Document Detail

Adrenomedullin, endothelin, neuropeptide Y, atrial, brain, and C-natriuretic prohormone peptides compared as early heart failure indicators.
MedLine Citation:
PMID:  9463636     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES:The present investigation was designed to determine the best endogenous plasma marker of early congestive heart failure (CHF). METHODS: Forty volunteers with mild CHF (New York Heart Association Class I, n = 12), moderate (Class II, n = 8), or severe (Class III and Class IV, each = n of 5) and 10 age-matched healthy individuals had the simultaneous evaluation of their respective plasma samples by the following radioimmunoassays: atrial natriuretic peptide, ANP; three N-terminal ANP prohormone assays, i.e., proANPs 1-30, 31-67, and 79-98 with the numbers referring to their amino acid (a.a.) sequences in their 126 a.a. prohormone; brain (BNP) and C-natriuretic peptides; N-terminal BNP prohormone; adrenomedullin; neuropeptide Y and endothelin. RESULTS: ProANPs 31-67, 1-30 and 79-98 had 100% (P = 0.01), 83% (P = 0.09) and 50% (P = 0.74) sensitivity in differentiating Class I CHF subjects from healthy subjects. The ANP, BNP, NT-proBNP, CNP, adrenomedullin, neuropeptide Y, and endothelin assays could not differentiate mild CHF subjects from healthy individuals. Logistic regression analysis revealed that only proANP 31-67 significantly (P = 0.0001) discriminated between early CHF (5226 +/- 377 pg/ml) and healthy individuals (1595 +/- 157 pg/ml). The positive and negative predicative values of proANP 31-67 were excellent (100% for each). The peptides measured in these assays were found to be independent markers of CHF with respect to left ventricular ejection fraction. CONCLUSIONS: ProANPs 31-67 is the most sensitive marker in discriminating NYHA Class I CHF subjects from healthy individuals. The ANP, BNP, NT-proBNP, CNP, adrenomedullin, neuropeptide Y and endothelin radioimmunoassays cannot discern mild CHF. These peptides are independent of left ventricular ejection fraction.
S Daggubati; J R Parks; R M Overton; G Cintron; D D Schocken; D L Vesely
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Cardiovascular research     Volume:  36     ISSN:  0008-6363     ISO Abbreviation:  Cardiovasc. Res.     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1998-02-27     Completed Date:  1998-02-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0077427     Medline TA:  Cardiovasc Res     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  246-55     Citation Subset:  IM    
Department of Medicine, James A. Haley Veterans Hospital, Tampa, FL 33612, USA.
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MeSH Terms
Atrial Natriuretic Factor / blood*
Biological Markers / blood
Endothelins / blood
Heart Failure / diagnosis*
Natriuretic Peptide, Brain
Nerve Tissue Proteins / blood
Neuropeptide Y / blood
Peptide Fragments / blood*
Peptides / blood
Predictive Value of Tests
Protein Precursors / blood*
Regression Analysis
Reg. No./Substance:
0/Biological Markers; 0/Endothelins; 0/Nerve Tissue Proteins; 0/Neuropeptide Y; 0/Peptide Fragments; 0/Peptides; 0/Protein Precursors; 0/atrial natriuretic factor prohormone (1-30), human; 0/atrial natriuretic factor prohormone (31-67); 114471-18-0/Natriuretic Peptide, Brain; 148498-78-6/Adrenomedullin; 85637-73-6/Atrial Natriuretic Factor
Erratum In:
Cardiovasc Res 1999 Nov;44(2):452-3

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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