying rates (PER).The study population comprised 69 patients with CAD, aged 30-79 years. All subjects underwent gated equilibrium radionuclide ventriculography at rest. From the data acquired, LVEF and PER were calculated. The plasma BNP concentrations were determined in blood samples taken from patients with CAD and in 18 healthy subjects and the obtained results were compared with those by radionuclide ventriculography. For this purpose patients with CAD were divided into two subgroups: dLVEF (LVEF<50%) and nLVEF (LVEF>50%). Subjects with normal LVEF (nLVEF) were divided into subgroups with PER greater than median value of this parameter and lower than or equal to the median.In patients with CAD both the BNP concentration and its frequency were significantly higher than in controls. In patients with CAD and dLVEF the BNP concentration was significantly higher than in nLVEF cases. Increased BNP concentration was distinctly more frequent in dLVEF group than in nLVEF, but the difference was not significant (p>0.05). In group with nLVEF, the BNP concentration was higher in patients with PER<2.33 (dPER) in comparison to those with PER>2.3 (p>0.05). Not very close, but statistically significant correlation was found between the BNP level on the one hand and the LVEF and PER on the other.Increased plasma BNP in patients with CAD seem to depend not only on the degree of the myocardial contraction, but also on the dynamics of the left ventricular emptying. The reason for the BNP elevation in cases with CAD and reduced LV ejection rate but normal EF needs to be investigated.
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Objective:To investigate brain natriuretic peptide(NT-proBNP) levels value and significance in diagnosis of patients with chronic heart failure.Methods:Took quantitative immunofluorescence assay detect 35 cases chronic heart failure patients(study group 1) and 15 asymptomatic heart failure patients(study group 2) brain natriuretic peptide levels,and compared with 15 healthy adults(control group) .Results:The patients with heart failure,heart failure with healthy asymptomatic patients brain natriuretic peptide levels were(850.5±325.0) ,(434.3±135.7) and(112.3±29.4) ng/L,the difference between the two groups were statistically significant(P0.01);three groups of brain natriuretic peptide levels in 95% confidence interval,respectively were 767.9-925.6,368.0-520.4 and 93.1-119.8 ng/L;when brain natriuretic peptide levels for diagnosis of heart failure circles was 120 ng/L,the diagnostic sensitivity and specificity were 100% and 87.6%;cardiac function grade Ⅰ,Ⅱ grade,Ⅲ and Ⅳ grade level of brain natriuretic peptide levels were(429.8±129.6) ng/L,(638.7±237.5) ,(878.9±320.8) and(1 033.7±545.9) ng/L,there were significant difference between the various levels(P0.01);brain natriuretic peptide levels and cardiac function was positively correlated(r=0.823,P0.01) ,with primary disease not related(P 0.05) .Conclusion:Brain natriuretic peptide level in patients with chronic heart failure diagnosis has important clinical value.
Brain natriuretic peptide
Atrial natriuretic peptide
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Brain natriuretic peptide
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textabstractIn humans, the natriuretic peptide family consists of three different types of
peptides: atrial natriuretic peptide (synonym: atrial natriuretic factor), B-type
natriuretic peptide (synonym: brain natriuretic peptide) and C-natriuretic
peptide.1 Atrial natriuretic peptide (ANP) was the fi rst natriuretic peptide to
be discovered and in humans ANP is predominantly formed in the cardiomyocytes
of the atria.2 B-type natriuretic peptide (BNP) was fi rst discovered in
porcine brain hence its original name brain natriuretic peptide.3 In humans,
the majority of BNP is formed in ventricular cardiomyocytes, and mRNA levels
in brain are negligible. Therefore, brain natriuretic peptide is now recognized
as B-type natriuretic peptide. C-type natriuretic peptide (CNP) is basically a
neuropeptide, found in brain and vascular endothelial cells.
NPR2
NPR1
Brain natriuretic peptide
Atrial natriuretic peptide
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Eighty two heart failure (HF) patients were enrolled in the study, including 52 cases with pulmonary infection (infectious group) and 30 cases without pulmonary infection (noninfectious group). Plasma brain natriuretic peptide (BNP), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured and the correlation of plasma BNP, NT-proBNP and NT-proBNP/BNP with inflammatory markers (WBC count, CRP, PCT) and left ventricular ejection fraction (LVEF) was analyzed.Results show that NT-proBNP/BNP ratio in infectious group was significantly higher than that in noninfectious group (t=10.764, P 0.05); NT-proBNP and BNP levels were not correlated with inflammation markers and LVEF (P>0.05). In noninfectious group, NT-proBNP/BNP was not correlated with inflammation markers and LVEF (P>0.05), NT-proBNP and BNP were positively correlated with CRP and negatively correlated with LVEF (all P 0.05). Multiple linear regression analysis showed that NT-proBNP/BNP ratio had positive correlation with CRP in infectious group. The results reveal that in heart failure patients complicated with pulmonary infection, neither NT-proBNP nor BNP reflects the severity of heart failure or infection; but the NT-proBNP/BNP ratio can indicate the severity of infection independently.
Key words:
Natriuretic peptide, brain; Heart failure
Brain natriuretic peptide
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