Circulation, Vol 90, 195-203, Copyright © 1994 by American Heart Association
H Yasue, M Yoshimura, H Sumida, K Kikuta, K Kugiyama, M Jougasaki, H Ogawa, K Okumura, M Mukoyama and K Nakao
BACKGROUND: B-type or brain natriuretic peptide (BNP) is a novel
natriuretic peptide secreted from the heart that forms a peptide family
with A-type or atrial natriuretic peptide (ANP), and its plasma level has
been shown to be increased in patients with congestive heart failure. This
study was designed to examine the sources and mechanisms of the secretion
of BNP in comparison with those of ANP in control subjects and in patients
with heart failure. METHODS AND RESULTS: We measured the plasma levels of
BNP as well as ANP in 16 patients with dilated cardiomyopathy (11 men and 5
women; mean age, 59 years) and 18 control subjects (9 men and 9 women; mean
age, 54 years) by sampling blood from the femoral vein, the aortic root,
the anterior interventricular vein (AIV), and the coronary sinus using the
newly developed immunoradiometric assay systems. In the control subjects,
there was no significant difference in the plasma ANP level between the
aortic root and the AIV (24.0 +/- 5.2 pg/mL versus 32.2 +/- 17.0 pg/mL),
but there was a highly significant step-up of the level between the AIV and
the coronary sinus (32.2 +/- 17.0 pg/mL versus 371.4 +/- 111.1 pg/mL, P
< .001). In contrast, there was a significant step-up of the plasma BNP
level between the aortic root and the AIV (8.6 +/- 6.4 pg/mL versus 19.0
+/- 11.5 pg/mL, P < .01) but not between the AIV and the coronary sinus
(19.0 +/- 11.5 pg/mL versus 28.8 +/- 14.0 pg/mL). On the other hand, in
patients with dilated cardiomyopathy, there was a significant step-up in
the plasma ANP level between the aortic root and the AIV (280.6 +/- 183.7
pg/mL versus 612.3 +/- 431.6 pg/mL, P < .01) and between the AIV and the
coronary sinus (612.3 +/- 431.6 pg/mL versus 1229.0 +/- 772.7 pg/mL, P <
.01). There was a significant step- up in the plasma BNP level between the
aortic root and the AIV (268.4 +/- 293.2 pg/mL versus 511.6 +/- 458.1
pg/mL, P < .01) but not between the AIV and the coronary sinus (511.6
+/- 458.1 pg/mL versus 529.7 +/- 455.3 pg/mL) in patients with dilated
cardiomyopathy. The arteriovenous difference at the AIV of the plasma level
of BNP had a significant positive correlation with left ventricular
end-systolic volume index (r = 0.859, P < .001) and a significant
negative correlation with left ventricular ejection fraction (r = -.735, P
< .001). CONCLUSIONS: We conclude that (1) BNP is secreted mainly from
the left ventricle in normal adult humans as well as in patients with left
ventricular dysfunction, whereas ANP is secreted from atria in normal adult
humans and also from the left ventricle in patients with left ventricular
dysfunction; (2) secretion of BNP as well as ANP from the left ventricle
increases in proportion to the severity of the left ventricular
dysfunction, suggesting that the secretions of ANP and BNP from the left
ventricle are regulated mainly by wall tension of the left ventricle; and
(3) the peripheral plasma levels of ANP and BNP reflect the secretion rate
of these hormones from the left ventricle and may be used as a marker of
the degree of left ventricular dysfunction in patients with left
ventricular dysfunction.
ARTICLES
Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure
Division of Cardiology, Kumamoto University School of Medicine, Japan.
