CLINICAL RESEARCH: HEART FAILURE
Wall stress modulates brain natriuretic peptide production in pressure overload cardiomyopathy
Marc Vanderheyden, MD*,*,
Marc Goethals, MD*,
Sofie Verstreken, MD*,
Bernard De Bruyne, MD*,
Kristin Muller, RN ,
Eddy Van Schuerbeeck, RN* and
Jozef Bartunek, MD*
* Cardiovascular Center, Onze Lieve Vrouw Ziekenhuis, Aalst, Belgium
Cardiovascular Center, Imelda Ziekenhuis, Bonheiden, Belgium
Manuscript received May 11, 2004;
accepted September 13, 2004.
* Reprint requests and correspondence: Dr. Marc Vanderheyden, Cardiovascular Center, Onze Lieve Vrouwziekenhuis, Moorselbaan 164, 9400 Aalst, Belgium (Email: Marc.Vanderheyden{at}olvz-aalst.be).
OBJECTIVES: We postulated that both diastolic and systolic load modulate B-type natriuretic peptide (BNP) production in human pressure overload hypertrophy/failure.
BACKGROUND: In isolated myocytes, diastolic stretch induces BNP messenger ribonucleic acid expression. However, the mechanism of the BNP release in human hypertrophy remains controversial.
METHODS: In 40 patients with symptomatic aortic stenosis (AS), left ventricular (LV) performance and systolic and diastolic wall stress were calculated from combined invasive and echocardiographic data. Plasma BNP was determined by the rapid point-of-care bedside analyzer (Biosite Triage, Biosite Diagnostics Inc., San Diego, California).
RESULTS: A significant relationship was observed between plasma BNP and pulmonary capillary wedge pressure (p < 0.001), fractional shortening (p = 0.001), and aortic valve area (p = 0.006). Furthermore, a significant correlation was noted between BNP and LV mass index (p = 0.005) as well as between BNP and markers of diastolic load such as LV end-diastolic wall stress (p = 0.011), indexed LV end-diastolic volume (p < 0.001), and isovolumic relaxation time (p = 0.02). Preoperative BNP levels were elevated in patients with AS compared with patients without AS. Plasma BNP was higher in AS patients with impaired versus normal preload reserve (297 ± 56 pg/ml vs. 168 ± 44 pg/ml; p = 0.017) and in AS patients with clinical deterioration after valve replacement compared with those without (399 ± 82 pg/ml vs. 124 ± 41 pg/ml; p = 0.011).
CONCLUSIONS: In patients with AS, BNP appears to be regulated not only by systolic but also by diastolic load. This supports the hypothesis that myocardial stretch modulates BNP production in human pressure overload hypertrophy/failure.
|
Abbreviations and Acronyms
| | AS = aortic stenosis | | BNP = B-type natriuretic peptide | | LV = left ventricle/ventricular | | PCWP = pulmonary capillary wedge pressure |
|
This article has been cited by other articles:
|
|
|
|
 
A. Boccanelli, G. F. Mureddu, G. Cacciatore, F. Clemenza, A. Di Lenarda, A. Gavazzi, M. Porcu, R. Latini, D. Lucci, A. P. Maggioni, et al.
Anti-remodelling effect of canrenone in patients with mild chronic heart failure (AREA IN-CHF study): final results
Eur J Heart Fail,
January 1, 2009;
11(1):
68 - 76.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Bartunek, L. Delrue, F. Van Durme, O. Muller, F. Casselman, B. De Wiest, R. Croes, S. Verstreken, M. Goethals, H. de Raedt, et al.
Nonmyocardial Production of ST2 Protein in Human Hypertrophy and Failure Is Related to Diastolic Load
J. Am. Coll. Cardiol.,
December 16, 2008;
52(25):
2166 - 2174.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al.
ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease) Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons
J. Am. Coll. Cardiol.,
December 2, 2008;
52(23):
e143 - e263.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al.
ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease): Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons
Circulation,
December 2, 2008;
118(23):
e714 - e833.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. C H J Michielsen, J. A Bakker, R. R J V. Kimmenade, Y. M Pinto, and M. P V. Dieijen-Visser
The diagnostic value of serum and urinary NT-proBNP for heart failure
Ann Clin Biochem,
July 1, 2008;
45(4):
389 - 394.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R S Gabriel, A J Kerr, V Sharma, I S L Zeng, and R A H Stewart
B-type natriuretic peptide and left ventricular dysfunction on exercise echocardiography in patients with chronic aortic regurgitation
Heart,
July 1, 2008;
94(7):
897 - 902.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Della Corte, G. Salerno, E. Chiosi, D. Iarussi, G. Santarpino, M. Miraglia, S. Naviglio, and M. De Feo
Preoperative, postoperative and 1-year follow-up N-terminal pro-B-type natriuretic peptide levels in severe chronic aortic regurgitation: correlations with echocardiographic findings
Interactive CardioVascular and Thoracic Surgery,
June 1, 2008;
7(3):
419 - 424.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Baumgartner
Neurohormones in valvular heart disease: what can they tell us?
Eur. Heart J.,
February 1, 2008;
29(3):
290 - 292.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Knaapen, T. Germans, P. G. Camici, O. E. Rimoldi, F. J. ten Cate, J. M. ten Berg, P. A. Dijkmans, R. Boellaard, W. G. van Dockum, M. J. W. Gotte, et al.
Determinants of coronary microvascular dysfunction in symptomatic hypertrophic cardiomyopathy
Am J Physiol Heart Circ Physiol,
February 1, 2008;
294(2):
H986 - H993.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Jegger, R. F. da Silva, I. Lartaud, V. Gaillard, X. Jeanrenaud, M. Nasratullah, L. K. von Segesser, J. Atkinson, P. Segers, H. Tevaearai, et al.
Effects of an aging vascular model on healthy and diseased hearts
Am J Physiol Heart Circ Physiol,
September 1, 2007;
293(3):
H1334 - H1343.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Vonk Noordegraaf and N. Westerhof
Right ventricular ejection fraction and NT-proBNP are both indicators of wall stress in pulmonary hypertension
Eur. Respir. J.,
April 1, 2007;
29(4):
622 - 623.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. F. Carroll, W. J. Zenebe, and T. B. Strange
Cardiovascular Function in a Rat Model of Diet-Induced Obesity
Hypertension,
July 1, 2006;
48(1):
65 - 72.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Hirashiki, H. Izawa, F. Somura, K. Obata, T. Kato, T. Nishizawa, A. Yamada, H. Asano, S. Ohshima, A. Noda, et al.
Prognostic Value of Pacing-Induced Mechanical Alternans in Patients With Mild-to-Moderate Idiopathic Dilated Cardiomyopathy in Sinus Rhythm
J. Am. Coll. Cardiol.,
April 4, 2006;
47(7):
1382 - 1389.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Watanabe, J. Shite, H. Takaoka, T. Shinke, Y. Imuro, T. Ozawa, H. Otake, D. Matsumoto, D. Ogasawara, O. L. Paredes, et al.
Myocardial stiffness is an important determinant of the plasma brain natriuretic peptide concentration in patients with both diastolic and systolic heart failure
Eur. Heart J.,
April 1, 2006;
27(7):
832 - 838.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Iwanaga, I. Nishi, S. Furuichi, T. Noguchi, K. Sase, Y. Kihara, Y. Goto, and H. Nonogi
B-Type Natriuretic Peptide Strongly Reflects Diastolic Wall Stress in Patients With Chronic Heart Failure: Comparison Between Systolic and Diastolic Heart Failure
J. Am. Coll. Cardiol.,
February 21, 2006;
47(4):
742 - 748.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Nohria and M. M. Givertz
B-Type Natriuretic Peptide and the Stressed Heart
J. Am. Coll. Cardiol.,
February 21, 2006;
47(4):
749 - 751.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. H. Rahimtoola
The Year in Valvular Heart Disease
J. Am. Coll. Cardiol.,
January 17, 2006;
47(2):
427 - 439.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Mueller, A. Gegenhuber, B. Dieplinger, W. Poelz, and M. Haltmayer
Capability of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP as Indicators of Cardiac Structural Disease in Asymptomatic Patients with Systemic Arterial Hypertension
Clin. Chem.,
December 1, 2005;
51(12):
2245 - 2251.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
