Associates of an Elevated Natriuretic Peptide Level in Stable Heart Failure Patients: Implications for Targeted Management

Overview

Journal ScientificWorldJournal

Publisher Wiley

Specialty Biology

Date 2014 Jan 24

PMID 24453873

Citations 4

Authors

Aftab Jan

Ian Dawkins

Niamh Murphy

Patrick Collier

John Baugh

Mark Ledwidge

Kenneth McDonald

Chris J Watson

Affiliations

Soon will be listed here.

Abstract

Background: Persistently elevated natriuretic peptide (NP) levels in heart failure (HF) patients are associated with impaired prognosis. Recent work suggests that NP-guided therapy can improve outcome, but the mechanisms behind an elevated BNP remain unclear. Among the potential stimuli for NP in clinically stable patients are persistent occult fluid overload, wall stress, inflammation, fibrosis, and ischemia. The purpose of this study was to identify associates of B-type natriuretic peptide (BNP) in a stable HF population.

Methods: In a prospective observational study of 179 stable HF patients, the association between BNP and markers of collagen metabolism, inflammation, and Doppler-echocardiographic parameters including left ventricular ejection fraction (LVEF), left atrial volume index (LAVI), and E/e prime (E/e') was measured.

Results: Univariable associates of elevated BNP were age, LVEF, LAVI, E/e', creatinine, and markers of collagen turnover. In a multiple linear regression model, age, creatinine, and LVEF remained significant associates of BNP. E/e' and markers of collagen turnover had a persistent impact on BNP independent of these covariates.

Conclusion: Multiple variables are associated with persistently elevated BNP levels in stable HF patients. Clarification of the relative importance of NP stimuli may help refine NP-guided therapy, potentially improving outcome for this at-risk population.

Citing Articles

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PMID: 37685918 PMC: 10488150. DOI: 10.3390/ijms241713111.

Biomarker profiling for risk of future heart failure (HFpEF) development.

Watson C, Gallagher J, Wilkinson M, Russell-Hallinan A, Tea I, James S J Transl Med. 2021; 19(1):61.

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Tetranectin, a potential novel diagnostic biomarker of heart failure, is expressed within the myocardium and associates with cardiac fibrosis.

McDonald K, Glezeva N, Collier P, OReilly J, OConnell E, Tea I Sci Rep. 2020; 10(1):7507.

PMID: 32371911 PMC: 7200823. DOI: 10.1038/s41598-020-64558-4.

Natriuretic Peptide-based Screening and Prevention of Heart Failure.

Gallagher J, Watson C, Campbell P, Ledwidge M, McDonald K Card Fail Rev. 2018; 3(2):83-85.

PMID: 29387458 PMC: 5789219. DOI: 10.15420/cfr.2017:20:1.

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