Document Detail

Chronic hypoxemia increases ventricular brain natriuretic peptide precursors in neonatal swine.
MedLine Citation:
PMID:  18222277     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Circulating levels of atrial natriuretic peptide and brain natriuretic peptide (BNP) are elevated in patients with cyanotic congenital heart disease and associated with the severity of ventricular dysfunction. We evaluated the effect of chronic hypoxemia on left ventricle pro-atrial natriuretic peptide and pro-BNP, the cytoplasmic precursors of the plasma hormones. METHODS: Forty newborn piglets were randomized to placement of a pulmonary artery to left atrium shunt to create hypoxemia or sham thoracotomy. Animals were studied at 1 or 2 weeks after the procedure (four groups, n = 10 per group). Arterial oxygen tension and hematocrit were obtained. Left ventricular shortening fraction was measured by echocardiography. Left ventricular tissue was harvested and cytoplasm was extracted. Pro-BNP levels were determined by Western blot analysis. Pro-atrial natriuretic peptide levels were determined using enzyme-linked immunosorbent assay. RESULTS: Significant differences among treatment groups were observed for arterial oxygen tension (p < 0.001) and hematocrit (p < 0.001). Pairwise comparisons indicated lower arterial oxygen tension and higher hematocrit for hypoxemic piglets compared with control piglets at 1 and 2 weeks. Left ventricular shortening fraction was not decreased in the hypoxemic animals at any time (p = 0.638). Left ventricular pro-atrial natriuretic peptide decreased in hypoxemic piglets (p = 0.029), whereas left ventricular pro-BNP increased in hypoxemic piglets at 2 weeks (p = 0.002). CONCLUSIONS: Chronic hypoxemia alone, even in the absence of cardiac dysfunction, is sufficient to increase ventricular levels of pro-BNP. This finding may have implications for the interpretation of BNP levels in the clinical management of patients with cyanotic congenital heart disease.
Azeem R Khan; Mariusz Birbach; Meryl S Cohen; Richard F Ittenbach; Thomas L Spray; Richard J Levy; J William Gaynor
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  85     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-28     Completed Date:  2008-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  618-23     Citation Subset:  AIM; IM    
Division of Cardiothoracic Surgery, Department of Surgery, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19106, USA.
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MeSH Terms
Animals, Newborn
Anoxia / metabolism*
Atrial Natriuretic Factor / analysis,  metabolism*
Biological Markers / metabolism
Chronic Disease
Disease Models, Animal
Enzyme-Linked Immunosorbent Assay
Heart Defects, Congenital / metabolism,  physiopathology*
Natriuretic Peptide, Brain / analysis,  metabolism*
Protein Precursors / analysis,  metabolism*
Random Allocation
Sensitivity and Specificity
Reg. No./Substance:
0/Biological Markers; 0/N-terminal proatrial natriuretic peptide; 0/Protein Precursors; 114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor

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