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European Journal of Heart Failure 2005 7(1):69-74; doi:10.1016/j.ejheart.2004.04.012
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© 2004 European Society of Cardiology

B-type natriuretic peptide and its precursor in cardiac venous blood from failing hearts

Jens Peter Goetzea,b,*, Jens F. Rehfeldb, Regitze Videbaeka, Lennart Friis-Hansenb and Jens Kastrupa

a Cardiac Catheterization Laboratory Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
b Department of Clinical Biochemistry section 3014, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100, Copenhagen, Denmark

* Corresponding author. Tel.: +45-3545-8323; fax: +45-3545-4640. E-mail address: jpg{at}dadlnet.dk


  Abstract

Background: Plasma concentrations of B-type natriuretic peptide (BNP-32) and its precursor (proBNP) are increased in chronic heart failure. Accordingly, BNP-32 and proBNP are both being implemented as clinical markers.

Aim: To determine the molar relation of BNP-32 and proBNP in different cardiovascular regions.

Methods and results: Blood samples were obtained from different cardiovascular regions during right heart catheterization in heart failure patients, and from normal subjects. Plasma BNP-32 and proBNP concentrations were measured using sequence-specific radioimmunoassays. Patients with severe left ventricular dysfunction (n=21) displayed increased peripheral plasma concentrations of both BNP-32 (four-fold, P=0.0008) and proBNP (seven-fold, P=0.0002) compared with normal subjects. Moreover, the peripheral concentrations were highly correlated with the corresponding concentrations in the coronary sinus (BNP-32: r=0.97, P<0.0001; proBNP: r=0.94, P<0.0001). Despite comparable peripheral concentrations of BNP-32 and proBNP, the BNP-32 concentration was higher than the proBNP concentration in the coronary sinus (median 126 pmol/l (21–993) vs. 103 pmol/l (16–691), P=0.035).

Conclusions: The BNP-32 and proBNP concentrations are closely related in venous cardiac blood. The findings suggest an overall constitutive secretion of processed proBNP, i.e. an N-terminal precursor fragment and BNP-32, in chronic heart failure.

Key Words: B-type natriuretic peptide • Cardiac secretion • Heart failure • Natriuretic peptide • proBNP

Received November 26, 2003; Revised March 3, 2004; Accepted April 26, 2004


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