Document Detail

Urinary N-terminal prohormone brain natriuretic peptide excretion in patients with chronic heart failure.
MedLine Citation:
PMID:  19546389     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Urinary excretion is currently regarded as the main mechanism of elimination of N-terminal prohormone brain natriuretic peptide (NT-proBNP). The clinical implications and the value of measurement of urinary NT-proBNP in patients with heart failure are largely unknown. METHODS AND RESULTS: We studied 94 patients (age, 58+/-11 years; 79% men) with chronic heart failure (CHF) and 20 age- and sex-matched healthy control subjects. Glomerular filtration rate and effective renal plasma flow were measured as clearance of (125)I-iothalamate and (131)I-hippuran, respectively. NT-proBNP levels were determined in both plasma and 24-hour urine collections. Mean left ventricular ejection fraction of CHF patients was 0.28+/-0.09. Plasma NT-proBNP levels were higher in CHF patients compared with control subjects (median, 547 versus 41 pg/mL; P<0.001). Urinary NT-proBNP excretion, however, was substantially lower in CHF patients (median, 0.13 versus 2.3 mL/min; P<0.001). Urinary NT-proBNP excretion was independent of estimated glomerular filtration rate. In both CHF patients and control subjects, there was a strong and inverse relation between plasma NT-proBNP concentrations and urinary NT-proBNP excretion (r=-0.72 and r=-0.65 respectively; both P<0.001). Decreased renal plasma flow in CHF was significantly associated with a lower excretion of NT-proBNP (P=0.026). CONCLUSIONS: Urinary NT-proBNP excretion is lower in patients with CHF compared with control subjects and is inversely related to plasma NT-proBNP. Urinary NT-proBNP is associated with renal plasma flow but not with estimated glomerular filtration rate. Elevated levels of plasma NT-proBNP in patients with CHF might be explained not only by myocardial stress but also by a marked decrease in urinary excretion.
Gerard C M Linssen; Kevin Damman; Hans L Hillege; Gerjan Navis; Dirk J van Veldhuisen; Adriaan A Voors
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-06-22
Journal Detail:
Title:  Circulation     Volume:  120     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-07     Completed Date:  2009-07-30     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  35-41     Citation Subset:  AIM; IM    
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
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MeSH Terms
Chronic Disease
Glomerular Filtration Rate
Heart Failure / complications*,  physiopathology,  urine*
Iodine Radioisotopes / diagnostic use
Iothalamic Acid / diagnostic use
Middle Aged
Natriuretic Peptide, Brain / blood,  urine*
Peptide Fragments / blood,  urine*
Renal Circulation
Renal Insufficiency / etiology*,  radionuclide imaging,  urine*
Reg. No./Substance:
0/Iodine Radioisotopes; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 2276-90-6/Iothalamic Acid
Comment In:
Circulation. 2010 Mar 16;121(10):e242; author reply e243   [PMID:  20231541 ]

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

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