Title: Utility of B-Natriuretic Peptide in Detecting Diastolic Dysfunction: Comparison With Doppler Velocity Recordings
Abstract: HomeCirculationVol. 106, No. 15Utility of B-Natriuretic Peptide in Detecting Diastolic Dysfunction: Comparison With Doppler Velocity Recordings Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBUtility of B-Natriuretic Peptide in Detecting Diastolic Dysfunction: Comparison With Doppler Velocity Recordings Pierre Ambrosi, MD, Christiane Oddoze, PhD and Gilbert Habib, MD Pierre AmbrosiPierre Ambrosi Department of Cardiology and the Department of Biochemistry, Université de la Méditerranée, Marseille, France , Christiane OddozeChristiane Oddoze Department of Cardiology and the Department of Biochemistry, Université de la Méditerranée, Marseille, France and Gilbert HabibGilbert Habib Department of Cardiology and the Department of Biochemistry, Université de la Méditerranée, Marseille, France Originally published8 Oct 2002https://doi.org/10.1161/01.CIR.0000033850.92934.3ECirculation. 2002;106:e70To the Editor:Lubien et al1 found that, in the absence of left ventricular (LV) systolic dysfunction, plasma B-natriuretic peptide (BNP) levels were significantly higher in patients with LV diastolic dysfunction as assessed with echocardiography than in subjects without LV diastolic dysfunction. In the subgroup of patients with impaired relaxation, BNP levels were markedly higher than in controls (202 versus 33 pg/mL).1 This result is surprising because BNP is secreted from the ventricles mainly in response to pressure overload and ventricular filling pressures are usually normal in these patients.2 There are at least 3 explanations for this finding. First, patients with impaired relaxation may have abnormally high loading pressures during stress, resulting in an elevation of resting BNP levels. BNP half-life is short, however, about 20 minutes, making this hypothesis unlikely. Another explanation is that LV hypertrophy in the absence of ventricular pressure overload could result in marked plasma BNP elevation. We lack studies to assess the relevance of this explanation.3 The third explanation is that the control group in the study by Lubien et al1 is inadequate. Mean age of the control group was 60 years versus 71 years in the diastolic dysfunction group. BNP plasma levels increase with age and could be very high in patients with renal failure.4 The authors did not give any information about creatinine clearance in the 2 groups. Thus, we think that the data of Lubien et al1 do not support unequivocally the assertion that plasma BNP is a good tool for the diagnosis of any category of LV diastolic dysfunction. References 1 Lubien E, DeMaria A, Krishnaswamy P, et al. Utility of B-Natriuretic peptide in detecting diastolic dysfunction: comparison with Doppler velocity recordings. Circulation. 2002; 105: 595–601.CrossrefMedlineGoogle Scholar2 Hurrel DG, Nishimura RA, Ilstrup DM, et al. Utility of preload alteration in assessment of left ventricular filling pressure by Doppler echocardiography: a simultaneous catheterization and Doppler echocardiographic study. J Am Coll Cardiol. 1997; 30: 459–467.CrossrefMedlineGoogle Scholar3 Yamamoto K, Burnett JC, Jougasaki M, et al. Superiority of brain natriuretic peptide as a hormonal marker of ventricular systolic and diastolic dysfunction and ventricular hypertrophy. Hypertension. 1996; 28: 988–994.CrossrefMedlineGoogle Scholar4 Boomans F, van den Meiracker AH. Plasma A- and B-natriuretic peptides: physiology, methodology and clinical use. Cardiovasc Res. 2001; 51: 442–449.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited By Zhou K, Zhou Y, Zhao Y, Tan C, Yuan Z, Li J, Liao X, Gu L and Zhou X (2016) The Relationship between Galectin-3 and Different Patterns of Ventricular Geometry Remodelling in Aortic Valve Stenosis, Heart, Lung and Circulation, 10.1016/j.hlc.2015.08.021, 25:4, (371-377), Online publication date: 1-Apr-2016. Krzesiński P, Gielerak G, Stańczyk A, Piotrowicz K, Piechota W and Skrobowski A (2014) Association of N-terminal pro-brain natriuretic peptide and hemodynamic parameters measured by impedance cardiography in patients with essential hypertension, Clinical and Experimental Hypertension, 10.3109/10641963.2014.913611, 37:2, (148-154), Online publication date: 17-Feb-2015. ElGuindy A and Yacoub M (2012) Heart failure with preserved ejection fraction, Global Cardiology Science and Practice, 10.5339/gcsp.2012.10, 2012:1, (10), Online publication date: 1-Jul-2012. Jug B, Šebeštjen M, Šabovič M, Pohar M and Keber I (2009) Atrial fibrillation is an independent determinant of increased NT-proBNP levels in outpatients with signs and symptoms of heart failureVorhofflimmern ist eine unabhängige Determinante erhöhter NT-proBNP Werte bei Patienten mit Herzinsuffizienz, Wiener klinische Wochenschrift, 10.1007/s00508-009-1269-5, 121:21-22, (700-706), Online publication date: 1-Nov-2009. Lee J, Choi S, Huh W, Park S, Kim D, Oh H and Kim Y (2009) N-terminal Pro-Brain Natriuretic Peptide Levels Predict Left Ventricular Systolic Function in Patients with Chronic Kidney Disease, Journal of Korean Medical Science, 10.3346/jkms.2009.24.S1.S63, 24:Suppl 1, (S63), . Ambrosi P, Oddoze C, Riberi A, Vailloud J, Aviérinos J, Bouvenot G, Portugal H, Métras D and Habib G (2003) Aminoterminal pro-brain natriuretic peptide and ventricular filling pressures in heart transplant recipients, The Journal of Heart and Lung Transplantation, 10.1016/S1053-2498(02)01158-0, 22:7, (822-825), Online publication date: 1-Jul-2003. Huang L, Huang L, Yu J, Wu X and Zhao J (2020) An association between N‑terminal pro‑brain natriuretic protein level and risk of left ventricular hypertrophy in patients without heart failure, Experimental and Therapeutic Medicine, 10.3892/etm.2020.8598 October 8, 2002Vol 106, Issue 15 Advertisement Article InformationMetrics https://doi.org/10.1161/01.CIR.0000033850.92934.3EPMID: 12370236 Originally publishedOctober 8, 2002 PDF download Advertisement