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S. Kasama, T. Toyama, H. Kumakura, Y. Takayama, S. Ichikawa, S. Tange, T. Suzuki, and M. Kurabayashi Dobutamine Stress 99mTc-Tetrofosmin Quantitative Gated SPECT Predicts Improvement of Cardiac Function After Carvedilol Treatment in Patients with Dilated Cardiomyopathy J. Nucl. Med., November 1, 2004; 45(11): 1878 - 1884. [Abstract] [Full Text] [PDF]
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L. B. Yap, D. Mukerjee, P. M. Timms, H. Ashrafian, and J. G. Coghlan Natriuretic Peptides, Respiratory Disease, and the Right Heart Chest, October 1, 2004; 126(4): 1330 - 1336. [Abstract] [Full Text] [PDF]
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Z. Golbathy, O. Ucar, A. G. Yuksel, O. Gulel, S. Aydogdu, and V. Ulusoy Plasma brain natriuretic peptide levels in patients with rheumatic heart disease Eur J Heart Fail, October 1, 2004; 6(6): 757 - 760. [Abstract] [Full Text] [PDF]
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S. Suzuki, M. Yoshimura, M. Nakayama, Y. Mizuno, E. Harada, T. Ito, S. Nakamura, K. Abe, M. Yamamuro, T. Sakamoto, et al. Plasma Level of B-Type Natriuretic Peptide as a Prognostic Marker After Acute Myocardial Infarction: A Long-Term Follow-Up Analysis Circulation, September 14, 2004; 110(11): 1387 - 1391. [Abstract] [Full Text] [PDF]
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Y.J. Akashi, H. Musha, K. Nakazawa, and F. Miyake Plasma brain natriuretic peptide in takotsubo cardiomyopathy QJM, September 1, 2004; 97(9): 599 - 607. [Abstract] [Full Text] [PDF]
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R. J. Rodeheffer Measuring plasma B-type natriuretic peptide in heart failure: Good to go in 2004? J. Am. Coll. Cardiol., August 18, 2004; 44(4): 740 - 749. [Abstract] [Full Text] [PDF]
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T. Nishikimi, H. Matsuoka, W.H. W. Tang, R. C. Starling, J. B. Young, G. S. Francis, J. P. Girod, M. J. Lee, and F. Van Lente Plasma Brain Natriuretic Peptide Levels Indicate the Distance From Decompensated Heart Failure * Response Circulation, June 29, 2004; 109(25): e329 - e330. [Full Text] [PDF]
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J. Hokamaki, H. Kawano, M. Yoshimura, H. Soejima, S. Miyamoto, I. Kajiwara, S. Kojima, T. Sakamoto, S. Sugiyama, N. Hirai, et al. Urinary biopyrrins levels are elevated in relation to severity of heart failure J. Am. Coll. Cardiol., May 19, 2004; 43(10): 1880 - 1885. [Abstract] [Full Text] [PDF]
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M. Shimpo, D. A. Morrow, E. O. Weinberg, M. S. Sabatine, S. A. Murphy, E. M. Antman, and R. T. Lee Serum Levels of the Interleukin-1 Receptor Family Member ST2 Predict Mortality and Clinical Outcome in Acute Myocardial Infarction Circulation, May 11, 2004; 109(18): 2186 - 2190. [Abstract] [Full Text] [PDF]
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O. Bazzino, J. J Fuselli, F. Botto, D. Perez de Arenaza, C. Bahit, J. Dadone, and for the PACS group of investigators Relative value of N-terminal probrain natriuretic peptide, TIMI risk score, ACC/AHA prognostic classification and other risk markers in patients with non-ST-elevation acute coronary syndromes Eur. Heart J., May 2, 2004; 25(10): 859 - 866. [Abstract] [Full Text] [PDF]
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M. Vanderheyden, J. Bartunek, and M. Goethals Brain and other natriuretic peptides: molecular aspects Eur J Heart Fail, March 15, 2004; 6(3): 261 - 268. [Abstract] [Full Text] [PDF]
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J. M. Tapanainen, K. S. Lindgren, T. H. Makikallio, O. Vuolteenaho, J. Leppaluoto, and H. V. Huikuri Natriuretic peptides as predictors of non-sudden and sudden cardiac death after acute myocardial infarction in the beta-blocking era J. Am. Coll. Cardiol., March 3, 2004; 43(5): 757 - 763. [Abstract] [Full Text] [PDF]
