Document Detail

Increased brain natriuretic peptide secretion is a marker of disease progression in nonobstructive hypertrophic cardiomyopathy.
MedLine Citation:
PMID:  17602985     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is associated with increased plasma brain natriuretic peptide (BNP), but sequential plasma and myocardial BNP assessment in stable and dilated HCM has never been performed. METHODS AND RESULTS: Forty consecutive HCM patients (42 +/- 8 years, 25 males) underwent cardiac catheterization, angiography, and left ventricular (LV) endomyocardial biopsy. During follow-up (70.5 +/- 6.7 months), 30 patients (Group 1) remained stable whereas 10 patients (Group 2) progressed to dilated phase. Group 2 patients underwent a second invasive study with LV biopsy. BNP plasma levels were measured at baseline and at follow-up in all patients. All biopsies were processed for histology and immunohistochemistry with anti-BNP antibodies. BNP plasma levels remained unchanged in Group 1, whereas it significantly increased in all Group 2 patients who exhibited an elevation of LV and right ventricular end-diastolic pressure. Immunohistochemistry showed an increase of BNP-positive myocytes in follow-up biopsies when compared with baseline (75.0 +/- 15.0 % versus 29.8 +/- 10.0 %; P = .005) with a significant correlation with LV end-diastolic pressure (r = 0.78, P < .001) and plasma BNP (r = 0.83, P < .001). CONCLUSIONS: Progression to end-stage of HCM is characterized by further increase of myocardial and plasma BNP. Serial assessment of plasma BNP may provide noninvasive recognition of hemodynamic deterioration, allowing prompt institution of heart failure therapy.
Maurizio Pieroni; Fulvio Bellocci; Tommaso Sanna; Romina Verardo; Carolina Ierardi; Attilio Maseri; Andrea Frustaci; Filippo Crea
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  13     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-07-02     Completed Date:  2007-07-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  380-8     Citation Subset:  IM    
Cardiology Department, Catholic University, Rome, Italy.
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MeSH Terms
Cardiomyopathy, Dilated / blood*,  ultrasonography
Disease Progression
Heart Ventricles / chemistry
Middle Aged
Myocardium / chemistry
Natriuretic Peptide, Brain / blood,  secretion*
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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