Natriuretic peptides as indicators of cardiac remodeling in hypertensive patients
Magnusson M et al. – Findings show that natriuretic peptide levels increased with increasing number of markers of cardiac remodeling. N-terminal pro-atrial natriuretic peptide (Nt-ANP) and brain natriuretic peptide (BNP) are useful to discriminate between pts for cardiac remodeling and may be considered a screening tool to select pts eligible for further examination with echocardiography. Methods- Study of the relationship between 3 different natriuretic peptides and left ventricular mass, function, and diameter and kidney function in hypertensive pts
- Subjects: 139 consecutive pts with moderate hypertension
- Analysis of Nt-BNP, BNP, and N-terminal pro-atrial natriuretic peptide (Nt-ANP)
- Echocardiography to assess cardiac remodeling
- Cystatin C to assess glomerular filtration
- Stratification by extent of cardiac remodeling: 1) no remodeling; 2) 1 of left ventricular hypertrophy, left ventricular dysfunction or left ventricular dilatation; 3) 2 of above and 4) all 3 parameters
Results- All peptides differed significantly between groups with a continuous stepwise increase from groups 1 through 4
- Receiver operating characteristic analysis showed equal diagnostic performances for detection of any cardiac abnormalities for Nt-BNP and BNP; both superior to Nt-ANP
- In multivariable linear regression analysis, all 3 indicators of cardiac remodeling independently correlated with Nt-BNP and BNP
- Only left ventricular diameter independently correlated with Nt-ANP
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