OBJECTIVES: This study sought to evaluate the relationship between brain natriuretic peptide (BNP), renal function, and the severity of congestive heart failure (CHF). BACKGROUND: Both BNP and renal function are prognostic predictors in CHF patients. METHODS: We measured the plasma BNP level in the aortic root and coronary sinus in 366 consecutive patients with CHF. Estimated glomerular filtration rate (eGFR) by the Cockcroft-Gault equation was used as an indicator of renal function. RESULTS: By stepwise multivariate analyses, hemodynamic parameters such as left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (LVEDP) but not eGFR were independent predictors of a transcardiac increase (coronary sinus-aortic root) in BNP. Regarding the plasma level of BNP in the aortic root, not only LVEF (p < 0.0001) and LVEDP (p < 0.0001) but also eGFR (p < 0.0001) were independent predictors. Patients were divided into two groups, patients with an eGFR > or =60 ml/min (group 1, n = 229) and patients with an eGFR <60 ml/min (group 2, n = 137). There was no difference in LVEF, LVEDP, or the transcardiac gradient of BNP between the two groups, but the plasma level of BNP in the aortic root was approximately two-fold greater in group 2 than in the group 1. CONCLUSIONS: These findings suggest that decreased clearance from the kidney contributes to the elevated BNP in CHF patients with renal dysfunction, especially in patients with an eGFR <60 ml/min.
OBJECTIVES: This study sought to evaluate the relationship between brain natriuretic peptide (BNP), renal function, and the severity of congestive heart failure (CHF). BACKGROUND: Both BNP and renal function are prognostic predictors in CHFpatients. METHODS: We measured the plasma BNP level in the aortic root and coronary sinus in 366 consecutive patients with CHF. Estimated glomerular filtration rate (eGFR) by the Cockcroft-Gault equation was used as an indicator of renal function. RESULTS: By stepwise multivariate analyses, hemodynamic parameters such as left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (LVEDP) but not eGFR were independent predictors of a transcardiac increase (coronary sinus-aortic root) in BNP. Regarding the plasma level of BNP in the aortic root, not only LVEF (p < 0.0001) and LVEDP (p < 0.0001) but also eGFR (p < 0.0001) were independent predictors. Patients were divided into two groups, patients with an eGFR > or =60 ml/min (group 1, n = 229) and patients with an eGFR <60 ml/min (group 2, n = 137). There was no difference in LVEF, LVEDP, or the transcardiac gradient of BNP between the two groups, but the plasma level of BNP in the aortic root was approximately two-fold greater in group 2 than in the group 1. CONCLUSIONS: These findings suggest that decreased clearance from the kidney contributes to the elevated BNP in CHFpatients with renal dysfunction, especially in patients with an eGFR <60 ml/min.
Authors: Nirav Patel; Mary Cushman; Orlando M Gutiérrez; George Howard; Monika M Safford; Paul Muntner; Raegan W Durant; Sumanth D Prabhu; Garima Arora; Emily B Levitan; Pankaj Arora Journal: JCI Insight Date: 2019-06-04
Authors: Alison Morris; Matthew R Gingo; M Patricia George; Lorrie Lucht; Cathy Kessinger; Vikas Singh; Maria Hillenbrand; Michelle Busch; Deborah McMahon; Karen A Norris; Hunter C Champion; Mark T Gladwin; Yingze Zhang; Chad Steele; Frank C Sciurba Journal: AIDS Date: 2012-03-27 Impact factor: 4.177
Authors: Matthew W Semler; Annis M Marney; Todd W Rice; Hui Nian; Chang Yu; Arthur P Wheeler; Nancy J Brown Journal: Chest Date: 2016-03-23 Impact factor: 9.410
Authors: Matthew R Gingo; Jiayan He; Catherine Wittman; Carl Fuhrman; Joseph K Leader; Cathy Kessinger; Lorrie Lucht; William A Slivka; Yingze Zhang; Deborah K McMahon; Frank C Sciurba; Alison Morris Journal: Eur Respir J Date: 2013-02-21 Impact factor: 16.671
Authors: Marco Budeus; Emanuel Salibassoglu; Anna Maria Schymura; Nico Reinsch; Nils Lehmann; Heinrich Wieneke; Stefan Sack; Raimund Erbel Journal: Indian Pacing Electrophysiol J Date: 2010-03-05