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European Journal of Heart Failure 2007 9(6-7):667-673; doi:10.1016/j.ejheart.2007.01.003
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© 2007 European Society of Cardiology

Direct comparison of transcardiac difference between brain natriuretic peptide (BNP) and N-terminal pro-BNP in patients with chronic heart failure

Takayoshi Tsutamoto*, Hiroshi Sakai, Chitose Ishikawa, Masanori Fujii, Toshinari Tanaka, Takashi Yamamoto, Hiroyuki Takashima, Masato Ohnishi, Atsuyuki Wada and Minoru Horie

Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu 520–2192, Japan

* Corresponding author. Tel: +81 77 548 2213; fax: +81 77 543 5839. E-mail address: tutamoto{at}belle.shiga-med.ac.jp


  Abstract

Background: Direct comparison of transcardiac increase in brain natriuretic peptide (BNP) and NT-pro-BNP has not been performed previously.

Aims: To evaluate the relation between BNP and NT-pro-BNP secretion, plasma levels and renal function.

Methods: We measured the plasma levels of BNP and NT-pro-BNP in the aortic root and coronary sinus in 326 consecutive patients with chronic heart failure (CHF). Patients were divided into two groups [group I: estimated glomerular filtration rate (eGFR)≥60 mL/min and group II: eGFR<60mL/min].

Results: The molar level of the transcardiac increase in NT-pro-BNP is lower than that of BNP. There were no differences in haemodynamics or the transcardiac gradient of BNP and NT-pro-BNP between group I and group II. The molar ratio of the plasma NT-pro-BNP to BNP was significantly higher in group II than in group I. By stepwise multivariate analyses, not only the left ventricular (LV) ejection fraction and LV end-diastolic pressure, but also eGFR, LV mass index (LVMI) and haemoglobin were independent predictors of plasma NT-pro-BNP and BNP.

Conclusion: The molar level of the transcardiac increase in NT-pro-BNP is lower than that of BNP; however, the influence of renal function on plasma NT-pro-BNP is greater than that on BNP.

Key Words: Brain natriuretic peptide • N-terminal pro brain natriuretic peptide • Haemodynamic parameters • Renal failure • Glomerular filtration rate • Chronic heart failure

Received August 7, 2006; Revised November 1, 2006; Accepted January 10, 2007


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 Eur J Heart FailHome page
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