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P.-Y. Marie, P. M. Mertes, N. Hassan-Sebbag, N. de Talence, K. Djaballah, W. Djaballah, J. Friberg, P. Olivier, G. Karcher, F. Zannad, et al. Exercise release of cardiac natriuretic peptides is markedly enhanced when patients with coronary artery disease are treated medically by beta-blockers J. Am. Coll. Cardiol., February 4, 2004; 43(3): 353 - 359. [Abstract] [Full Text] [PDF]
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H. Yamaguchi, J. Yoshida, K. Yamamoto, Y. Sakata, T. Mano, N. Akehi, M. Hori, Y.-J. Lim, M. Mishima, and T. Masuyama Elevation of plasma brain natriuretic peptide is a hallmark of diastolic heart failure independent of ventricular hypertrophy J. Am. Coll. Cardiol., January 7, 2004; 43(1): 55 - 60. [Abstract] [Full Text] [PDF]
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A. Kjaer, J. Appel, P. Hildebrandt, and C. L. Petersen Basal and exercise-induced neuroendocrine activation in patients with heart failure and in normal subjects Eur J Heart Fail, January 1, 2004; 6(1): 29 - 39. [Abstract] [Full Text] [PDF]
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Y. Ootaki, M. Yamaguchi, N. Yoshimura, S. Oka, M. Yoshida, and T. Hasegawa Secretion of A-type and B-type natriuretic peptides into the bloodstream and pericardial space in children with congenital heart disease J. Thorac. Cardiovasc. Surg., November 1, 2003; 126(5): 1411 - 1416. [Abstract] [Full Text] [PDF]
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R Senior, G Galasko, J V McMurray, and J Mayet Screening for left ventricular dysfunction in the community: role of hand held echocardiography and brain natriuretic peptides Heart, November 1, 2003; 89(90003): iii24 - 28. [Full Text] [PDF]
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M.R Cowie, P Jourdain, A Maisel, U Dahlstrom, F Follath, R Isnard, A Luchner, T McDonagh, J Mair, M Nieminen, et al. Clinical applications of B-type natriuretic peptide (BNP) testing Eur. Heart J., October 1, 2003; 24(19): 1710 - 1718. [Abstract] [Full Text] [PDF]
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R. S. McKelvie, J.-L. Rouleau, M. White, R. Afzal, J. B. Young, A. P. Maggioni, P. Held, and S. Yusuf Comparative impact of enalapril, candesartan or metoprolol alone or in combination on ventricular remodelling in patients with congestive heart failure Eur. Heart J., October 1, 2003; 24(19): 1727 - 1734. [Abstract] [Full Text] [PDF]
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D. Mariano-Goulart, M.-C. Eberle, V. Boudousq, A. Hejazi-Moughari, C. Piot, C. C. de Kerleau, R. Verdier, M.-L. Barge, F. Comte, N. Bressot, et al. Major increase in brain natriuretic peptide indicates right ventricular systolic dysfunction in patients with heart failure Eur J Heart Fail, August 1, 2003; 5(4): 481 - 488. [Abstract] [Full Text] [PDF]
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I Raymond, B A Groenning, P R Hildebrandt, J C Nilsson, M Baumann, J Trawinski, and F Pedersen The influence of age, sex and other variables on the plasma level of N-terminal pro brain natriuretic peptide in a large sample of the general population Heart, July 1, 2003; 89(7): 745 - 751. [Abstract] [Full Text] [PDF]
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T. M. Sutton, R. A. H. Stewart, I. L. Gerber, T. M. West, A. M. Richards, T. G. Yandle, and A. J. Kerr Plasma natriuretic peptide levels increase with symptoms and severity of mitral regurgitation J. Am. Coll. Cardiol., June 18, 2003; 41(12): 2280 - 2287. [Abstract] [Full Text] [PDF]
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J. E. Moller, G. S. Hillis, J. K. Oh, J. B. Seward, G. S. Reeder, R. S. Wright, S. W. Park, K. R. Bailey, and P. A. Pellikka Left Atrial Volume: A Powerful Predictor of Survival After Acute Myocardial Infarction Circulation, May 6, 2003; 107(17): 2207 - 2212. [Abstract] [Full Text] [PDF]
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