© 2007 European Society of Cardiology
Independent effects of both right and left ventricular function on plasma brain natriuretic peptide
a Department of Clinical Physiology, Nuclear Medicine and PET Rigshospitalet, Copenhagen, Denmark
b Cluster of Molecular Imaging, Department of Biomedicine The Panum Institute, University of Copenhagen, Denmark
* Corresponding author. Cluster for Molecular Imaging, Department of Biomedical Sciences, University of Copenhagen, The Panum Institute, Building 12.3, Blegdamsvej 3, DK-2200 Copenhagen. Tel.: +45 35 32 75 33; fax: +45 35 32 75 55. E-mail address: tvogelsang{at}mfi.ku.dk
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Abstract |
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Background: Brain natriuretic peptide (BNP) is increased in heart failure; however, the relative contribution of the right and left ventricles is largely unknown.
Aim: To investigate if right ventricular function has an independent influence on plasma BNP concentration.
Methods: Right (RVEF), left ventricular ejection fraction (LVEF), and left ventricular end-diastolic volume index (LVEDVI) were determined in 105 consecutive patients by first-pass radionuclide ventriculography (FP-RNV) and multiple ECG-gated equilibrium radionuclide ventriculography (ERNV), respectively. BNP was analyzed by immunoassay.
Results: Mean LVEF was 0.51 (range 0.10–0.83) with 36% having a reduced LVEF (<0.50). Mean RVEF was 0.50 (range 0.26–0.78) with 43% having a reduced RVEF (<0.50). The mean LVEDVI was 92 ml/m2 with 22% above the upper normal limit (117 ml/m2). Mean BNP was 239 pg/ml range (0.63–2523). In univariate linear regression analysis LVEF, LVEDVI and RVEF all correlated significantly with log BNP (p<0.0001). In a multivariate analysis only RVEF and LVEF remained significant. The parameter estimates of the final adjusted model indicated that RVEF and LVEF influence on log BNP were of the same magnitude.
Conclusion: BNP, which is a strong prognostic marker in heart failure, independently depends on both left and right ventricular systolic function. This might, at least in part, explain why BNP holds stronger prognostic value than LVEF alone.
Key Words: BNP • Ejection fraction • Heart failure • Right ventricle • Left ventricle
Received August 3, 2006; Revised March 5, 2007; Accepted May 24, 2007
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  P. Leszek and J. Korewicki Independent effects of both right and left ventricular function on plasma brain natriuretic peptide levels Eur J Heart Fail, March 1, 2008; 10(3): 328 - 328. [Full Text] [PDF]
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