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B-Type Natriuretic Peptide Predicts Clinical Presentations and Ventricular Overloading in Patients with Heart Failure

Authors
 Bo Young Joung  ;  Byung Eun Park  ;  Hyuck Moon Kwon  ;  Jeong Ho Kim  ;  Hyun Seung Kim  ;  Young Won Yoon  ;  Sang Hak Lee  ;  Yun Hyeong Cho  ;  Dong Yeon Kim  ;  Bum Kee Hong  ;  Dong Soo Kim 
Citation
 YONSEI MEDICAL JOURNAL, Vol.44(4) : 623-634, 2003 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2003
MeSH
Adult ; Aged ; Atrial Natriuretic Factor/blood* ; Echocardiography ; Female ; Heart Failure/blood* ; Heart Failure/complications* ; Heart Failure/diagnostic imaging ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; Prognosis ; Ventricular Dysfunction/etiology*
Keywords
B type natriuretic peptide ; congestive heart failure ; myocardial wall stress
Abstract
Brain natriuretic peptide (BNP), a neurohormone secreted from the ventricular myocardium in response to hemodynamic load/wall stress, in congestive heart failure (CHF). This study was performed to evaluate the correlation between BNP level and clinical presentations and hemodynamic parameters obtained by echo-Doppler (echo-Doppler) analysis, and its relation with disease severity and ventricular load/wall stress. CHF patients (n=246) were subgrouped by clinical presentations and echo-Doppler findings into 4 groups: diastolic HF only, chronic HF, acute HF, and chronic HF with acute exacerbation. A BNP level of 81.2 pg/ml showed a sensitivity/specificity of 53.3%/98.4% for detecting CHF (AUC, 0.882; p < 0.0001), and was found to be closely related with the NYHA classification (p < 0.0001). Log BNP was related with LVEF (r2=0.3015, p < 0.0001) and the Meridional wall stress index (r2=0.4052, p < 0.0001). The difference between the BNP levels of the subgroups and BNP control was significant (p < 0.0001), exept between the HF group and the controls; control (n=114, 20.9 ± 31.4pg/ml), only diastolic HF (n=84, 89.8 ± 117.6pg/ml), chronic HF (n=60, 208.2 ± 210.2pg/ml), acute HF (n=28, 477.9 ± 498.4 pg/ml), chronic HF with acute exacerbation (n= 74, 754.1 ± 419.2pg/ml). The BNP level was significantly higher in the only diastolic HF group than in the asymptomatic control group with diastolic dysfunction (89.8 ± 12.8 vs. 22.8 ± 5.1pg/ml, p < 0.0001). BNP may be a good indicator for the differential diagnosis of a broad spectrum of heart failures. And, elevated BNP might help to diagnose diastolic HF in patients with diastolic dysfunction.
Files in This Item:
T200304052.pdf Download
DOI
10.3349/ymj.2003.44.4.623
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Hyuck Moon(권혁문) ORCID logo https://orcid.org/0000-0001-9901-5015
Kim, Jeong Ho(김정호) ORCID logo https://orcid.org/0000-0003-2479-0548
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Hong, Bum Kee(홍범기) ORCID logo https://orcid.org/0000-0002-6456-0184
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/113743
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